Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice

BO Nguyen_Nausea_Vomiting

Pdf Summary

The document is a detailed presentation by Dr. Linda Nguyen on a case-based approach to diagnosing and treating nausea and vomiting, particularly chronic cases. Delivered on May 3, 2025, it includes an examination of normal upper gastrointestinal (GI) physiology and pathophysiology, outlines the differential diagnoses for chronic nausea and vomiting, and furnishes a framework for diagnostic testing and treatment. Dr. Nguyen emphasizes that medical history and physical examination should guide the diagnostic process, supplemented by targeted physiological testing.<br /><br />The presentation outlines two patient cases: <br /><br />1. Patient 1, a 24-year-old male with postprandial nausea, abdominal pain, and bloating. His case leads to a diagnosis of functional dyspepsia and chronic idiopathic constipation, partially managed with medication and lifestyle modifications. The possibility of cannabinoid hyperemesis is explored.<br /><br />2. Patient 2, a 27-year-old woman with symptoms including postprandial nausea, abdominal pain, and bloating. Her condition is evaluated in the context of existing comorbidities like POTS and fibromyalgia, leading to targeted treatments using Prucalopride and Cyproheptadine.<br /><br />Throughout the presentation, Dr. Nguyen discusses various causes of nausea and vomiting, both gastrointestinal and otherwise, like migraine, anxiety, and medication-induced symptoms. A comprehensive list of anti-nausea pharmacological treatments is provided, ranging from H1 antagonists to cannabinoid agonists, tailored towards specific patient symptoms. <br /><br />The presentation also highlights advanced diagnostic and therapeutic approaches, including the use of gastric emptying scintigraphy, gastric electrical stimulation, and G-POEM for refractory cases of gastroparesis. Emphasis is placed on the benefits of understanding the specific pathophysiological mechanisms at play to guide effective treatment choices, underscoring the complexity and individualized nature required in managing chronic nausea and vomiting cases.

Keywords

chronic nausea

vomiting treatment

gastrointestinal physiology

differential diagnoses

functional dyspepsia

cannabinoid hyperemesis

gastroparesis

gastric emptying scintigraphy

Prucalopride

pathophysiological mechanisms