Nausea Profile Research Articles

Somatic, emotional, and gastrointestinal symptom severity are increased among children and adolescents with COVID-19.

Post-infectious disorders of gut-brain interaction (PI-DGBI) have significant impact on children and adolescents. The effect of COVID-19 on PI-DGBI-associated symptoms in this population, however, is unknown. We performed electronic medical record searches to identify patients 8-17 years old with a SARS-CoV2 PCR test at Lurie Children's Hospital between November 2020 and March 2021 (cohort 1) and April-October 2021 (cohort 2). Questionnaires were administered to assess symptoms prior to and 3 months following the test. This included the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS), questionnaire of pediatric gastrointestinal symptoms-Rome IV, Nausea Profile (NP), dyspepsia symptom survey (DSS), nausea severity profile (NSP), and Pediatric Quality of Life Inventory (PedsQL). We grouped patients based on the presence of symptoms prior to COVID-19 test or the test result. One hundred and ninety-six parent(s) or guardian(s) in cohort 1 and 274 in cohort 2 completed surveys and self-reported their child's COVID-19 result. Cohort 1 had increased PEESS and DSS scores, lower PedsQL scores, and increased frequency of abdominal pain disorders among patients with symptoms prior to COVID-19 testing. Both cohorts had increased NP and NSP scores among patients with symptoms prior to COVID-19 testing that was highest among patients with a positive COVID-19 test. Abdominal pain and diarrhea prior to COVID-19 testing predicted higher NP scores. Among symptomatic COVID-19 tested children, we found increased severity of nausea-associated somatic, emotional, and gastrointestinal symptoms in the 3 months following the test that was most increased among patients with a positive COVID-19 test.

Higher Levels of Stress and Neuropsychological Symptoms Are Associated With a High Nausea Profile in Patients With Cancer Receiving Chemotherapy.

To evaluate differences in the severity of global, cancer-specific, and cumulative life stress, resilience, and common neuropsychological symptoms among four subgroups of patients with distinct chemotherapy-induced nausea (CIN) profiles. Adult patients with cancer (N = 1,343) receiving chemotherapy. Patients completed stress, resilience, and neuropsychological symptom severity measures. The Memorial Symptom Assessment Scale was used to assess CIN occurrence six times over two cycles of chemotherapy. Parametric and nonparametric statistics were used to evaluate differences among subgroups of patients with distinct CIN profiles. The high class had significantly higher levels of global, cancer-specific, and cumulative life stress; significantly higher levels of depression, anxiety, sleep disturbance, morning and evening fatigue, and pain; and lower levels of morning and evening energy and cognitive dysfunction. Clinicians need to evaluate CIN occurrence across each cycle of chemotherapy and assess patients for various types of stress and common neuropsychological symptoms.

Use of Cluster Analysis to Identify Subtypes of Pediatric Functional Nausea.

The aim of the study was to evaluate whether there are clinical subtypes in children with functional nausea based on comorbidities and responses to the Nausea Profile questionnaire. Patients from the Neurointestinal and Motility Program clinical registry at Lurie Children's Hospital were included if they met Rome IV criteria for functional nausea. Patients completed the Nausea Profile, a multidimensional measure of nausea with gastrointestinal, emotional, and somatic subscales. Comorbidities were assessed by chart review and self-report measures. Latent class analysis was used to identify patient groups based on comorbidities. To assess if model-identified groups were predictive of differences in nausea quality, Nausea Profile subscale means were compared between groups and used to predict group membership. Conversely, k-means analysis was used to divide the sample into groups based upon Nausea Profile subscale scores, to determine if identified groups had different comorbidities. Seventy-two patients (n = 53 girls) with a mean age (±SD) 14.5 ± 2.9 were included. Two clinical subtypes were identified based on comorbidities, with responses on the emotional subscale of the Nausea Profile predicting group membership (P < 0.04). When patients were grouped by nausea quality, the resulting clusters differed on psychiatric comorbidities (P < 0.001). Our findings support the existence of nausea subtypes within the broad diagnosis of functional nausea. One such subtype is an emotional predominant nausea supporting the notion that anxiety and depression constitute a subset of patients with nausea. Thus, patients may benefit from a treatment approach that integrates both GI assessment and psychiatric support in their care.

