title: Nausea in Children With Functional Abdominal Pain Predicts Poor Health Outcomes in Young Adulthood.
abstract: OBJECTIVE
  Nausea is common among children with functional abdominal pain (FAP). We evaluated the relation of nausea to short- and long-term morbidity in pediatric patients with FAP.
  
  
  METHODS
  We performed a prospective study of 871 children with FAP (age, 8-17 y) seen in a pediatric gastroenterology practice; follow-up data were collected from 392 of the patients at 8.7 ± 3.3 years later. Participants were defined as having significant nausea if they reported nausea "a lot" or "a whole lot" within the past 2 weeks. Validated questionnaires assessed abdominal pain, gastrointestinal and somatic symptoms, and depression. Baseline measures, anxiety, and the Rome III criteria were assessed in the follow-up evaluation.
  
  
  RESULTS
  At baseline, 44.8% of the patients reported significant nausea. Those with nausea reported worse abdominal pain, gastrointestinal symptoms, somatic symptoms, and depression than those without nausea (P < .001 for all). When the children had reached young adulthood, those with nausea in childhood continued to have more severe gastrointestinal (P < .001) and somatic symptoms (P = .003) than patients without nausea in childhood, as well as higher levels of anxiety (P = .02) and depression (P = .02). In the follow-up evaluation, somatic symptoms, depression, and anxiety remained significant after controlling for baseline abdominal pain severity.
  
  
  CONCLUSIONS
  Pediatric patients with FAP and nausea have more severe short- and long-term gastrointestinal and somatic symptoms than patients with FAP without nausea, as well as reductions in mental health and daily function. Pediatric patients with FAP and nausea therefore need intensive treatment and follow-up evaluation.
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee. Electronic address: Alexandra.c.russell@vanderbilt.edu.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Russell
authors.affiliation: Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Stone
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
mesh_terms: D015746:Abdominal Pain; D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D003863:Depression / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000473:pathology*; D006304:Health Status; D006801:Humans; D008297:Male; D009325:Nausea; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Anxiety; Functional Gastrointestinal Disorder; Pediatric Nausea