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. 2019 Jul;31(7):e13595.
doi: 10.1111/nmo.13595. Epub 2019 Apr 7.

Nausea exacerbates symptom burden, quality of life, and functioning in adolescents with functional abdominal pain disorders

Katja Kovacic  1 , Prasanna K Kapavarapu  1 , Manu R Sood  1 , B U K Li  1 , Melodee Nugent  2 , Pippa Simpson  2 , Adrian Miranda  1
Affiliations

Nausea exacerbates symptom burden, quality of life, and functioning in adolescents with functional abdominal pain disorders

Katja Kovacic et al. Neurogastroenterol Motil. 2019 Jul.

Abstract

Background: Nausea frequently co-exists with functional abdominal pain disorders (FAPDs) and may be linked to a higher disease burden. This study aimed to prospectively compare multisystem symptoms, quality of life, and functioning in FAPDs with and without nausea.

Methods: Adolescents ages 11-18 years fulfilling Rome III criteria for a FAPD were grouped by the presence or absence of chronic nausea. Subjects completed validated instruments assessing nausea (Nausea Profile Questionnaire = NPQ), quality of life (Patient-Reported Outcome Measurement Information System), functioning (Functional Disability Inventory), and anxiety (State-Trait Anxiety Inventory for Children). Group comparisons were performed for instruments, multisystem symptoms, school absences, and clinical diagnoses.

Key results: A total of 112 subjects were included; 71% reported chronic nausea. Patients with Nausea compared to No Nausea had higher NPQ scores (P ≤ 0.001), worse quality of life (P = 0.004), and greater disability (P = 0.02). State and trait anxiety scores were similar (P = 0.57, P = 0.25). A higher NPQ score correlated with poorer quality of life, more disability, and higher anxiety. Specific comorbidities were more common in Nausea vs No Nausea group: dizziness (81% vs 41%; P ≤ 0.001), concentrating difficulties (68% vs 27%; P ≤ 0.001), chronic fatigue (58% vs 20%; P = 0.01), and sleep disturbances (73% vs 48%; P = 0.02). The Nausea group reported more school absences (P = 0.001) and more commonly met criteria for functional dyspepsia (P = 0.034).

Conclusion and inferences: Nausea co-existing with FAPDs is associated with a higher extra-intestinal symptom burden, worse quality of life, and impaired functioning in children. Assessing and targeting nausea therapeutically is essential to improve outcomes in FAPDs.

Keywords: chronic nausea; disability; functional abdominal pain disorders; quality of life.

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