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


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.

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