title: Nausea and vomiting in gastroparesis: similarities and differences in idiopathic and diabetic gastroparesis.
abstract: BACKGROUND
  Nausea and vomiting are classic symptoms of gastroparesis. It remains unclear if characteristics of nausea and vomiting are similar in different etiologies of gastroparesis. The aims of this article were as follows: to describe characteristics of nausea and vomiting in patients with gastroparesis and to determine if there are differences in nausea and vomiting in diabetic (DG) and idiopathic gastroparesis (IG).
  
  
  METHODS
  Gastroparetic patients enrolling in the NIDDK Gastroparesis Registry underwent assessment with history and questionnaires assessing symptoms, quality of life, and a questionnaire characterizing nausea and vomiting.
  
  
  RESULTS
  Of 159 gastroparesis patients (107 IG, 52 DG), 96% experienced nausea, whereas 65% experienced vomiting. Nausea was predominant symptom in 28% and vomiting was predominant in 4%. Nausea was severe or very severe in 41%. PAGI-SYM nausea/vomiting subscore was greater with increased vomiting severity, but not nausea severity in DG than IG. Nausea was related to meals in 71%; lasting most of the day in 41%. Increasing nausea severity was related to decreased quality of life. Nausea often preceded vomiting in 82% of patients and vomiting often relieved nausea in 30%. Vomiting was more common in DG (81%) compared to IG (57%; p = 0.004). Diabetic patients more often had vomiting in the morning before eating, during the night, and when not eating.
  
  
  CONCLUSIONS
  Nausea is present in essentially all patients with gastroparesis irrespective of cause and associated with decreased quality of life. In contrast, vomiting was more prevalent, more severe, and occurred more often in DG than IG. Thus, characteristics of vomiting differ in IG vs DG.
authors.affiliation: Temple University, Philadelphia, PA, USA.
authors.forename: H P
authors.initials: HP
authors.lastname: Parkman
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: E K
authors.initials: EK
authors.lastname: Hallinan
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: W L
authors.initials: WL
authors.lastname: Hasler
authors.affiliation: Mayo Clinic, Rochester, MN, USA.
authors.forename: G
authors.initials: G
authors.lastname: Farrugia
authors.affiliation: Wake Forest University, Winston-Salem, NC, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Koch
authors.affiliation: Wake Forest University, Winston-Salem, NC, USA.
authors.forename: J
authors.initials: J
authors.lastname: Calles
authors.affiliation: California Pacific Medical Center, San Francisco, CA, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Snape
authors.affiliation: University of Louisville, Louisville, KY, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Abell
authors.affiliation: Texas Tech University, El Paso, TX, USA.
authors.forename: I
authors.initials: I
authors.lastname: Sarosiek
authors.affiliation: Texas Tech University, El Paso, TX, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: McCallum
authors.affiliation: Stanford University, Palo Alto, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Pasricha
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: J
authors.initials: J
authors.lastname: Clarke
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: L
authors.initials: L
authors.lastname: Miriel
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: L
authors.initials: L
authors.lastname: Lee
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: J
authors.initials: J
authors.lastname: Tonascia
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
authors.forename: F
authors.initials: F
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D012042:Registries; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*
keywords: Nausea; diabetic gastroparesis; gastric emptying; gastroparesis; vomiting