1/5. Anticipatory nausea in cyclical vomiting.BACKGROUND: Cyclical vomiting syndrome (CVS) is characterised by discrete, unexplained episodes of intense nausea and vomiting, and mainly affects children and adolescents. Comprehending Cyclical vomiting syndrome requires awareness of the severity of nausea experienced by patients. As a subjective symptom, nausea is easily overlooked, yet is the most distressing symptom for patients and causes many behavioural changes during attacks. CASE PRESENTATION: This first-hand account of one patient's experience of Cyclical vomiting syndrome shows how severe nausea contributed to the development of anticipatory nausea and vomiting (ANV), a conditioned response frequently observed in chemotherapy patients. This conditioning apparently worsened the course of the patient's disease. Anticipatory nausea and vomiting has not previously been recognised in Cyclical vomiting syndrome, however predictors of its occurrence in oncology patients indicate that it could complicate many cases. CONCLUSION: We suggest a model whereby untreated severe and prolonged nausea provokes anxiety about further cyclical vomiting attacks. This anxiety facilitates conditioning, thus increasing the range of triggers in a self-perpetuating manner. Effective management of the nausea-anxiety feedback loop can reduce the likelihood of anticipatory nausea and vomiting developing in other patients. ( info) |
2/5. Distraction and relaxation training in the treatment of anticipatory vomiting: a single subject intervention.A within-series phase change design (ABABC) was used to evaluate the effect of video distraction and relaxation in the treatment of a 29-year-old male with anticipatory vomiting associated with cancer chemotherapy. heart rate, blood pressure, nausea ratings, and the occurrence of emesis were recorded during 18 chemotherapy treatments over a 9 month period. Video distraction initially inhibited vomiting but the treatment effects were not maintained. Subsequent relaxation training inhibited vomiting after two sessions. These effects were maintained for the remainder of the patient's chemotherapy protocol. ( info) |
3/5. Anticipatory nausea and vomiting: a form of chemotherapy phobia?This paper proposes that the phenomenon of anticipatory nausea and/or vomiting is a component of a phobic response to chemotherapy. Two cases are presented to highlight the clinical aspects of chemotherapy phobia. The evidence confirming such a diagnosis is put forth as it relates to anticipatory anxiety, phobic response, avoidance behaviour and treatment. ( info) |
4/5. Treating patients with nervous vomiting in the dental office by point-stimulating therapy.Treating patients with nervous vomiting in the dental office is a difficult problem for dentists. An efficient method--point-stimulating therapy--is recommended for dealing with such cases. ( info) |
5/5. Optimal management of nausea and vomiting in clinical oncology.The exact mechanisms involved in chemotherapy-induced nausea and vomiting are not known. Therapies are largely empiric. There is no completely effective single agent or even combination-agent regimen. This paper identifies important factors in selecting antiemetic therapy, particularly the emetogenic potential of the chemotherapy and the fact that antiemetic drugs have differing sites of action. Regarding acute emesis, great strides have been made in the 1980s. Anticipatory and delayed symptoms remain a challenge and are a focus of this article. A key in the timing of pharmacologic intervention is pinpointed in each of these situations. ( info) |