The diagnosis and management of nausea and vomiting: a review

Nausea and vomiting can result from a wide variety of organic and psychogenic disorders. In evaluating these symptoms, a thorough history with careful attention to their duration and relation to meals, as well as to concomitant drug use and underlying chronic medical problems, often will point to the correct diagnosis. A wide variety of diagnostic modalities exist, including radiographic studies, endoscopy, radionuclide methods of assessing gastrointestinal motility, and imaging studies of the central nervous system. These techniques must be used wisely and are not all required to elucidate the etiology in every patient. Treatment can be symptomatic but is directed at the underlying pathological process whenever possible. Recently developed gastrointestinal "prokinetic" agents have helped to improve the course of patients with identifiable motility disorders.