Chronic Idiopathic Nausea of Childhood

• Published in: The Journal of pediatrics Vol. 164; no. 5; pp. 1104 - 1109
• Main Authors: Kovacic, Katja, Miranda, Adrian, Chelimsky, Gisela, Williams, Sara, Simpson, Pippa, Li, B U.K.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2014
• Subjects: Abdominal Pain - complications; Abdominal Pain - psychology; Adolescent; Amitriptyline - therapeutic use; Antidepressive Agents, Tricyclic - therapeutic use; Anxiety - complications; Child; Chronic Disease; Female; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - psychology; Humans; Male; Migraine Disorders - complications; Nausea - diagnosis; Nausea - drug therapy; Nausea - etiology; Nausea - psychology; Pediatrics; Proton Pump Inhibitors - therapeutic use; Retrospective Studies; Serotonin Antagonists - therapeutic use; Severity of Illness Index; CVS; GI; MRI; PMHx; AM; FGIDs; 5-HT3; AP; CT; CHW; FAP; FHx; POTS; 5-hydroxytryptamine; Children's Hospital of Wisconsin; Gastrointestinal; Family history; Abdominal migraine; Computed tomography; Functional gastrointestinal disorders; Cyclic vomiting syndrome; Magnetic resonance imaging; Postural tachycardia syndrome; Abdominal pain; 5-HT 3; Personal history; Functional abdominal pain
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2014.01.046

To compare children with primary, chronic idiopathic nausea to those with secondary nausea associated with functional abdominal pain. Retrospective chart review of 45 children with a primary complaint of chronic nausea several times per week. Comparisons were made to prospectively collected data on 49 children with functional abdominal pain and comorbid nausea. The majority of those affected were adolescent Caucasian females. Subjects with chronic nausea had a more severe presentation with daily 88% (vs 26%) and constant 60% (vs 10%) nausea (P < .001), one-half with peak morning intensity. In the chronic nausea group, 62% had migraines, and 71% (vs 22%) had familial migraines (P < .001), 36% had postural tachycardia syndrome and 27% cyclic vomiting syndrome. Both groups suffered comorbid symptoms (anxiety, dizziness, fatigue, and sleep problems). The chronic nausea cohort underwent extensive, negative medical evaluations. Chronic idiopathic nausea of childhood is a poorly described symptom. Patients with primary (vs secondary) chronic nausea were more likely Caucasian, older adolescent females with severe, daily nausea and comorbid conditions such as anxiety, dizziness, and fatigue as well as significantly more migraine features. Chronic nausea is a major, disabling symptom that requires increased recognition as a separate functional entity. Future studies may need to focus on comorbid conditions including migraine and dysautonomia.