IDIAPJGol
Published April 1, 2025 | Version v1
Journal article Open

European Guideline on Chronic Nausea and Vomiting-A UEG and ESNM Consensus for Clinical Management

Authors/Creators

  • 1. Autonomous Univ Barcelona, Hosp Gen Vall dHebron, Digest Syst Res Unit, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
  • 2. Univ Hamburg, Israelit Hosp, Acad Hosp, Hamburg, Germany
  • 3. Queen Mary Univ London, Wingate Inst Neurogastroenterol, Blizard Inst, Barts & London Sch Med & Dent, London, England
  • 4. UZ Leuven, Dept Gastroenterol & Hepatol, Leuven, Belgium
  • 5. Wroclaw Med Univ, Dept Gastroenterol & Hepatol, Wroclaw, Poland
  • 6. Free Univ Berlin, Charite Univ Med, Clin Psychosomat Med, Berlin, Germany; Free Univ Berlin, Charite Univ Med, Psychotherapy Klinikum Stuttgart, DZPG Site Tubingen,Psychosomat Med & Psychotherapy, Berlin, Germany
  • 7. Vall dHebron Univ Hosp, Digest Syst Res Unit, Barcelona, Spain
  • 8. Aalborg Univ Hosp, Ctr Pancreat Dis & Mech Sense, Dept Gastroenterol & Hepatol, Aalborg, Denmark
  • 9. Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden
  • 10. CHU, Grenoble Inst Neurosci, Stress & Interact Neurodigest, Ctr Rech,INSERM UJF CEA 836, Grenoble, France
  • 11. Iuliu Hatieganu Univ Med & Pharm, Dept Internal Med 2, Cluj Napoca, Romania
  • 12. Maastricht Univ, Med Ctr, Dept Gastroenterol Hepatol, Maastricht, Netherlands
  • 13. Inst Clin Malalties Digest & Metab Hosp Clin Barce, Inst Clin Malalties Digest & Metab ICMDM, Diabet Unit, Barcelona, Spain
  • 14. Univ Hosp Leuven, Dept Gastroenterol & Hepatol, Leuven, Belgium
  • 15. Univ Bordeaux, Hop Haut Leveque, Ctr Med Chirurg Magellan, CHU Bordeaux,Dept Gastroenterol,INSERM,CIC 1401, Bordeaux, France
  • 16. Univ Padua, Dept Surg Oncol & Gastroenterol DiSCOG, Padua, Italy
  • 17. Univ Rijeka, Clin Hosp Ctr Rijeka, Dept Gastroenterol, Fac Med, Rijeka, Croatia
  • 18. Univ Rouen Normandie, INSERM U1096, Dept Pharmacol, ADEN UMR 1073,CHU Rouen, Rouen, France
  • 19. Med Univ Graz, Dept Internal Med, Div Gastroenterol & Hepatol, Graz, Austria
  • 20. Univ Sheffield, Dept Gastroenterol, Sheffield, England; Univ Sheffield, Div Clin Med, Sheffield, England
  • 21. Hlth Ctr Zagreb West, Zagreb, Croatia
  • 22. Univ Barcelona, Catalan Inst Hlth, La Mina Primary Care Acad Ctr, Barcelona, Spain
  • 23. Great Ormond St Hosp Sick Children, Dept Pediat Gastroenterol, London, England
  • 24. Med Univ Silesia, Dept Oncol, Katowice, Poland
  • 25. Carol Davila Univ Med & Pharm, Dept Internal Med & Gastroenterol, Bucharest, Romania
  • 26. Nottingham Univ Hosp NHS Trust, NIHR Nottingham Biomed Res Ctr BRC, Nottingham, England; Univ Nottingham, Nottingham, England
  • 27. Katholieke Univ Leuven, Dept Neurosci Deglutol Expt Otorhinolaryngol ExpOR, Leuven, Belgium; Univ Hosp Leuven, Dept Gastroenterol Neurogastroenterol & Motil, Leuven, Belgium
  • 28. Wellington Hosp, Dept Radiol, London, England
  • 29. Univ Ferrara, Dept Translat Med, Ferrara, Italy
  • 30. Queen Mary Univ London, Wingate Inst Neurogastroenterol, London Sch Med & Dent, Dept Gastroenterol, London, England

Description

IntroductionChronic nausea and vomiting are symptoms of a wide range of gastrointestinal and non-gastrointestinal conditions. Diagnosis can be challenging and requires a systematic and well-structured approach. If the initial investigation for structural, toxic and metabolic disorders is negative, digestive motility and gut-brain interaction disorders should be assessed. United European Gastroenterology (UEG) and the European Society for Neurogastroenterology and Motility (ESNM) identified the need for an updated, evidence-based clinical guideline for the management of chronic nausea and vomiting.MethodsA multidisciplinary team of experts in the field, including European specialists and national societies, participated in the development of the guideline. Relevant questions were addressed through a literature review and statements were developed and voted on according to a Delphi process.ResultsNinety-eight statements were identified and voted following the Delphi process. Overall agreement was high, although the grade of scientific evidence was low in many areas. Disagreement was more evident for some pharmacological treatment options. A diagnostic algorithm was developed, focussing on the differentiating features between gastrointestinal motility and gut-brain interaction disorders with predominant nausea and vomiting.ConclusionThese guidelines provide an evidence-based framework for the evaluation and treatment of patients with chronic nausea and vomiting.

Notes

These guidelines have been funded by United European Gastroenterology.

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