Epidemiology of Nausea or Vomiting in the Olmsted County Population

Abstract

Purpose: Nausea and vomiting are very common and bothersome, but poorly understood clinical problems. Most studies have looked at the occurrence of nausea and vomiting in relation to pregnancy, post-chemotherapy, MI, etc. There are no reported studies on occurrence of nausea or vomiting in association with Irritable Bowel Syndrome (IBS). Aim: To estimate nausea or vomiting in Olmsted County population, and evaluate association between nausea or vomiting and age, gender, subset of Somatic Symptomatic Checklist (SSC), IBS, Proton Pump Inhibitors (PPI), Calcium Channel Blockers (CCB), Antidepressants and Narcotics. Methods: A prospective, population-based cohort of randomly selected community residents (n=8006) were mailed a validated self-report symptom questionnaire (Bowel Disease Questionnaire in 2008). Irritable Bowel Syndrome was defined according to Rome criteria. Questions regarding the presence of nausea or vomiting in the preceding one year and their frequency were contained in the questionnaire along with medication data and partial-SSC scores. The medical records of 150 randomly selected subjects from the study population were abstracted to record the presence of clinically recorded possible organic causes of nausea or vomiting in the preceding one year from the survey. Results: 3,567 subjects responded to the questionnaire and were divided into three groups: no nausea or vomiting group (Control) n=2316, infrequent nausea or vomiting group (Infrequent) n=902, and frequent nausea or vomiting group (Frequent) n=349. Amongst the 150 randomly selected subjects with 50 subjects from each group, positive association was detected for gender, SSC, IBS, narcotics and antidepressants in the frequent group as opposed to control group. Conclusion: IBS and SSC may be risk factors of nausea or vomiting but its causal relationship remains to be established. Antidepressants and narcotics are also strongly associated with nausea or vomiting.Table: Odds ratios of frequent and infrequent nausea or vomiting and associated factors