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

Sally E. Tarbell*, Hossam A. Shaltout, Ashley L. Wagoner, Debra I. Diz, John E. Fortunato

*Corresponding author for this work

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2645-2650
Number of pages6
JournalExperimental Brain Research
Volume232
Issue number8
DOIs
StatePublished - Jan 1 2014

Keywords

  • Anxiety
  • Autonomic dysfunction
  • Functional gastrointestinal disorders
  • Heart rate variability
  • Nausea
  • Orthostatic intolerance

ASJC Scopus subject areas

  • Neuroscience(all)

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