Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice | May 2025-CASE-BASED APPROACH TO NAUSEA AND VOMITING

Video Transcription

Video Summary

The session on K-Spaces focuses on a systematic approach to diagnosing and treating unexplained nausea and vomiting. The discussion begins with a review of normal and pathological physiology to guide therapy choices, emphasizing the importance of history and physical exams alongside targeted physiological testing. Various diagnoses, including functional dyspepsia and the impact of normal and delayed gastric emptying, are explored. The session highlights the significance of a comprehensive diagnostic framework and physiological understanding to facilitate appropriate treatment, especially given the limited therapeutic options approved for gastrointestinal nausea and vomiting.<br /><br />A case study of a 24-year-old patient with chronic nausea and vomiting illustrates the diagnostic process, revealing a diagnosis of functional dyspepsia with chronic constipation. Treatment with amitriptyline and polyethylene glycol offers partial symptom relief. The effects of environmentally and behaviorally induced nausea, like cannabinoid hyperemesis syndrome resulting from cannabis use, are discussed to underline the multifactorial etiology of nausea.<br /><br />Various therapeutic agents are introduced, highlighting their mechanisms: D2 antagonists for nausea, vomiting, and bloating, and newer treatments like procalipride, which demonstrate benefits across several gastrointestinal symptoms. Additionally, non-chemical therapies like capsaicin patches for some etiologies, such as cannabinoid hyperemesis syndrome, are considered.<br /><br />The session also covers diagnostic and treatment approaches for related syndromes, including postural orthostatic tachycardia syndrome (POTS), and how physiological testing guides therapy when patients exhibit refractory symptoms or complex conditions like gastroparesis.<br /><br />Ultimately, the goal is to tailor treatment through understanding disorders' underlying pathophysiology, thereby improving management efficacy when standard therapies may fall short.

Keywords

K-Spaces

nausea

vomiting

functional dyspepsia

gastric emptying

cannabinoid hyperemesis syndrome

D2 antagonists

procalipride

gastroparesis

postural orthostatic tachycardia syndrome