Some medical conditions that arise as a result of cancer or as a complication of its treatment are known to be associated with a high risk of<unk>  and/or vomiting. These include malignant bowel obstruction (MBO), chemotherapy induced<unk>  and vomiting (CINV), anticipatory<unk>  and vomiting (ANV), and radiotherapy induced<unk>  and vomiting (RINV). Malignant bowel obstruction Malignant bowel obstruction (MBO) of the gastrointestinal tract is a common complication of advanced cancer, especially in patients with bowel or gynaecological cancer. These include colorectal cancer, ovarian cancer, breast cancer, and melanoma. Three percent of all advanced cancers lead to malignant bowel obstruction and 25 to 50 percent of patients with ovarian cancer experience at least one episode of malignant bowel obstruction. The mechanisms of action that may lead to<unk>  in MBO include mechanical compression of the gut, motility disorders, gastrointestinal secretion accumulation, decreased gastrointestinal absorption, and inflammation. Bowel obstruction and the resulting<unk>  may also occur as a result of anti-cancer therapy such as radiation, or adhesion after surgery. Impaired gastric emptying as a result of bowel obstruction may not respond to drugs alone, and surgical intervention is sometimes the only means of symptom relief. Some constipating drugs used in cancer therapy such as opioids may cause a slowing of peristalsis of the gut, which may lead to a functional bowel obstruction. Chemotherapy Chemotherapy-induced<unk>  and vomiting (CINV) is one of the most feared side effects of chemotherapy and is associated with a significant deterioration in quality of life. CINV is classified into three categories: * early onset (occurring within 24 hours of initial exposure to chemotherapy) * delayed onset (occurring 24 hours to several days after treatment) * anticipatory (triggered by taste, odor, sight, thoughts, or anxiety) Risk factors that predict the occurrence and severity of CINV include sex and age, with females, younger people and people who have a high pretreatment expectation of<unk>  being at a higher risk, while people with a history of high alcohol consumption being at a lower risk. Other person-related variables, such as chemotherapy dose, rate and route of administration, hydration status, prior history of CINV, emesis during pregnancy or motion sickness, tumour burden, concomitant medication and medical conditions also play a role in the degree of CINV experienced by a person. By far the most important factor which determines the degree of CINV is the emetogenic potential of the chemotherapeutic agents used. Chemotherapeutic agents are classified into four groups according to their degree of emetogenicity: high, moderate, low and minimal. + Chemotherapeutic agents associated with vomiting Association with vomiting Examples Highly emetogenic (>90%) Intravenous agents Cisplatin, Mechlorethamine, Streptozotocin, Cyclophosphamide > 1500 mg/m2, Carmustine, Dacarbazine, Anthracycline Highly emetogenic (>90%) oral agents Hexamethylmelamine, Procarbazine Moderately emetogenic (30-90%) intravenous agents Oxaliplatin, Cytarabine > 1g/m2, Carboplatin, Ifosfamide, Cyclophosphamide 2, Doxorubicin, Daunorubicin, Epirubicin, Idarubicin, Irinotecan, Azacitidine, Bendamustine, Clofarabine, Alemtuzumab Moderately emetogenic (30-90%) oral agents Cyclophosphamide, Temozolomide, Vinorelbine, Imatinib The European Society of Medical Oncology (ESMO) and the Multinational Association of Supportive Care in Cancer (MASCC) in 2010 as well as the American Society of Clinical Oncology (ASCO) (2011) recommend a prophylaxis to prevent acute vomiting and<unk>  following chemotherapy with high emetic risk drugs by using a three-drug regimen including a 5-HT3 receptor antagonist, dexamethasone and aprepitant (a neurokinin-1 antagonist) given before chemotherapy. Anticipatory A common consequence of cancer treatment is the development of anticipatory<unk>  and vomiting (ANV). This kind of<unk>  is usually elicited by the re-exposure of the patients to the clinical context they need to attend to be treated. Approximately 20% of people undergoing chemotherapy are reported to develop anticipatory<unk>  and vomiting. Once developed, ANV is difficult to control by pharmacological means. Benzodiazepines are the only drugs that have been found to reduce the occurrence of ANV but their efficacy decreases with time. Recently, clinical trials suggests that cannabidiolic acid suppresses conditioned gaping (ANV) in shrews. Because ANV is widely believed to be a learned response, the best approach is to avoid the development of ANV by adequate prophylaxis and treatment of acute vomiting and<unk>  from the first exposure to therapy. Behavioral treatment techniques, such as systematic desensitization, progressive muscle relaxation and hypnosis have been shown to be effective against ANV. Radiation therapy The incidence and severity of radiation therapy-induced<unk>  and vomiting (RINV) depends on a number of factors including therapy related factors such as irradiated site, single and total dose, fractionation, irradiated volume and radiotherapy techniques. Also involved are person related factors such as gender, general health of the person, age, concurrent or recent chemotherapy, alcohol consumption, previous experience of<unk> , vomiting, anxiety as well as the tumor stage. The emetogenic potential of radiotherapy is classified into high, moderate, low and minimal risk depending on the site of irradiation: * High risk: total body irradiation (TBI) is associated with a high risk of RINV * Moderate risk: radiation of the upper abdomen, half body irradiation and upper body irradiation * Low risk: radiation of the cranium, spine, head and neck, lower thorax region and pelvis * Minimal risk: radiation of extremities and breast
Cancer and nausea
symptoms of Peptic ulcer disease
Diabetes and pregnancy
Old age and driving
symptoms of Gastrointestinal bleeding
symptoms of Pancreatitis
symptoms of Diverticulitis
Cancer signs and symptoms