Функциональная тошнота и рвота у детей

The diagnoses «functional nausea» and «functional vomiting» were for the first time described in the structure of paediatric functional digestive disorders in the 2016 Rome IV criteria. The prevalence of functional nausea approximates 0.1–0.5%, functional vomiting – 0.6–1.4%. Functional nausea and vomiting arise from complex interactions between the gastrointestinal tract, the central and autonomic nervous systems. Furthermore, functional nausea is considered in the continuum of gastroparesis and is also associated with an increased mast cell density in the duodenal mucosa. Functional nausea and vomiting are clinical diagnoses that do not require additional testing. Sometimes, recommendations are to examine the nausea profile and the Baxter retching faces scale. No evidence of the efficacy of specific pharmacological and nonpharmacological methods of treating functional nausea and vomiting have been received by now. The use of antidepressants, metoclopramide, ondansetron and other drugs is considered. It is necessary to develop clinical guidelines on diagnosis and treatment of functional nausea and functional vomiting. Key words: functional nausea, functional vomiting, children, Rome IV criteria

Role of lactic acidosis as a mediator of sprint-mediated nausea.

This study aims to determine whether there is a relationship between nausea level and lactic acidosis during recovery from sprinting. In all, 13 recreationally active males completed a 60 s bout of maximal intensity cycling. Prior to and for 45 min following exercise, blood pH, pCO2, and lactate levels were measured together with nausea. In response to sprinting, nausea, lactate, and H+ concentrations increased and remained elevated for at least 10 min (p < .001), whereas pCO2 increased only transiently (p < .001) before falling below pre‐exercise levels (p < .001), with all these variables returning toward pre‐exercise levels during recovery. Both measures of nausea adopted for analyses (nausea profile, NP; visual analogue scale, VAS), demonstrated significant repeated measures correlation (rmcorr) post‐exercise between nausea and plasma lactate (VAS and NPrrm> 0.595, p < .0001) and H+ concentrations (VAS and NPrrm> 0.689, p < .0001), but an inconsistent relationship with pCO2 (VAS rrm = 0.250, p = .040; NP rrm = 0.144, p = .248) and bicarbonate levels (VAS rrm = −0.252, p = .095; NP rrm = −0.397, p = .008). Linear mixed modeling was used to predict the trajectory of nausea over time, with both lactate and H+ concentrations found to be key predictors of nausea (p < .0001). In conclusion, this study reveals a strong positive relationship between nausea and both H+ and lactate concentrations during recovery from sprinting, a finding consistent with H+ and lactate being potential mediators of nausea post‐sprinting. However, as the timing of the recovery of both H+ and lactate was delayed, compared to that of nausea, further research is required to confirm these findings and investigate other potential mechanisms.

Nausea exacerbates symptom burden, quality of life, and functioning in adolescents with functional abdominal pain disorders.

Nausea frequently co-exists with functional abdominal pain disorders (FAPDs) and may be linked to a higher disease burden. This study aimed to prospectively compare multisystem symptoms, quality of life, and functioning in FAPDs with and without nausea. Adolescents ages 11-18years fulfilling Rome III criteria for a FAPD were grouped by the presence or absence of chronic nausea. Subjects completed validated instruments assessing nausea (Nausea Profile Questionnaire=NPQ), quality of life (Patient-Reported Outcome Measurement Information System), functioning (Functional Disability Inventory), and anxiety (State-Trait Anxiety Inventory for Children). Group comparisons were performed for instruments, multisystem symptoms, school absences, and clinical diagnoses. A total of 112 subjects were included; 71% reported chronic nausea. Patients with Nausea compared to No Nausea had higher NPQ scores (P≤0.001), worse quality of life (P=0.004), and greater disability (P=0.02). State and trait anxiety scores were similar (P=0.57, P=0.25). A higher NPQ score correlated with poorer quality of life, more disability, and higher anxiety. Specific comorbidities were more common in Nausea vs No Nausea group: dizziness (81% vs 41%; P≤0.001), concentrating difficulties (68% vs 27%; P≤0.001), chronic fatigue (58% vs 20%; P=0.01), and sleep disturbances (73% vs 48%; P=0.02). The Nausea group reported more school absences (P=0.001) and more commonly met criteria for functional dyspepsia (P=0.034). Nausea co-existing with FAPDs is associated with a higher extra-intestinal symptom burden, worse quality of life, and impaired functioning in children. Assessing and targeting nausea therapeutically is essential to improve outcomes in FAPDs.

