3 Patients experiencing severe nausea and vomiting can develop psychological symptoms such as anxiety and depression. In addition, severe cases of CINV can result in other complications, such as esophageal tears, fractures, dehydration, anticipatory vomiting, anorexia, weight loss, malaise, and aspiration pneumonia. These adverse effects can have a significant impact on patient quality of life. Since much of cancer chemotherapy is given with palliative intent, effects on quality of life are clearly of clinical significance. Thus, effective control of nausea and vomiting is a primary goal in patients receiving emetogenic chemotherapy.
Nausea is accompanied by gastric stasis.
4 Retching is the synchronized rhythmic motion of the respiratory and abdominal muscles that occurs prior to or during emesis. Coordinated movements of the diaphragm and abdominal muscles create increased intrathoracic pressure that facilitates vomiting. 4 Recorded pressure patterns can clearly differentiate between retching and vomiting. Retching is associated with negative deflections in the thorax coinciding with positive deflections in the abdomen. In contrast, the expulsive squeeze associated with vomiting is characterized by positive deflections in both the thorax and abdomen, which usually terminate an emetic episode.