title: High prevalence of nausea in children with pain-associated functional gastrointestinal disorders: are Rome criteria applicable?
abstract: OBJECTIVE
  The aim of the study was to determine the prevalence of nausea in pediatric patients with pain-associated functional gastrointestinal disorders (FGIDs), examine the effect on social and school functioning, and examine the applicability of pediatric Rome III criteria.
  
  
  METHODS
  A total of 221 pediatric patients (6-18 years of age) with chronic abdominal pain prospectively completed a demographic, history, and gastrointestinal symptom questionnaire adapted from the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS). The 6-item, revised Pediatric Migraine Disability Assessment Score tool was used to assess the effect of symptoms on school, home, and social disability. Rome III criteria were applied to all subjects.
  
  
  RESULTS
  A total of 183 patients with pain and nausea for a minimum of 2 months were identified. Ninety-six patients were studied after excluding those with vomiting and/or organic disease. Among these, 53% had nausea at least 2 times per week and 28% experienced daily nausea. Frequency of nausea was significantly correlated with poor school and social functioning, and uniquely predicted social disability beyond pain. Although 87% met adult Rome criteria for functional dyspepsia, only 29% met corresponding pediatric Rome criteria. Additionally, 22% met the criteria for irritable bowel syndrome (IBS)-diarrhea, 13% for IBS-constipation, 13% for abdominal migraine, and 31% were classified as having functional abdominal pain. Pediatric IBS-diarrhea and IBS-constipation overlapped in 5% of patients.
  
  
  CONCLUSIONS
  Nausea is a prevalent symptom in patients with pain-associated FGIDs and correlates with poor school and social functioning. There is substantial overlap among FGIDs in children with nausea.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Katja
authors.initials: K
authors.lastname: Kovacic
authors.forename: Sara
authors.initials: S
authors.lastname: Williams
authors.forename: B U K
authors.initials: BU
authors.lastname: Li
authors.forename: Gisela
authors.initials: G
authors.lastname: Chelimsky
authors.forename: Adrian
authors.initials: A
authors.lastname: Miranda
mesh_terms: D015746:Abdominal Pain / Q000150:complications; D000293:Adolescent; D002648:Child; D003248:Constipation / Q000150:complications; D003967:Diarrhea / Q000150:complications; D004415:Dyspepsia / Q000150:complications*; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications*; D006801:Humans; D007398:Interpersonal Relations; D043183:Irritable Bowel Syndrome / Q000150:complications*; D008297:Male; D008881:Migraine Disorders / Q000150:complications*; D009325:Nausea / Q000453:epidemiology / Q000209:etiology*; D010146:Pain / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000150:complications; D011795:Surveys and Questionnaires