Treatments for Cyclic vomiting syndrome
Treatments for Cyclic vomiting syndrome
The list of treatments mentioned in various sources
for Cyclic vomiting syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Discussion of treatments for Cyclic vomiting syndrome:
CVS cannot be cured. Treatment varies, but people with CVS are
generally advised to get plenty of rest; sleep; and take medications that
prevent a vomiting episode, stop or alleviate one that has already
started, or relieve other symptoms.
Once a vomiting episode begins, treatment is supportive. It helps to
stay in bed and sleep in a dark, quiet room. Severe nausea and vomiting
may require hospitalization and intravenous fluids to prevent dehydration.
Sedatives may help if the nausea continues.
Sometimes, during the prodrome phase, it is possible to stop an episode
from happening altogether. For example, people who feel abdominal pain
before an episode can ask their doctor about taking ibuprofen (Advil,
Motrin) to try to stop it. Other medications that may be helpful are
ranitidine (Zantac) or omeprazole (Prilosec), which help calm the stomach
by lowering the amount of acid it makes.
During the recovery phase, drinking water and replacing lost
electrolytes are very important. Electrolytes are salts that the body
needs to function well and stay healthy. Symptoms during the recovery
phase can vary: Some people find that their appetites return to normal
immediately, while others need to begin by drinking clear liquids and then
move slowly to solid food.
People whose episodes are frequent and long-lasting may be treated
during the symptom-free intervals in an effort to prevent or ease future
episodes. Medications that help people with migraine
headaches--propranolol, cyproheptadine, and amitriptyline--are sometimes
used during this phase, but they do not work for everyone. Taking the
medicine daily for 1 to 2 months may be necessary to see if it helps.
In addition, the symptom-free phase is a good time to eliminate
anything known to trigger an episode. For example, if episodes are brought
on by stress or excitement, this period is the time to find ways to reduce
stress and stay calm. If sinus problems or allergies cause episodes, those
conditions should be treated.
(Source: excerpt from Cyclic Vomiting Syndrome: NIDDK)
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Treatments of Cyclic vomiting syndrome: Online Medical Books
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for more information about the treatments of Cyclic vomiting syndrome.
Nausea & Vomiting:
Treatment
(In a Page: Signs and Symptoms)
-
Fluid resuscitation is a mainstay of therapy, because vomiting may cause significant dehydration
-
Antiemetics (e.g., metoclopramide, ondansetron, prochlorperazine) may be administered to control symptoms
-
Treat reversible causes as necessary (e.g., uremia, hypercalcemia, CNS infections, toxic exposures)
-
Treatment of underlying etiologies generally eliminates vomiting
-
Inner ear causes of vomiting may respond to treatment with anticholinergics (e.g., meclizine)
-
Endoscopy/colonoscopy may be used diagnostically and therapeutically in cases of peptic ulcer disease or large bowel obstruction
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
GI Bleeding - Hematemesis:
Treatment
(In a Page: Signs and Symptoms)
-
Ensure adequate airway, breathing, and circulation
-
Stabilize and resuscitate patients as necessary
–Insert two large-bore IV lines
–Administer IV fluids (Ringer's lactate or normal saline)
–Type and cross match two units of packed RBCs
–Correct coagulopathies if present (e.g., fresh frozen plasma, vitamin K, platelets)
–Consider blood transfusion
-
Identify and treat the source of bleeding
–IV octreotide (vasoconstrictor) infusion
–Vasopressin for significant variceal bleeding (contraindicated in CAD or CVA patients)
–Endoscopy with injection of vasoconstrictors (e.g., epinephrine), sclerosing agents, or electrocautery
–Angiography with visualization of bleeding vessel and subsequent embolization
–Surgical control of bleeding if all else fails
-
H2 blockers or proton pump inhibitors may be started for suspected peptic ulcer disease or gastritis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hematemesis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Large bleeds require two large-bore IVs and volume support with normal saline or packed red blood cells
-
Closely monitor vital signs
-
Acid blockade with histamine receptor antagonist or proton pump inhibitor