Chronic nausea and orthostatic intolerance: Diagnostic utility of orthostatic challenge duration, Nausea Profile Questionnaire, and neurohumoral measures.

Chronic nausea in pediatrics is a debilitating condition with unclear etiology. We aimed to define hemodynamic and neurohumoral characteristics of chronic nausea associated with orthostatic intolerance in order to improve identification and elucidate mechanism. Children (10-18years) meeting Rome III criteria for functional dyspepsia with nausea and symptoms of orthostatic intolerance (OI) completed a Nausea Profile Questionnaire followed by prolonged (45minutes rather than the traditional 10minutes) head-upright tilt (HUT) (70° tilt up) test. Circulating catecholamines, vasopressin, aldosterone, renin, and angiotensins were measured supine and after 15minutes into HUT. Beat-to-beat heart rate and blood pressure were continuously recorded to calculate their variability and baroreflex sensitivity. Within 10 and 45minutes of HUT, 46% and 85% of subjects, respectively, had an abnormal tilt test (orthostatic hypotension, postural orthostatic tachycardia, or syncope). At 15 and 45minutes of HUT, nausea was elicited in 42% and 65% of subjects respectively. Higher Nausea Profile Questionnaire scores correlated with positive HUT testing at 10minutes (P=0.004) and baroreflex sensitivity at 15minutes (P≤0.01). Plasma vasopressin rose 33-fold in subjects with HUT-induced nausea compared to twofold in those who did not experience HUT-induced nausea (P<0.01). In children with chronic nausea and OI, longer duration HUT elicited higher frequency of abnormal tilt testing and orthostatic-induced nausea. The Nausea Profile Questionnaire predicted the orthostatic response to tilt testing. Exaggerated vasopressin release differentiated patients with HUT-induced nausea (vs those without nausea), suggesting a possible mechanism for chronic nausea in childhood.

Meta-analysis of trials comparing standard antiemetic treatment (SAT) with aprepitant containing antiemetic regimens (ACAR) for prevention of chemotherapy-induced nausea and vomiting (CINV).

171 Background: Various randomized controlled trials (RCTs) have shown improved outcomes with addition of aprepitant to standard antiemetic treatment (SAT) in preventing CINV. We conducted a meta-analysis to study the overall impact of ACAR in CINV prevention in adults. Methods: We searched Pubmed and Ovid databases, and American Society of Clinical Oncology meetings abstracts for RCTs using ACAR with SAT for CINV prevention in adult cancer patients (pts). Major study end points were complete response to treatment (CR; defined as no emesis and no use of rescue medications) in overall phase (OP; 0-120 hours of chemotherapy), acute phase (AP; 0-24 hours) and delayed phase (DP; 24-120 hours). Additionally, we assessed the control of nausea and toxicity profile (TP). Stouffer's Z-score method was used to calculate the overall effect. Results: 16 RCTs (5,547 pts) were included. 11 trials (3,314 pts) involved highly emetogenic chemotherapy (HEC) and 5 trials (2,233 pts) involved moderately emetogenic chemotherapy (MEC). ACAR increased CR in OP from 47% to 63% (OR=0.52, CI=0.46 to 0.58; p&lt;0.001), in AP from 73% to 81% (p&lt;0.01), and in DP from 51% to 66% (p&lt;0.001). Significant increase in nausea control was seen in DP (p=0.03) but not in OP or AP. Incidence of various toxicities was statistically similar in both groups except slightly higher rate of fatigue (p=0.02) and hiccups (p&lt;0.001), and lower rate of neutropenia (p=0.02) in ACAR. Conclusions: ACAR is effective in CINV due to both HEC and MEC in adult cancer pts. ACAR improves the control of emesis in all phases, and nausea in delayed phase only. With the exception of causing more fatigue &amp; hiccups, and lesser neutropenia, overall TP of ACAR is similar to SAT.

