Nausea, Gastroparesis, and Aerophagia

Abstract

Nausea, gastroparesis, and aerophagia are gastrointestinal phenomena that have variable impact on affected patients. The causes of nausea are varied; treatment of these conditions relates to the underlying etiology. Antiemetic agents acting on several distinct receptor subtypes produce benefits in distinct patient subsets. Gastroparesis is characterized by delays in gastric emptying, usually defined scintigraphically. Standard care of gastroparesis relies on dietary modification, antiemetic drug therapy, and initiation of medications that stimulate gastric motor activity. Recent advances include pyloric injection of botulinum toxin and surgical implantation of an electrical neurostimulator. Other surgical therapies are reserved for refractory cases. Aerophagia presents in individuals of normal and impaired cognitive function, most commonly with symptoms of overdistension or eructation. There are no pharmaceutical remedies for this condition; thus, therapy relies on behavioral treatments.

Affective modulation of swallowing rates: Unpleasantness or arousal?

“…Current evidence on treatment options for this disorder is very limited, with psychosocial interventions as key therapeutic strategies [3,35,36]. Our findings confirm that behavioral treatments including relaxation [25] and breathing training [29] may be worth more systematic exploration in this patient population.…”

The attention network changes in breast cancer patients receiving neoadjuvant chemotherapy: Evidence from an arterial spin labeling perfusion study

“…Second, for the current study, we have eliminated the effects of chemotherapy-induced acute symptoms such as fatigue, vomiting, and anemia, which are involved in cognitive functioning. However, it is difficult to eliminate the potential effects of other factors, for example, the use of glucocorticoids and antiemetic drugs 39 40 , which could also influence cognitive functioning across the blood brain barrier. Thus, future studies should control for these factors when examining cognitive function to clarify the neural mechanisms of chemotherapy-induced cognitive impairment.…”

Systematic review: applications and future of gastric electrical stimulation

“…64 Currently, medical management for gastroparesis includes hydration, dietary manipulation, nutritional supplementation and pharmacological therapy: prokinetic agents, such as domperidone and metoclopramide; antiemetic agents, such as granisetron, or ondansetron. [65][66][67][68][69][70] Severe cases may require enteral tube feedings (jejunostomy tube) or total parenteral nutrition (nutrition is fed into the blood stream) to sustain nutritional support. Two methods of GES have been applied for their therapeutic potentials in gastroparesis: GES with short pulses (or called high frequency/low energy) and GES with long pulses (or called low frequency/high energy).…”