-
Endoscopic therapy including
–Heater probe and bipolar coagulation for ulcers
–Band ligation or sclerotherapy for varices
-
Octreotide or vasopressin to reduce splanchnic blood flow for variceal bleeding
-
-
-
Selective embolization
-
Surgical repair rarely indicated
-
Treat infections including triple therapy (antibiotics and proton pump inhibitor) for H. pylori
-
-
-
Remove allergen in case of allergy
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Vomiting:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Stabilize patient and fluid resuscitation as initial therapy with electrolyte correction
-
Surgical consultation if obstruction suspected
-
Oral rehydration with small amounts of liquids if tolerated
-
If signs of obstruction, nasogastric tube decompression and bowel rest
-
Treat infections if indicated
-
Remove toxins and allergens
-
Surgical interventions for volvulus, Hirschprung, intracranial masses, pyloric stenosis, other anatomic causes
-
Correct metabolic derangements
-
Lifelong gluten-free diet for celiac disease
-
Rare use of antiemetics/promotility agents for chemotherapy, motion sickness, postsurgery, gastroesophageal reflux disease
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Vomiting – Projectile:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Maintain fluid balance
-
Correct electrolytes
-
Surgical correction
–Pyloroplasty for pyloric stenosis
–Ladd procedure for malrotation
-
Treat infections
-
Superior mesenteric artery syndrome
–May require nasojejunal feeds/TPN
-
Acid blockers for gastroesophageal reflux
-
Amino acid or hydrolysate formula for milk allergy
-
PKU
–Avoid phenylalanine (requires special formula, dietary restrictions until maturation, possibly lifelong)
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hematemesis:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient has massive hematemesis, check his vital signs. If you detect signs of shock — such as tachypnea, hypotension, and tachycardia — place the patient in a supine position, and elevate his feet 20 to 30 degrees. Start a large-bore I
V. line for emergency fluid replacement. Also, send a blood sample for typing and crossmatching, hemoglobin level, and hematocrit and administer oxygen. Emergency endoscopy may be necessary to locate the source of bleeding. Prepare to insert a nasogastric (NG) tube for suction or iced lavage. A Sengstaken-Blakemore tube may be used to compress esophageal varices. (See Managing hematemesis with intubation
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Hematemesis:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient has massive hematemesis, check his vital signs. If you detect signs of shock—such as tachypnea, hypotension, and tachycardia—place the patient in a supine position, and elevate his feet 20 to 30 degrees. Start a large-bore I.V. line for emergency fluid replacement. Also, obtain a blood sample for typing and crossmatching, hemoglobin level, and hematocrit, and administer oxygen. Emergency endoscopy may be necessary to locate the source of bleeding. Prepare to insert a nasogastric (NG) tube for suction or iced lavage. A Sengstaken-Blakemore tube may be used to compress esophageal varices. (See Managing hematemesis with intubation, page 404.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Vomiting:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Advise patients to replace fluid losses to avoid dehydration. If vomiting is persistent, administer an antiemetic; consider hospitalizing the patient for I.V. fluid replacement or parenteral nutrition therapy. Advise patients suffering from migraine headaches that vomiting may be a prodromal symptom and that they should take antimigraine medication.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Hematemesis:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Closely monitor the patient’s vital signs, and watch for signs of shock. Check the patient’s stools regularly for occult blood, and keep accurate intake and output records. Place the patient on bed rest in a low or semi-Fowler’s position to prevent aspiration of vomitus. Keep suctioning equipment nearby, and use it as needed. Provide frequent oral hygiene and emotional support — the sight of bloody vomitus can be very frightening. Administer a histamine-2 blocker I.V.; vasopressin may be required for variceal hemorrhage. As the bleeding tapers off, monitor the pH of gastric contents, and give hourly doses of antacids by NG tube as necessary.
