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

• Published in: Neurogastroenterology and motility 2019-07, Vol.31 (7), p.e13595-n/a
• Main Authors: Kovacic, Katja, Kapavarapu, Prasanna K., Sood, Manu R., Li, B U. K., Nugent, Melodee, Simpson, Pippa, Miranda, Adrian
• Format: Article
• Language: English
• Subjects: Abdominal Pain - complications; Abdominal Pain - psychology; Adolescent; Adolescents; Anxiety; Children; Chronic Disease; chronic nausea; disability; Dyspepsia; Female; functional abdominal pain disorders; Gastrointestinal Diseases - complications; Humans; Information systems; Intestine; Male; Nausea; Nausea - etiology; Nausea - psychology; Pain; Quality of Life; Sleep
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.13595

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. This prospective study documents that chronic nausea co‐existing with functional abdominal pain disorders is associated with a higher extra‐intestinal symptom burden, worse quality of life, and impaired functioning in children. Specifically, addressing nausea therapeutically is essential to improve outcomes.