Literature DB >> 21397732

Characteristics of patients with chronic unexplained nausea and vomiting and normal gastric emptying.

Pankaj J Pasricha1, Ryan Colvin, Katherine Yates, William L Hasler, Thomas L Abell, Aynur Unalp-Arida, Linda Nguyen, Gianrico Farrugia, Kenneth L Koch, Henry P Parkman, William J Snape, Linda Lee, James Tonascia, Frank Hamilton.   

Abstract

BACKGROUND & AIMS: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics.
METHODS: We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry.
RESULTS: Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period.
CONCLUSIONS: Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature--it might be a separate clinical entity.
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21397732      PMCID: PMC3123425          DOI: 10.1016/j.cgh.2011.03.003

Source DB:  PubMed          Journal:  Clin Gastroenterol Hepatol        ISSN: 1542-3565            Impact factor:   11.382


  27 in total

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5.  Assessment of gastric emptying using a low fat meal: establishment of international control values.

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  76 in total

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