Patient teaching
Explain diagnostic tests, such as endoscopy, barium swallow, and variceal banding. Explain laboratory tests, such as serum electrolyte levels and complete blood count. Provide information on medications that the patient should avoid, such as aspirin or anticoagulants, and instruct the patient on nondrug measures, such as relaxation and stress management, which help minimize symptoms. Stress the importance of avoiding alcohol.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Vomiting:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Draw blood to determine fluid, electrolyte, and acid-base balance. (Prolonged vomiting can cause dehydration, electrolyte imbalances, and metabolic alkalosis.) Have the patient breathe deeply to ease his nausea and help prevent further vomiting. Keep his room fresh and clean smelling by removing bedpans and emesis basins promptly after use. Elevate his head or position him on his side to prevent aspiration of vomitus. Continuously monitor his vital signs and intake and output (including vomitus and liquid stools). If necessary, administer I.V. fluids or have the patient sip clear liquids to maintain hydration.
Because pain can precipitate or intensify nausea and vomiting, administer pain medications promptly. If possible, give these by injection or suppository to prevent exacerbating associated nausea. If an opioid is used to treat pain, monitor bowel sounds and flatus and bowel movements carefully because they slow down GI motility and may exacerbate vomiting. If you administer an antiemetic, be alert for abdominal distention and hypoactive bowel sounds, which may indicate gastric retention. If this occurs, insert a nasogastric tube.
Patient teaching
Advise the patient to replace fluid losses to avoid dehydration. Inform the patient suffering from migraine headaches that vomiting may be a prodromal symptom; advise him to take antimigraine medication should vomiting occur.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Hematemesis:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient has massive hematemesis, check his vital signs. If you detect signs of shock — such as tachypnea, hypotension, and tachycardia — place him in a supine position, and elevate his feet 20 to 30 degrees. Start a large-bore I.V. line for emergency fluid replacement. Also, send a blood sample for typing and crossmatching, hemoglobin level, and hematocrit, and administer oxygen. Emergency endoscopy may be necessary to locate the source of bleeding. Prepare to insert a nasogastric (NG) tube for suction or iced lavage. A Sengstaken-Blakemore tube may be used to compress esophageal varices. (See Managing hematemesis with intubation.)
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Nausea:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Advise the patient to avoid reading because eye movement can aggravate nausea. Also instruct him to avoid sudden position changes. Encourage him to practice good oral hygiene to remove unpleasant tastes and to moisten the mucous membranes. Tell the patient to avoid foods that may aggravate feelings of nausea such as spicy foods.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Vomiting:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Have the patient breathe deeply to ease his nausea and help prevent further vomiting. Advise him to replace fluid losses to avoid dehydration. A patient suffering from migraine headaches should be advised that vomiting may be a prodromal symptom and antimigraine medication should be taken.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hematemesis:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Closely monitor the patient's vital signs, and watch for signs of shock.
▪ Check the patient's stools regularly for occult blood.
▪ Keep accurate intake and output records.
▪ Monitor NG drainage for blood.
▪ Place the patient on bed rest in low or semi-Fowler's position to prevent aspiration of vomitus.
▪ Keep suctioning equipment nearby, and use it as needed.
▪ Provide frequent oral hygiene and emotional support.
▪ Administer a histamine-2 receptor antagonist I.V.; vasopressin may be required for variceal hemorrhage.
Patient teaching
▪ Explain any food or fluid restrictions.
▪ Stress the importance of avoiding the use of alcohol.
▪ Teach the patient about prescribed medications and what drugs to avoid.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Nausea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ If the patient is experiencing severe nausea, prepare him for blood tests to determine fluid and electrolyte status and acid-base balance.
▪ To prevent aspiration, elevate the patient's head or position him on his side.
▪ Because pain can precipitate or intensify nausea, administer pain medications promptly, as needed.
▪ If possible, give medications by injection or suppository to prevent exacerbating nausea.
▪ Be alert for abdominal distention and hypoactive bowel sounds which may indicate gastric retention.
▪ Be prepared to insert a nasogastric tube, as needed.
▪ Prepare the patient for such procedures as a computed tomography scan, an ultrasound scan, endoscopy, and colonoscopy.
▪ Consult the nutritionist to determine the patient's need for parenteral nutrition.
Patient teaching
▪ Teach the patient to breathe deeply to ease his nausea.
▪ Discuss triggers for nausea and how to avoid them.
▪ Teach the patient the importance of aspiration precautions.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Vomiting:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Draw blood to determine fluid, electrolyte, and acid-base balance.