Effects of overshadowing on conditioned and unconditioned nausea in a rotation paradigm with humans.

We examine whether overshadowing by salient stimuli is effective in reducing the ability of a certain environment (the putative conditioned stimulus) to evoke conditioned nausea in healthy humans that experience nausea-evoking rotation (as the unconditioned stimulus, US) in that environment. Twenty-four rotation-susceptible subjects (12 males, 12 females) were randomly assigned to receive either overshadowing by salient tasting beverages (OS+), or a control treatment (a familiar beverage, water; OS-) prior to rotation on three consecutive days (acquisition). To control for taste experiences, the alternative beverage was consumed 12h later in the home environment (OS+: water, OS-: salient beverage). At Day 4 (test), all subjects drank the familiar beverage (water) prior to rotation (US). Rotation was standardized as 2×1-min rotation/day. Nausea was determined by a 7-item symptom scale measuring symptom number (SN) prior to (anticipatory), immediately after, and 15 and 30min after rotation and by the Nausea Profile (NP) questionnaire immediately after rotation. Cortisol and tumour necrosis factor (TNF)-α in saliva were sampled at the same time-points. SN and cortisol were also measured at home. Overshadowing reduced anticipatory (conditioned) SN. Post-rotation nausea (i.e. the unconditioned response) measured by the NP decreased within the OS+ group only. Anticipatory cortisol and TNF-α were not affected by overshadowing. Treatment × gender interactions manifested for post-rotation cortisol and TNF-α. Groups did not differ in SN and cortisol at home. Overshadowing is effective in reducing symptoms of anticipatory nausea and rotation-induced unconditioned nausea; its effect on endocrine and immunological parameters is gender specific. Its application in alleviation of anticipatory nausea in cancer patients is considered.

Relationship among nausea, anxiety, and orthostatic symptoms in pediatric patients with chronic unexplained nausea.

This study evaluated the relationship among nausea, anxiety, and orthostatic symptoms in pediatric patients with chronic unexplained nausea. We enrolled 48 patients (36 females) aged 15 ± 2 years. Patients completed the Nausea Profile, State-Trait Anxiety Inventory for Children and underwent 70° head upright tilt testing (HUT) to assess for orthostatic intolerance (OI) and measure heart rate variability (HRV). We found nausea to be significantly associated with trait anxiety, including total nausea score (r = 0.71, p < 0.01) and 3 subscales: somatic (r = 0.64, p < 0.01), gastrointestinal (r = 0.48, p = 0.01), and emotional (r = 0.74, p < 0.01). Nausea was positively associated with state anxiety, total nausea (r = 0.55, p < 0.01), somatic (r = 0.48, p < .01), gastrointestinal (r = .30, p < .05), and emotional (r = .64, p < .01) subscales. Within 10 min of HUT, 27 patients tested normal and 21 demonstrated OI. After 45 min of HUT, only 13 patients (27%) remained normal. Nausea reported on the Nausea Profile before HUT was associated with OI measured at 10 min of tilt (nausea total r = 0.35, p < 0.05; nausea emotional subscale r = 0.40, p < 0.01) and lower HRV at 10 min of HUT (F = 6.39, p = 0.01). We conclude that nausea is associated with both anxiety symptoms and OI. The finding of decreased HRV suggests an underlying problem in autonomic nervous system function in children and adolescents with chronic unexplained nausea.

