The heart of the matter: Unexplained nausea may not be digestive issue

Article

Unexplained chronic nausea often is treated as a digestive entity, but a new study suggests that regulating heart rate and blood pressure may be a better approach in some cases. Read more to find out how fludrocortisone worked in reducing debilitating chronic nausea in young patients.

Unexplained chronic nausea can be debilitating for children and frustrating for the pediatricians who seek to treat it.

Now, a small study has found that the key may be regulating heart rate and blood pressure.

Fludrocortisone, commonly used to treat orthostatic intolerance (OI), was also shown to reduce debilitating chronic nausea in patients. The study, which said that unexplained chronic nausea affects up to 25% of US children, noted that treatment usually focuses on alleviating the gastrointestinal symptoms.

“There seems to be a connection between heart rate and blood pressure, and chronic nausea,” said John Fortunato, MD, assistant professor of pediatrics at Wake Forest Baptist and lead researcher. “When we treated the heart rate issues, the nausea was reduced.”

The retrospective study involved 17 patients, aged 11 to 17 years, who had suffered from unexplained nausea and dizziness for a year and had OI. After 4 weeks of treatment with fludrocortisone, 65% (11 out of 17) experienced at least 50% or greater improvement in nausea.

Fortunato said that he hopes to conduct a larger trial to confirm the small study’s results.

Go back to the current issue of the eConsult.

Newsletter

Access practical, evidence-based guidance to support better care for our youngest patients. Join our email list for the latest clinical updates.

Recent Videos
Lori Handy, MD on importance of vaccine catch-up before the school year | Image credit: CHOP
Richard Wong, DO, explains challenges children with asthma face in school
Infectious Insights | Image Credit: Contemporary Pediatrics
John Browning, MD, provides practical skincare reminders ahead of summer season
Potential downstream benefits of RSV preventive measures, with Octavio Ramilo, MD
Discussing phase 3 data of Panzyga for PANS, with Michael Daines, MD
Contemporary Pediatrics: RX Review: Updates and Unmet Need in RSV thumbnail
© 2025 MJH Life Sciences

All rights reserved.