title: Chronic idiopathic nausea of childhood.
abstract: OBJECTIVE
  To compare children with primary, chronic idiopathic nausea to those with secondary nausea associated with functional abdominal pain.
  
  
  METHODS
  Retrospective chart review of 45 children with a primary complaint of chronic nausea several times per week. Comparisons were made to prospectively collected data on 49 children with functional abdominal pain and comorbid nausea.
  
  
  RESULTS
  The majority of those affected were adolescent Caucasian females. Subjects with chronic nausea had a more severe presentation with daily 88% (vs 26%) and constant 60% (vs 10%) nausea (P < .001), one-half with peak morning intensity. In the chronic nausea group, 62% had migraines, and 71% (vs 22%) had familial migraines (P < .001), 36% had postural tachycardia syndrome and 27% cyclic vomiting syndrome. Both groups suffered comorbid symptoms (anxiety, dizziness, fatigue, and sleep problems). The chronic nausea cohort underwent extensive, negative medical evaluations.
  
  
  CONCLUSIONS
  Chronic idiopathic nausea of childhood is a poorly described symptom. Patients with primary (vs secondary) chronic nausea were more likely Caucasian, older adolescent females with severe, daily nausea and comorbid conditions such as anxiety, dizziness, and fatigue as well as significantly more migraine features. Chronic nausea is a major, disabling symptom that requires increased recognition as a separate functional entity. Future studies may need to focus on comorbid conditions including migraine and dysautonomia.
authors.affiliation: Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI. Electronic address: kkovacic@mcw.edu.
authors.forename: Katja
authors.initials: K
authors.lastname: Kovacic
authors.affiliation: Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Adrian
authors.initials: A
authors.lastname: Miranda
authors.affiliation: Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Gisela
authors.initials: G
authors.lastname: Chelimsky
authors.affiliation: Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Sara
authors.initials: S
authors.lastname: Williams
authors.affiliation: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Pippa
authors.initials: P
authors.lastname: Simpson
authors.affiliation: Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: B U K
authors.initials: BU
authors.lastname: Li
mesh_terms: D015746:Abdominal Pain / Q000150:complications* / Q000523:psychology; D000293:Adolescent; D000639:Amitriptyline / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001007:Anxiety / Q000150:complications; D002648:Child; D002908:Chronic Disease; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000150:complications; D009325:Nausea / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012702:Serotonin Antagonists / Q000627:therapeutic use; D012720:Severity of Illness Index
chemical_list: D000929:Antidepressive Agents, Tricyclic; D054328:Proton Pump Inhibitors; D012702:Serotonin Antagonists; D000639:Amitriptyline