CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Palliative cancer care - nausea & vomiting - Management
What features of nausea and vomiting may suggest a cause?
- Patterns of symptoms can be indicative of the cause of nausea and vomiting. See Table 1.
- There may be more than one cause of nausea and vomiting.
Table 1. Features of nausea and vomiting of different causes.
Features of nausea and vomiting | Cause |
|---|
Large-volume, infrequent vomiting, relief of symptoms after vomiting. Oesophageal reflux, epigastric fullness, early satiation, hiccups. Succussion splash in some people. | Gastric stasis |
Symptoms similar to gastric stasis, but also forceful vomiting and rapid dehydration. | Gastric outflow obstruction |
Symptoms similar to gastric stasis, but low-volume vomiting. | 'Squashed stomach syndrome' (reduction in gastric cavity by tumour or external compression) |
Vomiting soon after eating or drinking, vomitus consisting of what has just been swallowed, sensation of food sticking. | Oesophageal blockage |
Intermittent nausea (often relieved by vomiting), worsening nausea and/or feculent vomiting as obstruction progresses, abdominal pain (may be colicky), abdominal distention (may be absent if high obstruction). | Bowel obstruction |
Effortless vomiting, often in the morning which may be associated with headache (diurnal) and papilloedema; nausea (may be diurnal); neurological signs and photophobia may be absent. | Increased intracranial pressure |
Nausea and/or sudden vomiting on movement (e.g. turning in bed). | Motion-associated emesis |
Nausea present in waves, may be triggered by a previously experienced stimulus, may be relieved by distraction. | Anxiety-related nausea |
Constant nausea, variable vomiting. | Chemically induced nausea |
|
© NHS Institute for Innovation and Improvement