The effect of educational intervention on the quality of life of women suffering from pregnancy-related nausea and vomiting: a systematic review.

OBJECTIVE: The present study aimed to determine the influence of educational interventions on improving the quality of life (QOL) of women suffering from pregnancy-related nausea and vomiting (NVP) as a systematic review. METHODS: The current systematic review followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guideline. The English electronic databases were used to identify relevant studies published 2000 until 14 August 2023. The search strategies employed were based on Mesh browser keywords and free-text words. The study risk of bias was evaluated using the Cochrane Collaboration's tool for assessing the risk of bias tools and publication bias was evaluated using a funnel plot and Begg and Egger tests. The heterogeneity of the studies was evaluated using I2 and tau-squared tests. Data were analyzed using the RevMan 5 software. Results of the random-effects meta-analysis were presented using the standard mean difference, along with a 95% confidence interval (CI). RESULTS: Out of the seven randomized clinical/control trial (RCT) studies with a total of 946 subjects included in the review, five studies reported a significant result, indicating that the interventions had a statistically significant effect on the QOL of women suffering NVP and in two studies did not have a significant result. A subgroup analysis was done based on the type of quality-of-life measurements. The pooled standardized mean difference (SMD) of four articles (Nausea and Vomiting Pregnancy Quality of Life, NVPQOL) with a total of 335 subjects was -2.91, and CI of -4.72 to -1.11, p value = .002, I2 = 97.2%. The pooled SMD of three articles (SF36) with a total of 611 subjects was -0.05, and CI of -0.23 to -0.12, p value = .550, I2 = 10%. CONCLUSIONS: The overall results of the analysis indicated that educational intervention had a small positive impact on the QOL of women experiencing NVP. However, to draw a better conclusion, it is recommended to conduct further studies with larger sample sizes and longer follow-up periods.

Meal related symptoms in youth with chronic abdominal pain: Relationship to anxiety, depression, and sleep dysfunction.

OBJECTIVE: The objective of the current study was to describe meal-related symptoms in youth with chronic abdominal pain fulfilling criteria for a disorder of gut-brain interaction (DGBI) and their associations with anxiety, depression, and sleep disturbances. METHODS: This was a retrospective evaluation of 226 consecutive patients diagnosed with an abdominal pain-associated DGBI. As part of routine care, all had completed a standardized symptom history, the Sleep Disturbances Scale for Children (utilized to assess for disorders of initiation and maintenance of sleep and excessive daytime somnolence) and the Behavior Assessment System for Children-Third Edition (utilized to assess for anxiety and depression). Four meal related symptoms were assessed: early satiety, postprandial bloating, postprandial abdominal pain, and postprandial nausea. RESULTS: Overall, 87.6% of patients reported at least one meal related symptom and the majority reported at least three symptoms. All meal related symptoms were significantly related to each other. Postprandial pain and nausea were more often reported by females. Early satiety, postprandial bloating, and postprandial nausea, but not postprandial pain demonstrated significant though variable associations with anxiety, depression, disorders of initiation and maintenance of sleep, and disorders of excessive somnolence, but only in adolescents. CONCLUSIONS: Meal related symptoms are very common in youth with abdominal pain-associated DGBIs. Early satiety, bloating, and postprandial nausea demonstrate variable associations with anxiety, depression, and disordered sleep while increased postprandial pain was not associated with psychologic or sleep dysfunction, suggesting a different pathway for symptom generation.

Testing effects of partner support and use of oral contraception during relationship formation on severity of nausea and vomiting in pregnancy.

