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Nausea and vomiting

MedGen UID:
45015
Concept ID:
C0027498
Sign or Symptom
Synonyms: N&V - Nausea and vomiting; N+V - Nausea and vomiting; Nausea and Vomiting; Vomiting and Nausea
SNOMED CT: N&V - Nausea and vomiting (16932000); N+V - Nausea and vomiting (16932000); Nausea and vomiting (16932000)
 
HPO: HP:0002017

Definition

Nausea is a commonly encountered symptom that has been defined as an unpleasant painless subjective feeling that one will imminently vomit. Vomiting has been defined as the forceful expulsion of the contents of the stomach, duodenum, or jejunum through the oral cavity. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea. [from HPO]

Conditions with this feature

Spinocerebellar ataxia type 6
MedGen UID:
148458
Concept ID:
C0752124
Disease or Syndrome
Spinocerebellar ataxia type 6 (SCA6) is characterized by adult-onset, slowly progressive cerebellar ataxia, dysarthria, and nystagmus. The age of onset ranges from 19 to 73 years; mean age of onset is between 43 and 52 years. Initial symptoms are gait unsteadiness, stumbling, and imbalance (in ~90%) and dysarthria (in ~10%). Eventually all persons have gait ataxia, upper-limb incoordination, intention tremor, and dysarthria. Dysphagia and choking are common. Visual disturbances may result from diplopia, difficulty fixating on moving objects, horizontal gaze-evoked nystagmus, and vertical nystagmus. Hyperreflexia and extensor plantar responses occur in up to 40%-50%. Basal ganglia signs, including dystonia and blepharospasm, occur in up to 25%. Mentation is generally preserved.
Mitochondrial DNA depletion syndrome 12B (cardiomyopathic type), autosomal recessive
MedGen UID:
815773
Concept ID:
C3809443
Disease or Syndrome
Mitochondrial DNA depletion syndrome-12B is an autosomal recessive mitochondrial disorder characterized by childhood onset of slowly progressive hypertrophic cardiomyopathy and generalized skeletal myopathy resulting in exercise intolerance, and, in some patients, muscle weakness and atrophy. Skeletal muscle biopsy shows ragged-red fibers, mtDNA depletion, and accumulation of abnormal mitochondria (summary by Echaniz-Laguna et al., 2012). For a discussion of genetic heterogeneity of mtDNA depletion syndromes, see MTDPS1 (603041).
Combined oxidative phosphorylation defect type 26
MedGen UID:
1799164
Concept ID:
C5567741
Disease or Syndrome
Peripheral neuropathy with variable spasticity, exercise intolerance, and developmental delay (PNSED) is an autosomal recessive multisystemic disorder with highly variable manifestations, even within the same family. Some patients present in infancy with hypotonia and global developmental delay with poor or absent motor skill acquisition and poor growth, whereas others present as young adults with exercise intolerance and muscle weakness. All patients have signs of a peripheral neuropathy, usually demyelinating, with distal muscle weakness and atrophy and distal sensory impairment; many become wheelchair-bound. Additional features include spasticity, extensor plantar responses, contractures, cerebellar signs, seizures, short stature, and rare involvement of other organ systems, including the heart, pancreas, and kidney. Biochemical analysis may show deficiencies in mitochondrial respiratory complex enzyme activities in patient tissue, although this is not always apparent. Lactate is frequently increased, suggesting mitochondrial dysfunction (Powell et al., 2015; Argente-Escrig et al., 2022). For a discussion of genetic heterogeneity of combined oxidative phosphorylation deficiency, see COXPD1 (609060).
Neurodevelopmental disorder with poor growth and behavioral abnormalities
MedGen UID:
1840909
Concept ID:
C5830273
Disease or Syndrome
Neurodevelopmental disorder with poor growth and behavioral abnormalities (NEDGBA) is an autosomal recessive disorder characterized by global developmental delay, moderately to severely impaired intellectual development, often with absent speech, and behavioral abnormalities, including hyperactivity, short attention span, and ADHD. Affected individuals show failure to thrive with poor overall growth; some have microcephaly. Additional features may include nonspecific facial dysmorphism, hypotonia, and feeding difficulties (Vogt et al., 2022; Meng et al., 2023).