Characteristics of Nausea and Its Effects on Quality of Life in Diabetic and Idiopathic Gastroparesis

Nausea is a common symptom of gastroparesis (GP). The study is to determine the manifestations and impact of nausea in GP and to determine if there are any differences in diabetic (DG) and idiopathic gastroparesis (IG). The patients referred for GP symptoms underwent gastric emptying scintigraphy and completed the Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM), Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL), SF-36v2 Health-Related Quality-of-Life survey, and the Nausea Profile (NP). Fifty-nine GP patients (20 diabetic, 39 idiopathic; 52 female; mean age 43 y) with delayed gastric emptying were enrolled. Nausea was an important symptom in these patients as assessed by PAGI-SYM (2.3±0.2) and it correlated with worse quality of life by PAGI-QOL (r=-0.299; P=0.021). The nausea and vomiting scores were similar in DG and IG, but DG had more severe retching (2.6±0.3 vs. 1.4±0.3; P=0.02) and more episodes of vomiting per week (4.4±1.4 vs. 3.5±1.3; P=0.037) compared with IG. Using the NP, total nausea scores in DG (61±3) were found to be greater than IG (49 (3; P=0.03) with somatic distress scores (60±5 vs. 44±4; P=0.03), and the gastrointestinal (GI) distress scores (84±4 vs. 73±4; P=0.05) were found to be greater in DG than IG. Although DG had slower gastric emptying than IG, there was no significant correlation between the NP scores and the degree of gastric retention on gastric emptying scintigraphy. Nausea and vomiting symptoms correlate with worse quality of life in GP patients. The DG patients experience greater nausea and increased somatic distress than IG. The differential perception of nausea in DG versus IG might be because of distinct pathophysiologic mechanisms.

Susceptibility to Nausea and Motion Sickness as a Function of the Menstrual Cycle

The present study examined whether susceptibility to nausea and other symptoms of vection-induced motion sickness vary as a function of phase of the menstrual cycle, as research findings in this area are sparse and contradictory. Ninety young women (42 current users of oral contraceptives) were exposed to a rotating optokinetic drum during the peri-menses or peri-ovulatory phase of the menstrual cycle in an independent-groups, quasi-experimental design. Nausea and motion sickness symptoms were assessed using the Nausea Profile (NP) and the Subjective Symptoms of Motion Sickness (SSMS) questionnaire. Among women not on oral contraceptives, reports of nausea and motion sickness by women in the peri-menses phase were more severe than reports by women in the peri-ovulatory phase. By contrast, among women taking oral contraceptives, reports of nausea and motion sickness did not differ by the same categorical phase of the menstrual cycle. We speculate that fluctuating estrogen levels over the course of the menstrual cycle may influence the experience of or susceptibility to nausea and motion sickness during illusory self-motion and other nauseogenic contexts.

Measuring Nausea in the Emergency Department: A Prospective Observational Study Utilizing Factor Analysis to Evaluate an Emergency Department Nausea Profile

Measuring Nausea in the Emergency Department: A Prospective Observational Study Utilizing Factor Analysis to Evaluate an Emergency Department Nausea Profile

The contribution of expectations to motion sickness symptoms and gastric activity

Objective: The goal of this investigation was to determine in healthy adults the effect of expectation manipulations on the development of motion sickness, as indicated by abnormal gastric myoelectric activity and subjective reports of symptoms of motion sickness. Method: Eighty participants, moderately susceptible to motion sickness, experienced one of four conditions created from a two-variable (Expectation, Drum), two-factor model (High/Low expectation for sickness; Rotating/Stable Drum). The electrogastrogram (EGG) was recorded 6 min prior to the expectation manipulation; 6 min following the expectation manipulation; 6 min before drum activation; and 16 min during drum activation. Self-report questionnaires indicating expectation for sickness (MSEx) and motion sickness symptoms (Nausea Profile [NP]) were obtained following the expectation manipulation and exposure to the drum, respectively. Results: No significant differences were observed among expectation groups for retrospective reports of motion sickness (NP); however, significant differences in EGG responses to drum rotation were obtained. The unexpected results of a univariate analysis of variance (ANOVA) revealed significantly greater gastric tachyarrhythmia and less normal activity, an indication of motion sickness, in the low expectation for sickness conditions. Conclusion: These results suggest that inducing a high expectation for sickness in healthy individuals about to be exposed to provocative motion results in a protective effect from motion sickness following exposure to the stimulus, while low expectations may induce abnormal gastric activity.

