Nausea and Vomiting in 2021: A Comprehensive Update

J Clin Gastroenterol. 2021 Apr 1;55(4):279-299. doi: 10.1097/MCG.0000000000001485.

Abstract

Goal: A comprehensive review of treatments for nausea and vomiting (N/V).

Background: N/V are common symptoms encountered in medicine. While most cases of acute N/V related to a specific cause can be straightforward to manage, other cases of acute N/V such as chemotherapy-induced N/V and especially chronic unexplained N/V can be difficult to control, leading to a significant decline in the patient's quality of life and increased cost of medical care from repeated hospitalizations.

Study: Traditional management has relied on pharmacotherapy which may be inadequate in a certain proportion of these patients. Many of the medications used in the management of N/V have significant side effect profiles making the need for new and improved interventions of great importance.

Results: This review covers a broad review of the pathophysiology of N/V, pharmacotherapy, including safety concerns and controversies with established pharmaceuticals, newer immunotherapies, bioelectrical neuromodulation (including gastric electrical stimulation), behavioral and surgical therapies, and complementary medicine.

Conclusion: On the basis of emerging understandings of the pathophysiology of N/V, improved therapies are becoming available.

Publication types

  • Review

MeSH terms

  • Antiemetics* / therapeutic use
  • Antineoplastic Agents*
  • Humans
  • Nausea / chemically induced
  • Nausea / therapy
  • Quality of Life
  • Vomiting / chemically induced
  • Vomiting / therapy

Substances

  • Antiemetics
  • Antineoplastic Agents