title: Prevalence of colonic motor or evacuation disorders in patients presenting with chronic nausea and vomiting evaluated by a single gastroenterologist in a tertiary referral practice.
abstract: BACKGROUND
  Nausea and vomiting are thought to result from upper gastrointestinal dysfunctions. Our clinical observations led to the hypothesis that colonic motor dysfunction is associated with nausea and vomiting.
  
  
  METHODS
  We reviewed electronic medical records (EMR) of 149 patients presenting with complaints of nausea and/or vomiting in a tertiary gastroenterology practice to investigate the association with disorders of colonic motor or evacuation disorders. We extracted demographics, gastric emptying (GE in 149) and colonic transit (CT in 138) of solids, ascending colon emptying half-time (AC t1/2 ), rectal evacuation by anorectal manometry (ARM) in 91 and balloon expulsion test (BE) in 55 patients. We estimated the proportions with delayed GE or CT, based on the 5th percentile of GE (in 319) and CT in 220 healthy volunteers using same method.
  
  
  RESULTS
  Among 11 patients with nausea and/or vomiting with only GE measured, five had delayed and six normal GE. Among the 149 patients, 77 (52%) patients had evacuation disorders, confirmed by objective tests in 68 patients, and clinical examination in nine patients. In the 138 patients with both GE and CT measured, 106 (76%) had both normal GE and CT, 11 (8%) only delayed GE, 16 (11%) normal GE with delayed CT, and five (3%) delayed GE and CT. Among 21 patients (15%) with delayed CT, nine had slow AC t1/2 and 12 evacuation disorder.
  
  
  CONCLUSIONS
  In patients with chronic nausea and/or vomiting in gastroenterology practice, evaluation of colonic motility and rectal evacuation should be considered, since about half the patients have abnormal functions that conceivably contribute to the presenting nausea and/or vomiting.
authors.affiliation: Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Kolar
authors.forename: M
authors.initials: M
authors.lastname: Camilleri
authors.forename: D
authors.initials: D
authors.lastname: Burton
authors.forename: A
authors.initials: A
authors.lastname: Nadeau
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003106:Colon / Q000473:pathology; D003109:Colonic Diseases, Functional / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D010820:Physicians / Q000592:standards; D015995:Prevalence; D012017:Referral and Consultation / Q000592:standards; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000592:standards; D014839:Vomiting / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult
keywords: colonic motility; nausea; rectal evacuation; vomiting