Despite the discomfort they cause, nausea and vomiting generally disappear fairly quickly. There are, however, rarer cases where vomiting can persist beyond four weeks and become a chronic disorder.
The causes can be multiple, involving both the digestive system and other organs and systems, which complicates the establishment of a precise diagnosis, a prior and essential step for adequate treatment.
This is why the ” European Society of Gastroenterology and the European Society of Neurogastroenterology (ESNM) have identified the field of nausea and chronic vomiting as a subject of interest in the development of a multidisciplinary guide “, Returned in context for Univadis Spain the Dre Carolina Malageladaassistant doctor at Gastroenterology service at the Vall d’Hebron university hospitaland coordinator of this work. This guide, in which 35 experts and experts participated (gastroenterologists, surgeons and primary care physicians) from 13 European countries, has recently been published in the form of consensus document in the journal United European Gastroenterology.
Creation of a diagnostic algorithm
One of the main contributions of this document is the development of a diagnostic algorithm which, in a schematic and visual manner, ” Guide the healthcare professional when a patient presents himself in consultation for vomiting evolving for several weeks. This document makes it possible to make a diagnosis in a structured manner, taking into account the most recent scientific data, in order to indicate the most appropriate treatments », has explained the Malagiada Dr.
The first step is ” Determine whether the patient presents vomiting, rumination, or regurgitation (a process during which ingested foods go up in the mouth without physical effort on the part of the person concerned; regurgitation being often confused with vomiting) “Continued the coordinator of the consensus document.
Once established that the patient effectively presents a table of chronic vomiting, it is necessary to identify whether these vomiting and nausea are side effects of other diseases. Experts have proposed 32 possible pathologies, divided into 10 categories: endocrine and metabolic disorders, nervous system diseases, reactions to treatments and drugs, inflammation of the gastrointestinal mucosa, gastrointestinal occlusion, vagus nerve lesions, dysautonomy, vestibular disorders, intracranial hypertension, cancer.
-If none of these 10 categories is at the origin of vomiting, several diagnoses are envisaged, by distinguishing the disorders of motility (esophageal, gastric, intestinal) from the problems of interaction-brain interaction: syndrome of cyclical vomiting, physiopathological mechanisms, migraine, irritable intestine syndrome, dyspepsia and psychosocial factors.
Recommendations
In total, the document presents 94 recommendations, 89 of them subject to more than 70 % consensus among professionals, and 31 exceeding 90 %. These recommendations follow the structure of the diagnostic algorithm; Their objective is to clarify doubts and deepen the necessary examinations in order to lead to the final diagnosis. For its development, ” All of the scientific data available for each case has been examined in depth since 2022 and for more than two years. Thereafter, a rigorous voting process was carried out, each recommendation having been evaluated separately and individually by each of the experts », said the Malagelada Dr., as a conclusion.
Funding and conflicts of interest
The complete list of interest conflicts of the authors of this study can be consulted in the original publication.
To go further, consult This article on univadis.frsynthesis of the intervention of Pr Guillaume Gourcerol (gastroenterology, CHU of Rouen) During the French -speaking days of hepatogastroenterology and digestive oncology (JFHOD 2025).
This article has been translated fromUnivadis.es. The content was reviewed by the editorial staff before publication.
