Clinical Pearls
Treating Intractable Nausea and Vomiting
Kyle Neale, DO
Nausea and vomiting are endemic among patients seen by palliative care specialists (PCSs).1 The etiology of nausea and vomiting typically is multifactorial, with components of gastric stasis, adverse medication effects, chemical and metabolic derangements, and neurologic and vestibular disorders. Emesis is a primitive brainstem response to rid the gastrointestinal tract of noxious stimuli; nausea is more recalcitrant and more disabling.2 The presence of nausea tends to exist in clusters with other symptoms, including pain, mood disorders, and fatigue, and results in poorer quality of life.3,4