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Intractable vomiting in diabetic patients.

Larissa Avilés-Santa1, Timothy K Wolff, Philip Raskin

  • 1Department of Internal Medicine, Division of Clinical Diabetes, University of Texas Southwestern Medical Center, Dallas, TX 75390-8858, USA.

Journal of Diabetes and Its Complications
|May 10, 2003
PubMed
Summary

Psychogenic vomiting, often linked to abuse and depression, can cause intractable nausea and vomiting, especially in those with chronic illnesses like Type 1 diabetes. Identifying and removing psychological triggers significantly improves these debilitating gastrointestinal symptoms.

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Area of Science:

  • Gastroenterology
  • Psychiatry
  • Endocrinology

Background:

  • Intractable nausea and vomiting (INV) can occur without identifiable physical causes.
  • These symptoms are sometimes associated with somatoform disorders, emotional abuse, and personality disorders.

Observation:

  • This study examined five patients with long-standing Type 1 diabetes experiencing INV.
  • The course of their illness was significantly influenced by personality disorders, depression, and emotional abuse.

Findings:

  • Psychogenic vomiting should be considered in the differential diagnosis of INV, particularly in patients with chronic conditions.
  • In most cases, symptoms improved markedly after identifying and removing psychological triggers.

Implications:

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  • Psychogenic vomiting is a crucial consideration for unexplained intractable nausea and vomiting.
  • A thorough evaluation for physical causes is essential, but a lack of symptom relief with medical treatment suggests psychological factors may be primary.
  • Addressing psychological distress and abuse can lead to significant improvement in gastrointestinal symptoms for patients with chronic illnesses.