BACKGROUND: A recent study focusing on dietary predictors of nausea and vomiting in pregnancy (NVP) found that women with higher levels of partner support, and those who had used oral contraception (OC) when they met the father, both tended to report less severe NVP compared with previous non-users or those with less supportive partners. We provide a further test of these factors, using a large sample of women from four countries who retrospectively scored their NVP experience during their first pregnancy. METHODS: We recruited women who had at least one child to participate in a retrospective online survey. In total 2321 women completed our questionnaire including items on demographics, hormonal contraception, NVP, and partner support. We used general linear models and path analysis to analyse our data. RESULTS: Women who had used OC when they met the father of their first child tended to report lower levels of NVP, but the effect size was small and did not survive adding the participant's country to the model. There was no relationship between NVP and partner support in couples who were still together, but there was a significant effect among those couples that had since separated: women whose ex-partner had been relatively supportive reported less severe NVP. Additional analyses showed that women who were older during their first pregnancy reported less severe NVP, and there were also robust differences between countries. CONCLUSIONS: These results provide further evidence for multiple influences on women's experience of NVP symptoms, including levels of perceived partner support.

A longitudinal investigation of the influence of psychological factors on nausea and vomiting in early pregnancy.

The purpose of this study was to elucidate psychological factors that may influence nausea and vomiting during pregnancy (NVP) progression in early pregnancy based on longitudinal observations. Fifty-nine pregnant women completed the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and General Health Questionnaire-28 (GHQ-28), and recorded their resting heart rate with photoplethysmography for 5 min to determine heart rate variability (HRV) indexes at 7-9 weeks and 11-13 weeks of gestation with a 4-week interval. GHQ-28 scores (total and subclasses) and HRV indexes at 7-9 weeks were compared among groups classified according to the presence of severe NVP (RINVR ≥ 9 points) at the two measurement points. Among women without severe NVP at 7-9 weeks, women who developed severe NVP at 11-13 weeks had significantly higher levels of anxiety/insomnia in the GHQ-28 subclasses (p = 0.018). The cross-lagged relationship from anxiety/insomnia at 7-9 weeks to RINVR at 11-13 weeks was significant (ß = 0.367, p < 0.001). Among women with severe NVP at 7-9 weeks, women whose severe symptoms subsided at 11-13 weeks had significantly higher high-frequency (HF) power (p = 0.010), and women with relatively higher HF power demonstrated a significant reduction in RINVR (interaction effect, p = 0.035). During early pregnancy, women with strong anxiety/insomnia symptoms tend to have NVP symptoms that become more severe as the pregnancy progresses. The higher HF power in women whose severe NVP subsided within 4 weeks suggests a contribution of emotion regulation to early amelioration of NVP.

Individualised Homeopathic Treatment of Nausea and Vomiting in the First Trimester and of COVID-19 in the Third Trimester of Pregnancy-A Case Report.

INTRODUCTION/BACKGROUND: Nausea and vomiting in pregnancy are common physiological disturbances, causing physical, social and psychological symptoms in the affected women. Though it is difficult to draw absolute conclusions on whether or not pregnant women are at high risk of acquiring severe consequences from corona-virus disease 2019 (COVID-19), clinical experience has shown them to be potentially vulnerable to other coronaviruses. Lack of specific conventional therapy for these conditions called for a complementary and individualised homeopathy approach in the presented case. METHODS: The homeopathic medical management of early symptoms of nausea and vomiting in pregnancy (NVP) and the beginning of COVID-19 symptoms shortly before a scheduled Caesarean section is described. No ongoing specific treatments were discontinued. The connection between intervention with individualised homeopathy and clinical improvement was assessed by two independent reviewers using the MOdified NARanjo Criteria for Homeopathy (MONARCH) inventory. RESULTS: There was improvement of NVP symptoms in early pregnancy and in later-onset COVID-19 symptoms following an individually prescribed unipotent homeopathic medicine, Sepia officinalis, after tele-consultation during lockdown. The agreed MONARCH score was +8 points, suggesting that homeopathy contributed to clinical improvement. CONCLUSION: Individualised homeopathy may be a helpful complementary medical approach for managing symptoms associated with NVP and COVID-19 during pregnancy.

Association between nausea and vomiting of pregnancy and postpartum depression: the Japan Environment and Children's Study.

