Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying

Pankaj Jay Pasricha, Ryan Colvin, Katherine Yates, William L. Hasler, Thomas L. Abell, Aynur Ünalp-Arida, Linda Nguyen, Gianrico Farrugia, Kenneth L. Koch, Henry P. Parkman, William J. Snape, Linda A Lee, James A Tonascia, Frank Hamilton

Research output: Contribution to journalArticle

Abstract

Background & Aims: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics. Methods: We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry. Results: Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period. Conclusions: Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature-it might be a separate clinical entity.

Original languageEnglish (US)
Pages (from-to)567-576
Number of pages10
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number7
DOIs
StatePublished - Jul 2011

Fingerprint

Gastric Emptying
Nausea
Gastroparesis
Vomiting
Meals
Stomach
National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
Anxiety
Patient Acceptance of Health Care
Appetite
Registries
Emotions
Fats
Quality of Life
Depression
Research

Keywords

  • Digestion
  • GCSI
  • PAGI-QOL
  • PAGI-SYM

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying. / Pasricha, Pankaj Jay; Colvin, Ryan; Yates, Katherine; Hasler, William L.; Abell, Thomas L.; Ünalp-Arida, Aynur; Nguyen, Linda; Farrugia, Gianrico; Koch, Kenneth L.; Parkman, Henry P.; Snape, William J.; Lee, Linda A; Tonascia, James A; Hamilton, Frank.

In: Clinical Gastroenterology and Hepatology, Vol. 9, No. 7, 07.2011, p. 567-576.

Research output: Contribution to journalArticle

Pasricha, PJ, Colvin, R, Yates, K, Hasler, WL, Abell, TL, Ünalp-Arida, A, Nguyen, L, Farrugia, G, Koch, KL, Parkman, HP, Snape, WJ, Lee, LA, Tonascia, JA & Hamilton, F 2011, 'Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying', Clinical Gastroenterology and Hepatology, vol. 9, no. 7, pp. 567-576. https://doi.org/10.1016/j.cgh.2011.03.003
Pasricha, Pankaj Jay ; Colvin, Ryan ; Yates, Katherine ; Hasler, William L. ; Abell, Thomas L. ; Ünalp-Arida, Aynur ; Nguyen, Linda ; Farrugia, Gianrico ; Koch, Kenneth L. ; Parkman, Henry P. ; Snape, William J. ; Lee, Linda A ; Tonascia, James A ; Hamilton, Frank. / Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying. In: Clinical Gastroenterology and Hepatology. 2011 ; Vol. 9, No. 7. pp. 567-576.
@article{a3e01ccdcf414eee8f566d757a162280,
title = "Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying",
abstract = "Background & Aims: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics. Methods: We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry. Results: Among the patients, 319 (75{\%}) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period. Conclusions: Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature-it might be a separate clinical entity.",
keywords = "Digestion, GCSI, PAGI-QOL, PAGI-SYM",
author = "Pasricha, {Pankaj Jay} and Ryan Colvin and Katherine Yates and Hasler, {William L.} and Abell, {Thomas L.} and Aynur {\"U}nalp-Arida and Linda Nguyen and Gianrico Farrugia and Koch, {Kenneth L.} and Parkman, {Henry P.} and Snape, {William J.} and Lee, {Linda A} and Tonascia, {James A} and Frank Hamilton",
year = "2011",
month = "7",
doi = "10.1016/j.cgh.2011.03.003",
language = "English (US)",
volume = "9",
pages = "567--576",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Characteristics of Patients With Chronic Unexplained Nausea and Vomiting and Normal Gastric Emptying

AU - Pasricha, Pankaj Jay

AU - Colvin, Ryan

AU - Yates, Katherine

AU - Hasler, William L.

AU - Abell, Thomas L.

AU - Ünalp-Arida, Aynur

AU - Nguyen, Linda

AU - Farrugia, Gianrico

AU - Koch, Kenneth L.

AU - Parkman, Henry P.

AU - Snape, William J.

AU - Lee, Linda A

AU - Tonascia, James A

AU - Hamilton, Frank

PY - 2011/7

Y1 - 2011/7

N2 - Background & Aims: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics. Methods: We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry. Results: Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period. Conclusions: Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature-it might be a separate clinical entity.

AB - Background & Aims: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics. Methods: We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry. Results: Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period. Conclusions: Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature-it might be a separate clinical entity.

KW - Digestion

KW - GCSI

KW - PAGI-QOL

KW - PAGI-SYM

UR - http://www.scopus.com/inward/record.url?scp=79959339821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959339821&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2011.03.003

DO - 10.1016/j.cgh.2011.03.003

M3 - Article

C2 - 21397732

AN - SCOPUS:79959339821

VL - 9

SP - 567

EP - 576

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 7

ER -