The etiology and management of gagging: A review of the literature

Psychosocial characteristics of adults who experience difficulties with retching

“…This marked cognitive component reported in relation to retching, supports the use of a cognitive behavioural approach in the management of this type of difficulty. As Bassi et al 2 discuss, a fear of choking, for example on impression material, water, or a dental instrument, is commonly expressed by patients who gag. Learning to generate alternative and more realistic beliefs can alter the level of anxiety or fear experienced, as can the use of relaxed breathing, imagery and other meditative techniques.…”

“…Retching has been described as being multifactorial in origin, with four main factors cited as being important in this respect: (1) local and systemic disorders; (2) anatomic factors; (3) psychological factors; (4) iatrogenic factors. 2 Obtaining a good in-depth medical history from the patient can provide important information in respect of the first two factors. A number of studies have described techniques, which might be helpful in the management of retching.…”

“…[3][4][5][6][7] However, there continue to be significant gaps in the literature, particularly in relation to psychosocial factors that might be predictive of this type of difficulty. A comprehensive and seminal review of the literature on the aetiology and management of retching was conducted by Bassi et al 2 in 2004. This reviewed peerreviewed articles from the years 1940-2002 and provides a summary of the assessment and behavioural techniques, which have been used in the management of retching.…”

The Effect of Gag Reflex on Cardiac Sympatovagal Tone

“…In some cases nontactile (visual, auditory, and olfactory) stimuli or some emotions can also trigger this reflex. 1 Different visceral afferents can affect the cardiac sympatovagal balance. Nucleus tractus solitarious receives these signals, integrates them and sends efferent commands to the cardiovascular system.…”

“…5 Gagging may also be accompanied by unpleasant sensation and can lead to fainting, panic attack or nausea. 1 There are few reports regarding the cardiac manifestation of gag reflex which potentially may be important in severe gagging, so the effect of gag reflex on heart velocity and sympatovagal tone of sinus node was studied.…”