OBJECTIVE: Postpartum depression (PPD) is a global emotional distress that affects women and their offspring regardless of their culture. The association between nausea and vomiting of pregnancy (NVP) and PPD has been widely described only for the severe form of NVP. We aimed to assess the relationship between PPD and NVP with regards to its severity. METHODS: Data from the Japan Environment and Children's Study (JECS), a birth cohort study, were analyzed. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Multiple logistic regression models were performed to assess the association between NVP and PPD. RESULTS: Out of the 80,396 women included in the study 14% had PPD. Among them 4,640 (42.1%) had mild NVP; 3,295 (29.9%) had moderate NVP whereas 1,481 (13.4%) had severe NVP. All forms of NVP were associated with PPD and the association gradually increased with the severity of NVP symptoms with odd ratio (OR): 1.26; 95% confidence interval (CI): 1.18-1.35 for mild, OR: 1.28; 95% CI: 1.19-1.38 for moderate and OR: 1.54; 95% CI: 1.42-1.68 for severe NVP. CONCLUSION: Japanese women with NVP were more susceptible to develop PPD and the more severe the NVP symptoms were, the greater the risk of PPD. Thus, close monitoring of NVP-affected women is recommended.

The preferences of women with ovarian cancer for oral versus intravenous recurrence regimens.

OBJECTIVE: To assess preferences of women with ovarian cancer regarding features of available anti-cancer regimens for platinum-resistant, biomarker-positive disease, with an emphasis on oral PARP inhibitor and standard intravenous (IV) chemotherapy regimens. METHODS: A discrete-choice-experiment preferences survey was designed, tested, and administered to women with ovarian cancer, with 11 pairs of treatment profiles defined using seven attributes (levels/ranges): regimen (oral daily, IV weekly, IV monthly); probability of progression-free (PFS) at 6 months (40%-60%); probability of PFS at 2 years (10%-20%); nausea (none, moderate); peripheral neuropathy (none, mild, moderate); memory problems (none, mild); and total out-of-pocket cost ($0 to $10,000). RESULTS: Of 123 participants, 38% had experienced recurrence, 25% were currently receiving chemotherapy, and 18% were currently taking a PARP inhibitor. Given attributes and levels, the relative importance weights (sum 100) were: 2-year PFS, 28; cost, 27; 6-month PFS, 19; neuropathy,14; memory problems, nausea, and regimen, all ≤5. To accept moderate neuropathy, participants required a 49% (versus 40%) chance of PFS at 6 months or 14% (versus 10%) chance at 2 years. Given a 3-way choice where PFS and cost were equal, 49% preferred a monthly IV regimen causing mild memory problems, 47% preferred an oral regimen causing moderate nausea, and 4% preferred a weekly IV regimen causing mild memory and mild neuropathy. CONCLUSIONS: These findings challenge the assumption that oral anti-cancer therapies are universally preferred by patients and demonstrate that there is no "one size fits all" regimen that is preferable to women with ovarian cancer when considering recurrence treatment regimens.

Using Positive Attribute Framing to Attenuate Nocebo Side Effects: A Cybersickness Study.

BACKGROUND: Side effect warnings can contribute directly to their occurrence via the nocebo effect. This creates a challenge for clinicians and researchers, because warnings are necessary for informed consent, but can cause harm. Positive framing has been proposed as a method for reducing nocebo side effects whilst maintaining the principles of informed consent, but the limited available empirical data are mixed. PURPOSE: To test whether positive attribute framing reduces nocebo side effects relative to negative framing, general warning, and no warning. METHODS: Ninety-nine healthy volunteers were recruited under the guise of a study on virtual reality (VR) and spatial awareness. Participants were randomized to receive positively framed ("7 out of 10 people will not experience nausea"), negatively framed ("3 out of 10 people will experience nausea"), general ("a proportion of people will experience nausea"), or no side effect warnings prior to VR exposure. RESULTS: Receiving a side effect warning increased VR cybersickness relative to no warning overall, confirming that warnings can induce nocebo side effects. Importantly, however, positive framing reduced cybersickness relative to both negative framing and the general warning, with no difference between the latter two. Further, there was no difference in side effects between positive framing and no warning. CONCLUSIONS: These findings suggest that positive framing not only reduces nocebo side effects relative to negative framing and general warnings, but actually prevents nocebo side effects from occurring at all. As such, positive attribute framing may be a cheap and ethical way to reduce nocebo side effects.

