Sensory neuromodulators in functional nausea and vomiting: predictors of response.

Journal Article (Journal Article)

BACKGROUND: Tricyclic antidepressants (TCAs) are known to benefit subjects with functional nausea and vomiting (FNV), but it is not known if alternate neuromodulators are also beneficial. We retrospectively evaluated outcomes and clinical predictors of response in FNV subjects treated with any neuromodulator, including TCAs. METHODS: We identified 94 subjects (43.8±1.4 year, 79 F) with FNV (Rome III criteria) over a 12 year period, treated with neuromodulators and followed up for 8.5±1.1 months. Clinical presentation, demographics and gastric emptying study (GES) findings (when available) were extracted. Likert scales determined symptom severity at baseline and symptom response or remission at follow-up. Outcomes and predictors of response were evaluated using univariate and multivariate analyses. RESULTS: At least moderate symptom improvement was reported by 72.3%, and 22.3% had symptom remission. Proportions achieving moderate improvement and remission, and mean outcome Likert scores were similar regardless of neuromodulator agent used or GES status. On univariate and multivariate logistic regression analysis, baseline symptom severity affected symptom response, and pain negatively impacted symptom remission to treatment (p≤0.04 for each); GES status failed to predict treatment response or remission. CONCLUSIONS: Symptom improvement with neuromodulators may be seen in over two-thirds of subjects with FNV regardless of the specific agent administered. Response may be suboptimal in pain predominant presentations.

Full Text

Duke Authors

Cited Authors

  • Patel, A; Sayuk, GS; Kushnir, VM; Gyawali, CP

Published Date

  • March 2013

Published In

Volume / Issue

  • 89 / 1049

Start / End Page

  • 131 - 136

PubMed ID

  • 23112216

Pubmed Central ID

  • PMC3957227

Electronic International Standard Serial Number (EISSN)

  • 1469-0756

Digital Object Identifier (DOI)

  • 10.1136/postgradmedj-2012-131284


  • eng

Conference Location

  • England