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Pathophysiology of Vomiting

Pathophysiology of Vomiting

Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through interaction...

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates these...

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

Chemotherapy-Induced Nausea and Vomiting: 5-HT₃ Receptor Antagonists

5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...

Bulimia Nervosa

Bulimia Nervosa

Bulimia nervosa is a complex and severe eating disorder characterized by a cyclical pattern of binge-and-purge eating pattern. It generally involves an episode of binge eating, followed by compensatory behaviors such as vomiting, excessive exercise, laxative use, or fasting, to prevent weight gain. Despite often maintaining a normal weight, individuals with bulimia are intensely preoccupied with their body image and harbor an overwhelming fear of gaining weight. This can contribute to the...

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...

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Updated: Jul 7, 2026

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

Published on: June 21, 2024

Cyclic nausea and vomiting in childhood.

David Forbes¹, Susan Fairbrother

¹School of Paediatrics & Child Health, University of Western Australia. dforbes@meddent.uwa.edu.au

Australian Family Physician

|February 2, 2008

Summary

Cyclic vomiting syndrome (CVS) is a common functional gastrointestinal disorder in children, characterized by severe nausea and vomiting episodes. Early recognition and tailored management are crucial for improving outcomes.

Area of Science:

Pediatric Gastroenterology
Functional Gastrointestinal Disorders

Background:

Cyclic vomiting syndrome (CVS) is an under-recognized functional gastrointestinal disorder in childhood.
It is relatively common and can be disabling, despite frequent misdiagnosis by healthcare providers.

Purpose of the Study:

To describe the clinical features of CVS in children.
To outline the differential diagnosis, treatment strategies, and expected outcomes for pediatric CVS.

Main Methods:

This article is a descriptive review of Cyclic Vomiting Syndrome.
Information is synthesized from existing literature on clinical features, diagnosis, and management.

Main Results:

CVS affects approximately 2% of children, presenting as recurrent, severe vomiting episodes with symptom-free intervals.

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Associated conditions include migraine, genetic factors, autonomic dysregulation, and anxiety. Triggers can be stress, infection, or food.

Conclusions:

Diagnosis of CVS requires excluding other causes of vomiting.
Management involves preventing attacks, terminating vomiting, sedation, and preventing complications.
Children may improve, develop migraines, or experience ongoing symptoms into adulthood.