Association of illness perception with chemotherapy-induced nausea and vomiting: a Turkish Oncology Group (TOG) study.

Chemotherapy-induced nausea and vomiting (CINV) may be linked to the psychological status of cancer patients. Therefore, the authors aimed to better understand the underlying risk factors for CINV using the Brief Illness Perception Questionnaire. A total of 238 patients were recruited during three cycles of chemotherapy. Patient, disease and treatment characteristics were noted at the onset of chemotherapy. The Brief Illness Perception Questionnaire was administered face-to-face prior to chemotherapy. The relationship between illness perceptions and CINV was analyzed using Spearman's rank correlation. Positive illness perception parameters, including personal and treatment control, were negatively correlated, whereas negative illness perception parameters, including consequences, timeline, identity, concern and emotions, were positively correlated with CINV after adjusting for age, sex and emetogenic potential of chemotherapy (p < 0.001). Illness perception may be an underlying risk factor for CINV.

A pilot study of the effect of a home-based multimodal symptom-management program in children and adolescents undergoing chemotherapy.

BACKGROUND: Prevalent symptoms that affect children and adolescents throughout the process of cancer diagnosis and treatment include nausea and vomiting, fatigue, pain, mucositis, and anxiety. AIM: To examine the effect of a home-based multimodal symptom-management program for alleviation of nausea and vomiting, fatigue, pain, mucositis, and anxiety in children and adolescents undergoing chemotherapy for hematological malignancies or solid tumors. METHODS: In an exploratory pilot randomized study with qualitative interview, patients between 10 and 18 years of age were randomly assigned to either the symptom-management program plus usual care (intervention group) or usual care (control group). The program consisted of multiple nonpharmacological interventional components. The targeted symptoms were measured at baseline (after diagnosis), at the first 2 weeks of each cycle of chemotherapy, and at 6 months after baseline, using the Memorial Symptom Assessment Scale 10-18 and the State Anxiety Scale for Children. RESULTS: Fifty children (31 boys; mean age, 13.7 years) were randomized either to the intervention group or the control group (25 each) and underwent baseline assessment. A comparison between the groups showed that the intervention group had a significant less fatigue over time (P < .05). However, no differences were found with respect to nausea and vomiting, pain, mucositis, and anxiety between groups. Both children and parents reported a positive experience with the symptom-management program. CONCLUSION: The home-based symptom-management program may have helped to reduce fatigue in children and adolescents undergoing chemotherapy. In addition, qualitative data support the importance of improving children and parents' knowledge, coping skills, and psychological preparation for symptoms associated with chemotherapy.

Analysis of neurotransmitters associated with neuropsychiatric status in workers following lead exposure.

