Clinical Features and Treatment of Functional or Nervous Vomiting

Wilbur, Dwight L.

doi:10.1001/jama.1938.02790070001001

Cited by 16 publications

(5 citation statements)

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“…These studies are outlined in Table 2. The largest of these studies was conducted by Wilbur in 1938 [1]. He reported on 140 patients with what he described as "nervous vomiting."…”

Section: Historical Backgroundmentioning

confidence: 99%

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Chronic nausea and vomiting: New insights and approach to treatment

Olden

Crowell²

2005

Curr Treat Options Gastro

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Chronic vomiting of unclear etiology has been given a number of names over time. For many years, it was known as "psychogenic" vomiting because a psychiatric etiology was considered the most likely cause. More recently, the concepts of cyclic vomiting syndrome (CVS) and functional vomiting (FV) have been proposed to better explain this perplexing phenomenon. CVS is a dramatic clinical syndrome characterized by intense episodes of vomiting lasting over a period of days but alternating with periods of intense quiescence. FV, as defined by the Rome II diagnostic criteria, is vomiting of at least 3 months, which need not be consecutive, in the preceding year with at least three separate vomiting episodes in a week. It is found in the absence of obvious metabolic, structural, or psychiatric disorders which could explain the vomiting (Table 1). It will be the purpose of this article to review the history of chronic vomiting from a nomenclature perspective. Methodologic limitations of early studies will be described as well as more contemporary reviews that used updated methodologic approaches to describe this perplexing problem.

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“…These studies are outlined in Table 2. The largest of these studies was conducted by Wilbur in 1938 [1]. He reported on 140 patients with what he described as "nervous vomiting."…”

Section: Historical Backgroundmentioning

confidence: 99%

“…Eighty percent of these patients were women, and the mean age was 28 years. Wilbur described an "abnormal mental state" in 26% of the patients; however, he made no attempt to describe exactly what this finding meant [1].…”

Section: Historical Backgroundmentioning

confidence: 99%

Chronic nausea and vomiting: New insights and approach to treatment

Olden

Crowell²

2005

Curr Treat Options Gastro

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“…The patient had no prior medical history of neurologic disorders, metabolic and endocrine abnormalities, or usage of drugs or toxins. Psychogenic vomiting was a well-described clinical syndrome characterized by recurrent vomiting in the absence of demonstrable organic pathology [ 14 ]. Because the patient had a history of depression, the diagnosis of psychogenic vomiting complicated by spontaneous pneumomediastinum was made.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of abdominal pain: psychogenic vomiting complicated by spontaneous pneumomediastinum

Wang

Rao

et al. 2023

BMC Pulm Med

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Background Spontaneous pneumomediastinum (SPM) was defined by the appearance of free air in the mediastinum that was not preceded by trauma, surgery, or other medical procedures. Among the numerous manifestations of SPM, abdominal pain had seldom been described. Case presentation A 25-year-old man presented to the emergency department with nausea, vomiting, and abdominal pain for 7 days. The presenting clinical features and the radiological results were suggestive of psychogenic vomiting with spontaneous pneumomediastinum in a patient who suffered from abdominal pain. Conclusions The special feature of this case was the elucidation of a rare cause of abdominal pain, which should be differentiated in patients with vomiting combined with abdominal pain. The importance of this case was that its recognition may prevent unnecessary procedures to rule out or treat other causes of abdominal pain.

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“…Wilbur and Washburn (2), in a review of 140 cases, found that vomiting that usually appeared without effort, nausea or important abdominal symptoms and within an hour after meals was typically functional. This was confirmed in the cases examined by the author.…”

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confidence: 99%

Psychogenic Vomiting

Leibovich¹

1973

Psychother Psychosom

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This paper reports on the clinical picture of the psychophysiologic disorder of psychogenic vomiting. This term is applied when it is the result of an emotional upset or of a more profound psychic disturbance, and only after no organic pathology was found. Especial emphasis is placed on the careful evaluation of various characteristics of the presenting symptom, i.e., accompanying manifestations, duration, time of day in which it occurs, stressing events related to the vomiting episode, patients’ motivation for psychiatric treatment, their ability to introspect, to verbalize their problems and emotions and their expectations from treatment. Since every variety of personality and every psychiatric disorder may show functional vomiting as a manifestation, the vomiting must be appraised in the context of a complete diagnostic work-up. Treatment will be different according to the various factors considered. For patients who principally present this psychophysiologic disorder, special psychotherapeutic tactics are suggested. The adherence to the tenet ‘treat the symptom, and the person as a whole will benefit’ is useful. The symptom is viewed as the fundamental step to develop the doctor-patient relationship. Special work is done in enabling the patient to become aware of his feelings, and to acknowledge the relationship between the emotions and the physical dysfunction. Clinical examples are described.

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Clinical Features and Treatment of Functional or Nervous Vomiting

Cited by 16 publications

References 1 publication

Chronic nausea and vomiting: New insights and approach to treatment

Chronic nausea and vomiting: New insights and approach to treatment

An unusual case of abdominal pain: psychogenic vomiting complicated by spontaneous pneumomediastinum

Psychogenic Vomiting

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