Professional guidelines

PubMed

Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, Jin Z, Kovac AL, Meyer TA, Urman RD, Apfel CC, Ayad S, Beagley L, Candiotti K, Englesakis M, Hedrick TL, Kranke P, Lee S, Lipman D, Minkowitz HS, Morton J, Philip BK
Anesth Analg 2020 Aug;131(2):411-448. doi: 10.1213/ANE.0000000000004833. PMID: 32467512
Committee on Practice Bulletins-Obstetrics
Obstet Gynecol 2018 Jan;131(1):e15-e30. doi: 10.1097/AOG.0000000000002456. PMID: 29266076
Feuerstein JD, Cheifetz AS
Mayo Clin Proc 2017 Jul;92(7):1088-1103. Epub 2017 Jun 7 doi: 10.1016/j.mayocp.2017.04.010. PMID: 28601423

Recent clinical studies

Etiology

Kovac AL
Paediatr Drugs 2021 Jan;23(1):11-37. Epub 2020 Oct 27 doi: 10.1007/s40272-020-00424-0. PMID: 33108649
Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H
F1000Res 2020;9 Epub 2020 Aug 13 doi: 10.12688/f1000research.21832.1. PMID: 32913634Free PMC Article
Lacy BE, Parkman HP, Camilleri M
Am J Gastroenterol 2018 May;113(5):647-659. Epub 2018 Mar 15 doi: 10.1038/s41395-018-0039-2. PMID: 29545633
Veiga-Gil L, Pueyo J, López-Olaondo L
Rev Esp Anestesiol Reanim 2017 Apr;64(4):223-232. Epub 2016 Dec 29 doi: 10.1016/j.redar.2016.10.001. PMID: 28041609
Horn CC, Wallisch WJ, Homanics GE, Williams JP
Eur J Pharmacol 2014 Jan 5;722:55-66. Epub 2013 Oct 26 doi: 10.1016/j.ejphar.2013.10.037. PMID: 24495419Free PMC Article

Diagnosis

Lowe SA, Steinweg KE
Emerg Med Australas 2022 Feb;34(1):9-15. Epub 2021 Dec 6 doi: 10.1111/1742-6723.13909. PMID: 34872159
Kovacic K, Li BUK
Headache 2021 Feb;61(2):231-243. Epub 2021 Feb 23 doi: 10.1111/head.14073. PMID: 33619730
Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, Jin Z, Kovac AL, Meyer TA, Urman RD, Apfel CC, Ayad S, Beagley L, Candiotti K, Englesakis M, Hedrick TL, Kranke P, Lee S, Lipman D, Minkowitz HS, Morton J, Philip BK
Anesth Analg 2020 Aug;131(2):411-448. doi: 10.1213/ANE.0000000000004833. PMID: 32467512
Lacy BE, Parkman HP, Camilleri M
Am J Gastroenterol 2018 May;113(5):647-659. Epub 2018 Mar 15 doi: 10.1038/s41395-018-0039-2. PMID: 29545633
Committee on Practice Bulletins-Obstetrics
Obstet Gynecol 2018 Jan;131(1):e15-e30. doi: 10.1097/AOG.0000000000002456. PMID: 29266076

Therapy

Tan MY, Shu SH, Liu RL, Zhao Q
Front Public Health 2023;11:1108756. Epub 2023 Mar 9 doi: 10.3389/fpubh.2023.1108756. PMID: 36969661Free PMC Article
Weibel S, Rücker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, Mayer D, Riemer M, Schaefer MS, Raj D, Backhaus I, Helf A, Schlesinger T, Kienbaum P, Kranke P
Cochrane Database Syst Rev 2020 Oct 19;10(10):CD012859. doi: 10.1002/14651858.CD012859.pub2. PMID: 33075160Free PMC Article
Hines S, Steels E, Chang A, Gibbons K
Cochrane Database Syst Rev 2018 Mar 10;3(3):CD007598. doi: 10.1002/14651858.CD007598.pub3. PMID: 29523018Free PMC Article
Benbadis SR, Sanchez-Ramos J, Bozorg A, Giarratano M, Kalidas K, Katzin L, Robertson D, Vu T, Smith A, Zesiewicz T
Expert Rev Neurother 2014 Dec;14(12):1453-65. doi: 10.1586/14737175.2014.985209. PMID: 25427150
Chong Y, Choo H
Expert Opin Investig Drugs 2010 Nov;19(11):1309-19. Epub 2010 Oct 15 doi: 10.1517/13543784.2010.528388. PMID: 20950056