OBJECTIVE: To explore the correlation between neuropsychiatric status and blood neurotransmitter in lead workers, and to provide theoretical basis for the prevention and treatment of lead workers. SUBJECTS AND METHODS: The study applied cross-sectional survey, 74 occupational lead exposed workers in a battery factory in a city of Hebei province were selected as the lead exposed group, and 62 workers (non-lead workers) were selected as the control group. The occupational health symptoms questionnaire and health examination and POMS (Profile of Mood State, POMS) emotional test questionnaire were applied to investigate the nearly emotional status of the studied objects, ICP-MS was used to determine the blood lead level of all subjects, HPLC (High performance liquid chromatography, HPLC) was applied to determine the concentration of neurotransmitter in peripheral blood of all studied subjects, and all results were applied the Pearson's correlation analysis. RESULTS: The blood lead concentration of the lead workers group (163.23±40.77 ug/L) was significantly higher than that in the control group (43.62±14.50 ug/L), and the difference was statistically significant. From the analysis of neuropsychiatric status, the neurological symptoms in the lead workers group were higher than that in the control group, among which the symptoms of sleep disturbance, dizziness, fatigue, numbness of limbs and dampness and coldness of limbs were more obvious. Among the symptoms of digestive system, the incidence of abdominal pain, abdominal distension, constipation and nausea and vomiting were higher. According to the POMS emotion questionnaire, the scores of 5 negative emotions and 1 positive emotion in the lead exposure group were higher than that in the control group, and the difference was statistically significant. Related to the control group, the concentration of neurotransmitters such as DA, 5-HT, GABA, Gly, Trp and Glu were statistically decreased, p<0.001. There was a negative correlation between neurotransmitters in peripheral blood and blood lead levels in lead workers, among which 5-HT had the greatest correlation with lead levels (r=-0.569, p<0.001). 5-HT and Trp were significantly correlated with tension-anxiety (T), depression-depression (D), anger-hostility (A), Vigor-hyperactivity (V), fatigue-inertia (F), and confusion-confusion (C). 5-HT, Trp and GABA were significantly correlated with the survey symptoms, among which, the sleep disorder, constipation and fatigue had most significantly positive correlation with 5-HT or Trp, r-value was respectively 0.373, 0.233 and 0.563. CONCLUSIONS: Lead exposure not only causes the alteration of neuropsychiatric behavior of lead workers, but also changes gastrointestinal symptoms. Serotonin may be involved as the main neurotransmitter synthesized in intestinal, and the synthesis and metabolism may be regulated by intestinal flora.

Factors that contribute to the impairment of quality of life in gastroparesis.

BACKGROUND: Understanding factors that impair quality of life (QOL) in gastroparesis is important for clinical management. AIMS: (a) Determine QOL in patients with gastroparesis; (b) Determine factors that impair QOL. METHODS: Gastroparetic patientsAQ6 underwent history and questionnaires assessing symptoms (PAGI-SYM and Rome III), QOL (SF-36v2 and PAGI-QOL), depression (Beck Depression Inventory [BDI]), and anxiety (State Trait Anxiety InventoryAQ7). KEY RESULTS: 715 gastroparesis patients (256 diabetic (DG), 459 idiopathic (IG)) were evaluated. SF-36 physical component (PC) score averaged 33.3 ± 10.5; 41% had impaired score <30. SF-36 PC scores were similar between diabetic and idiopathic gastroparesis. Impaired SF-36 PC associated with increased nausea/vomiting and upper abdominal pain subscores, acute onset of symptoms, higher number of comorbidities, use of narcotic pain medications, and irritable bowel syndrome (IBS). SF-36 mental component (MC) score averaged 38.9 ± 13.0; 26% had impaired score <30. Poor SF-36 MC associated with diabetic etiology, higher Beck depression inventory, and state anxiety scores. PAGI-QOL score averaged 2.6 ± 1.1; 50% had a score of <2.6. Low PAGI-QOL associated with higher fullness, bloating, and upper abdominal pain subscores, more depression and Trait anxiety, smoking cigarettes, need for nutritional support, progressively worsening symptoms and periodic exacerbations. CONCLUSIONS & INFERENCES: Multiple measures show poor QOL present in gastroparesis. Several areas impacted on reduced QOL: (a) Symptoms of nausea, vomiting, and abdominal pain, as well as IBS; (b) Etiology and acute onset and progressively worsening symptoms; (c) Comorbidities and psychological factors such as anxiety and depression; (d) Patient-related factors such as smoking. Targeting the modifiable factors may improve patient outcomes in gastroparesis.

Sleep During Pelvic-Abdominal Radiotherapy for Cancer: A Longitudinal Study With Special Attention to Sleep in Relation to Nausea and Quality of Life.

