Clinical presentation and diagnosis

CINV, though frequently discussed as one syndrome, are two distinct clinical entities. Nauseous patients may present with general GI upset and reflux and may report a sensation or desire to vomit without being able to do so (patients may describe this as having "dry heaves"). Patients with chemo-therapy-induced vomiting may experience vomiting with the first 24 hours of chemotherapy administration ("acute" nausea/ vomiting) or several days following chemotherapy ("delayed" nausea/vomiting).3 Patients may additionally experience nausea/vomiting prior to chemotherapy administration ("anticipatory" nausea/vomiting).3 In all cases, it is important that other causes of nausea and vomiting are ruled out before diagnosing chemotherapy as the source.6 Other causes of nausea and vomiting may include bowel obstruction, opioids, electrolyte imbalances, brain metastases, and vestibular dysfunction.6

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