Prognosis

Corner H, Barley M, Metodiev Y
Int J Obstet Anesth 2023 May;54:103650. Epub 2023 Mar 6 doi: 10.1016/j.ijoa.2023.103650. PMID: 36934515
Kovac AL
Paediatr Drugs 2021 Jan;23(1):11-37. Epub 2020 Oct 27 doi: 10.1007/s40272-020-00424-0. PMID: 33108649
Tan PC, Kartik B, Thanendran P, Zakaria R, Win ST, Omar SZ
Sci Rep 2020 Mar 10;10(1):4445. doi: 10.1038/s41598-020-61114-y. PMID: 32157169Free PMC Article
Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF
Cochrane Database Syst Rev 2018 Jun 8;6(6):CD012276. doi: 10.1002/14651858.CD012276.pub2. PMID: 29883514Free PMC Article
Edmonson MB, Eickhoff JC, Zhang C
J Pediatr 2015 Mar;166(3):607-12.e5. Epub 2014 Dec 16 doi: 10.1016/j.jpeds.2014.11.009. PMID: 25524315

Clinical prediction guides

Lowe SA, Steinweg KE
Emerg Med Australas 2022 Feb;34(1):9-15. Epub 2021 Dec 6 doi: 10.1111/1742-6723.13909. PMID: 34872159
Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H
F1000Res 2020;9 Epub 2020 Aug 13 doi: 10.12688/f1000research.21832.1. PMID: 32913634Free PMC Article
Feig DS, Donovan LE, Corcoy R, Murphy KE, Amiel SA, Hunt KF, Asztalos E, Barrett JFR, Sanchez JJ, de Leiva A, Hod M, Jovanovic L, Keely E, McManus R, Hutton EK, Meek CL, Stewart ZA, Wysocki T, O'Brien R, Ruedy K, Kollman C, Tomlinson G, Murphy HR; CONCEPTT Collaborative Group
Lancet 2017 Nov 25;390(10110):2347-2359. Epub 2017 Sep 15 doi: 10.1016/S0140-6736(17)32400-5. PMID: 28923465Free PMC Article
Hussein MR, Abdelwahed SR
Expert Rev Gastroenterol Hepatol 2015 Jan;9(1):67-78. Epub 2014 Sep 14 doi: 10.1586/17474124.2014.939632. PMID: 25220299
Gurvits GE, Lan G
World J Gastroenterol 2014 Dec 21;20(47):17819-29. doi: 10.3748/wjg.v20.i47.17819. PMID: 25548480Free PMC Article

Recent systematic reviews

Weibel S, Rücker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, Mayer D, Riemer M, Schaefer MS, Raj D, Backhaus I, Helf A, Schlesinger T, Kienbaum P, Kranke P
Cochrane Database Syst Rev 2020 Oct 19;10(10):CD012859. doi: 10.1002/14651858.CD012859.pub2. PMID: 33075160Free PMC Article
Hines S, Steels E, Chang A, Gibbons K
Cochrane Database Syst Rev 2018 Mar 10;3(3):CD007598. doi: 10.1002/14651858.CD007598.pub3. PMID: 29523018Free PMC Article
McParlin C, O'Donnell A, Robson SC, Beyer F, Moloney E, Bryant A, Bradley J, Muirhead CR, Nelson-Piercy C, Newbury-Birch D, Norman J, Shaw C, Simpson E, Swallow B, Yates L, Vale L
JAMA 2016 Oct 4;316(13):1392-1401. doi: 10.1001/jama.2016.14337. PMID: 27701665
Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J
JAMA 2015 Jun 23-30;313(24):2456-73. doi: 10.1001/jama.2015.6358. PMID: 26103030
Festin M
BMJ Clin Evid 2014 Mar 19;2014 PMID: 24646807Free PMC Article

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