Olfactory modulation of nausea during early pregnancy?

To investigate whether nausea and vomiting and olfactory sensitivity are correlated, we determined whether subjects with little or no nausea and vomiting are less sensitive to odours than subjects who indicate a high degree of nausea and vomiting, and whether subjects with relatively low olfactory sensitivity are less prone to nausea and vomiting than subjects with relatively higher olfactory sensitivity. Cross sectional study. The Unit of Perinatal Physiology, Department of Obstetrics, University Hospital, Zurich, Switzerland. Fifty-three women in early pregnancy. Following a detailed history related to olfaction and nausea and vomiting, subjects filled in a nausea profile which provided a 'general nausea score' comprised of the factors 'somatic distress', 'gastrointestinal distress', and 'emotional distress'. Olfactory function was assessed using pen-like odour dispensing devices ('sniffin' sticks'). Tests included n-butanol odour threshold, odour discrimination and odour identification. Olfactory function assessed by means of the sniffing sticks nausea profile. Correlational analyses between results of olfactory sensitivity and scores from the nausea questionnaire were not significant. Further, when subjects were divided into groups with relatively low or relatively high overall scores in the nausea profile, olfactory sensitivity did not differ between groups. Similarly, other analyses did not indicate a modulation of nausea and vomiting through olfactory sensitivity. These findings do not support the hypothesis that higher olfactory sensitivity relates to an increase of nausea. However, they do support the idea that olfactory-induced nausea is independent of subjectively perceived intensity. Olfactory-induced nausea appears to be due to the cognitive processing of olfactory information which, in early pregnancy, is reported to be altered in an unsystematic fashion.

Olfactory modulation of nausea during early pregnancy?

Objectives To investigate whether nausea and vomiting and olfactory sensitivity are correlated, we determined whether subjects with little or no nausea and vomiting are less sensitive to odours than subjects who indicate a high degree of nausea and vomiting, and whether subjects with relatively low olfactory sensitivity are less prone to nausea and vomiting than subjects with relatively higher olfactory sensitivity. Design Cross sectional study. Setting The Unit of Perinatal Physiology, Department of Obstetrics, University Hospital, Zurich, Switzerland. Population Fifty-three women in early pregnancy. Methods Following a detailed history related to olfaction and nausea and vomiting, subjects filled in a nausea profile which provided a ‘general nausea score’ comprised of the factors ‘somatic distress’, ‘gastrointestinal distress’, and ‘emotional distress’. Olfactory function was assessed using pen-like odour dispensing devices (‘sniffin' sticks’). Tests included n-butanol odour threshold, odour discrimination and odour identification. Main outcome measures Olfactory function assessed by means of the sniffing sticks nausea profile. Results Correlational analyses between results of olfactory sensitivity and scores from the nausea questionnaire were not significant. Further, when subjects were divided into groups with relatively low or relatively high overall scores in the nausea profile, olfactory sensitivity did not differ between groups. Similarly, other analyses did not indicate a modulation of nausea and vomiting through olfactory sensitivity. Conclusions These findings do not support the hypothesis that higher olfactory sensitivity relates to an increase of nausea. However, they do support the idea that olfactory-induced nausea is independent of subjectively perceived intensity. Olfactory-induced nausea appears to be due to the cognitive processing of olfactory information which, in early pregnancy, is reported to be altered in an unsystematic fashion.

Is nausea associated with chronic hepatitis C infection?