BACKGROUND: Poor sleep, nausea, psychological distress, and a lowered quality of life are common during radiotherapy for cancer. There is a lack of studies on the relationship between radiotherapy-induced nausea and sleep. This longitudinal study analyzes data from 196 patients who underwent pelvic-abdominal radiotherapy for cancer. OBJECTIVE: The aim of this study was to investigate sleep parameters weekly before, during, and after radiotherapy in relation to nausea and other patient characteristics, clinical characteristics, psychological distress, and quality of life. METHODS: Patients (n = 196, 84% women; mean age, 63 years; 68% had gynecological tumor, 28% had colorectal tumor, and 4% had other tumors) longitudinally answered questionnaires before, during, and after their radiotherapy over the abdominal and pelvic fields. RESULTS: Poor sleep was experienced by 30% of the participants, and sleep (quality and difficulty falling asleep) improved during and after treatment compared with baseline. Experiencing nausea during treatment was associated with worse sleep quality during radiotherapy. Baseline anxiety was associated with worse sleep quality before, during, and after treatment. Poor sleep was associated with worse quality of life. CONCLUSION: Nausea, more than a number of other variables, is a possible predictor of poor sleep in patients during radiotherapy for cancer. IMPLICATIONS FOR PRACTICE: The results indicate that effectively managing nausea may be important for sleep quality, and possibly quality of life, in patients undergoing radiotherapy for cancer. More research is needed before recommendations for practice can be made.

Anxiety may be a risk factor for experiencing gastrointestinal symptoms during endurance races: An observational study.

Scarce research has examined the links between stress, anxiety, and gastrointestinal (GI) symptoms during competition, despite that they are positively correlated in the general population. A total of 186 endurance athletes completed the Perceived Stress Scale (PSS)-14, Anxiety Sensitivity Index (ASI)-3, and State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) before races. Afterwards, they reported the severity of in-race GI symptoms. Associations between high levels of stress and anxiety (defined as the top tertile) and GI distress (≥3 on a 0-10 scale) were examined using logistic regression. Athletes with high PSS-14 scores did not have greater odds of GI symptoms, except nausea (odds ratio [OR] = 2.21, 95% confidence interval [CI] 1.02-4.78). High scores on the STICSA-trait were associated with nausea (OR = 3.43, 95% CI 1.57-7.50) and regurgitation/reflux (OR = 3.31, 95% CI 1.26-8.73). Among a sub-sample of 125 participants that completed STICSA-state questionnaires, higher anxiety was associated with nausea (OR = 5.57, 95% CI 1.96-15.83), regurgitation/reflux (OR = 3.75, 95% CI 1.17-12.00), fullness (OR = 2.98, 95% CI 1.05-8.49), and cramping (OR = 3.99, 95% CI 1.36-11.68). The ORs remained relatively stable after adjusting for age, gender, experience, body mass index, type of race, and race duration. ASI-3 scores were not associated with symptoms. Individuals with higher levels of anxiety, especially on the morning of a race, may be prone GI distress, particularly nausea, regurgitation/reflux, and cramping.

Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Recommendations, and New Trends.

The significant physical and emotional effects of chemotherapy-induced nausea and vomiting (CINV) are experienced by cancer patients. Severe symptoms decrease the patient's quality of life and potentially deters further treatment. The five main forms of CINV (i.e., acute, delayed, anticipatory, breakthrough, and refractory) require different treatment regimens, which often include 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids. Despite a significant amount of research and development of antiemetic agents, management of CINV remains a great challenge with many needs waiting to be adequately addressed, such as controlling non-acute CINV, developing appropriate CINV treatment protocols for multiple-day chemotherapy patients, and providing options for those prone to CINV despite treatment. Further research is required to optimize CINV management for these patients.

The effect of a pharmacist consultation on pregnant women's quality of life with a special focus on nausea and vomiting: an intervention study.