▪ Keep the patient's room clean smelling by removing bedpans and emesis basins promptly after use.
▪ Elevate the patient's head or position him on his side to prevent aspiration of vomitus.
▪ Monitor vital signs and intake and output (including vomitus and liquid stools).
▪ If necessary, administer I.V. fluids, or have the patient sip clear liquids to maintain hydration.
▪ Because pain can precipitate or intensify nausea and vomiting, administer pain medications promptly.
▪ Insert a nasogastric tube, as ordered.
Patient teaching
▪ Teach the patient deep-breathing exercises to ease nausea.
▪ Explain the importance of replacing fluid losses.
▪ Teach the patient about dietary restrictions and how to advance the diet.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Vomiting - Case 3-1: 7-Week-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Treatment regimens for methemoglobinemia depend on the level and the patient's symptoms. In general, only symptomatic patients with methemoglobin levels
greater than 20% or asymptomatic patients with methemoglobin levels greater
than 30% require specific therapy. Patients with concurrent problems that
impair oxygen delivery, such as anemia, cardiac disease, or pulmonary disease,
should be treated even if they have low methemoglobin levels. Symptomatic
patients must receive proper airway management and supplemental oxygen as
needed. Intravenous methylene blue, after reduction to leukomethylene blue by
NADPH-methemoglobin reductase, aids in the reduction of methemoglobin back to
hemoglobin. It is the treatment of choice and should reduce methemoglobin
levels significantly within 1 hour after administration. Exchange transfusions
are necessary for those patients who have extremely high levels of
methemoglobin that do not respond to methylene blue therapy.
Glucose-6-phosphate dehydrogenase (G6PD) is the first enzyme in the hexose
monophosphate shunt, which is the sole source of NADPH in the red blood cell.
Patients with G6PD deficiency may not produce sufficient NADPH to reduce
methylene blue to leukomethylene blue. Therefore, methylene blue therapy may
not be effective in patients with G6PD deficiency. In such patients, methylene
blue may also induce hemolysis.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Vomiting - Case 3-2: 9-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Treatment of SVT depends on the etiology and the duration of symptoms. Automatic
rhythms are difficult to treat medically but respond well to ablation surgery.
Acute treatment of reentrant tachycardias depends on the age and stability of
the patient. In hemodynamically stable children, vagotonic maneuvers such as
straining, breath-holding, applying ice to the face, or adopting a particular
posture should be attempted first. For patients who do not respond to simple
vagal maneuvers, medical cardioversion should be attempted. Adenosine, a
nucleoside derivative that blocks the orthodromic conduction at the AV node, is
the medication of choice. Intravenous verapamil and propranolol can break an
SVT but are contraindicated in infants and children because of the risk of
bradycardia, hypotension, and cardiac arrest. If these modalities fail or if
the patient is hemodynamically unstable, then synchronized electrical
cardioversion should be performed immediately.
Once a patient has been successfully converted to a normal sinus rhythm,
maintenance therapy is selected depending on the age of the patient and the
cause of the SVT. In newborns and infants, digoxin remains the primary
medication for prevention of SVT, which is usually self-limited. Medications
that target the specific area of reentry (nodal or accessory) tend to work
better. In patients with a hidden accessory pathway, digoxin or
β-blockers are the mainstay of therapy. In children with evidence of
preexcitation syndrome (e.g., Wolff-Parkinson-White syndrome), digoxin and
calcium channel blockers are contraindicated, and
β-blockers are usually used.
Radiofrequency ablation of the accessory pathway is one choice for definitive
treatment. Success rates range from approximately 80% to 95%, depending on the
location of the bypass tract or tracts. Surgical ablation of bypass tracts can
also be successful in selected patients.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Vomiting - Case 3-6: 10-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Medical treatment with fluids and antibiotics, if necessary, is used to
stabilize the patient before surgery. Surgical treatment includes resection of
the aganglionic segment, with the creation of a stoma until 6 to 12 months of
age. Ninety percent of patients return to a normal stooling pattern, and the
remaining 10% have a continuing problem with either constipation or
incontinence. Death occurs in one third of those patients presenting with
enterocolitis.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
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