Hepatitis C virus is a common chronic infection that is widely associated with symptoms of fatigue and pain in the right upper quadrant. Nausea may be an underrecognized symptom. This study was designed to study the frequency of nausea in patients with hepatitis C virus infection compared to controls. A cross-sectional study design with consecutive outpatients was used. Three groups were administered a dyspepsia and a previously validated Nausea Profile questionnaire. Univariate and multivariate analysis was performed. A total of 64 hepatitis C virus (HCV) patients, 53 liver disease controls (LC), and 64 normal controls (NC) were studied. An increased period prevalence of nausea was found in HCV patients 43% versus 29.7% in NC and 18.9% in LC (p = 0.009). There was an increased frequency of fatigue and abdominal pain in HCV patients over 1 month compared to LC and NC combined (p = 0.0001 and 0.0065 respectively). The Nausea Profile score revealed statistically higher total scores and higher subscale scores in the HCV group compared to controls. The total NP score expressed as a percentage of the maximum was 27% in HCV versus 12.7% for LC and 9.2% for NC (p = 0.0005). The odds of nausea using logistic regression were 2.1 CI (1.0-4.5) in HCV patients compared to controls (p = 0.05). Using linear regression, higher Nausea Profile scores were found to be independently associated with the diagnosis of HCV (.0005), fatigue (p = 0.0003), and abdominal pain (p = 0.0001). HCV infection is associated with an increased risk for nausea. The strong association between abdominal pain and nausea may be a clue to the etiology of nausea in these patients. Further etiological studies are needed.

Is nausea associated with chronic hepatitis C infection?

OBJECTIVES: Hepatitis C virus is a common chronic infection that is widely associated with symptoms of fatigue and pain in the right upper quadrant. Nausea may be an underrecognized symptom. This study was designed to study the frequency of nausea in patients with hepatitis C virus infection compared to controls. METHODS: A cross-sectional study design with consecutive outpatients was used. Three groups were administered a dyspepsia and a previously validated Nausea Profile questionnaire. Univariate and multivariate analysis was performed. RESULTS: A total of 64 hepatitis C virus (HCV) patients, 53 liver disease controls (LC), and 64 normal controls (NC) were studied. An increased period prevalence of nausea was found in HCV patients 43% versus 29.7% in NC and 18.9% in LC ( p = 0.009). There was an increased frequency of fatigue and abdominal pain in HCV patients over 1 month compared to LC and NC combined ( p = 0.0001 and 0.0065 respectively). The Nausea Profile score revealed statistically higher total scores and higher subscale scores in the HCV group compared to controls. The total NP score expressed as a percentage of the maximum was 27% in HCV versus 12.7% for LC and 9.2% for NC ( p = 0.0005). The odds of nausea using logistic regression were 2.1 CI (1.0–4.5) in HCV patients compared to controls ( p = 0.05). Using linear regression, higher Nausea Profile scores were found to be independently associated with the diagnosis of HCV (.0005), fatigue ( p = 0.0003), and abdominal pain ( p = 0.0001). CONCLUSIONS: HCV infection is associated with an increased risk for nausea. The strong association between abdominal pain and nausea may be a clue to the etiology of nausea in these patients. Further etiological studies are needed.

Assessment of the multiple dimensions of nausea: The Nausea Profile (NP)

Nausea, unlike emesis, is a subjective experience that is difficult to describe to others, be they clinicians or researchers. Previous research has been limited to examining the frequency, severity, and duration of nausea. The goal of this study was to design a questionnaire that would allow for the evaluation of the characteristics of nausea across individuals and situations. This study consisted of 4 stages: descriptors were generated, categorized into 3 dimensions, and reevaluated to verify their reliability; in the final stage, the developed checklist was compared to a visual-analogue-scale (VAS) report of nausea in subjects exposed to a rotating optokinetic drum to stimulate nausea. The overall nausea checklist score and the VAS score were highly correlated ( r=0.71, p<0.01). The development and use of the nausea checklist are discussed.