BACKGROUND: Maternal wellbeing and quality of life (QOL) are increasingly being recognized as important for healthy pregnancies. The aim of this study was to investigate the impact of a pharmacist consultation on pregnant women's QOL focusing on nausea and vomiting in pregnancy (NVP), and patient satisfaction. METHODS: For this intervention study in 14 community pharmacies, women in early pregnancy were recruited and assigned to a pharmacist consultation (intervention) or standard care (control). The consultation aimed to address each woman's concerns regarding medications and pregnancy-related ailments. Data were collected through online questionnaires at baseline (Q1) and during the second trimester (Q2). The intervention group completed an additional satisfaction questionnaire after the consultation was completed. The primary outcome was the impact of the intervention on the Quality of Life Scale (QOLS) scores between the first and second trimesters. The impact of the intervention was assessed by linear regression, and secondary analyses were performed to assess effect modification by NVP. RESULTS: Of the 340 women enrolled in the study, we analyzed data for 245. Half (170/340) of the original participants were allocated to the intervention group, of whom 131 received the pharmacist consultation. Most women (75%, 78/96) reported that the consultation was useful to a large/very large extent. The consultation had no overall impact on QOLS scores between the first and the second trimesters compared with standard care (adjusted ß: 0.7, 95% CI: -2.1, 3.4). The impact of the intervention on QOLS was greater amongst women with moderate/severe NVP (adjusted ß: 3.6, 95% CI: -0.6, 7.7) compared to those with no/mild NVP (adjusted ß: -1.4, 95% CI: -5.1, 2.2) (interaction term study group*NVP severity, p = 0.048). CONCLUSIONS: The pregnant women highly appreciated the pharmacist consultation, but the intervention did not affect their QOL scores compared with standard care. Future studies should further explore the effect of a pharmacist consultation specifically for NVP and on other outcomes such as use of health care services and medication use in pregnancy. TRIAL REGISTRATION: Retrospectively registered in ClinicalTrials.gov (identifier: NCT04182750 , registration date: December 2, 2019).

The effects of nausea, vomiting, and social support on health-related quality of life during early pregnancy: A prospective cohort study.

OBJECTIVE: To date, no previous study has examined the independent association between nausea, vomiting, and social support and health-related quality of life among early pregnant women. METHODS: To fill this gap, we investigated these associations within this group using repeated-measurement data. METHODS: A prospective cohort design was conducted from August 2018 to February 2019 with perinatal outpatients in a general hospital. Participants were 153 pregnant women aged 20 years or older and under 20 weeks of gestation at their first prenatal visit. Along with reporting their sociodemographic data, participants completed the Index of Nausea, Vomiting, and Retching (INVR), the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support (MSPSS) and re-completed INVR, and SF-12 at follow-up checkups a maximum of three times. RESULTS: After controlling for internal correlations and confounding factors, INVR was found to be significantly negatively associated with the physical component summary scale score of SF-12; however, MSPSS showed no association with the physical component summary scale score. Conversely, the scores for both INVR and MSPSS were negatively and positively, respectively, significantly associated with the mental component summary scale score of SF-12. CONCLUSION: The severity of nausea and vomiting significantly impacts physical quality of life during early pregnancy. Both nausea and vomiting and social support significantly and independently affect mental quality of life. Health professionals should recognize these impacts and be aware that social support contributes to improving mental quality of life.

A cross-sectional study of nausea in functional abdominal pain: relation to mucosal mast cells and psychological functioning.

BACKGROUND: Nausea is a common symptom in youth with chronic abdominal pain. The aims of the current study were to assess: 1) the frequency of nausea in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), respectively, as defined by Rome IV criteria; and, 2) relationships between nausea and mucosal inflammation as defined by antral and duodenal eosinophil and mast cell densities. A secondary aim was to assess relationships between nausea and other gastrointestinal symptoms, non-gastrointestinal somatic symptoms, and psychological dysfunction. METHODS: Records from patients with pain associated functional gastrointestinal disorders were retrospectively reviewed for gastrointestinal and somatic symptoms and anxiety, depression, and somatizations scores as assessed by the Behavior Assessment System for Children (BASC-2). In addition, previous gastric and mucosal biopsies were assessed for mast cell and eosinophil densities, respectively. RESULTS: 250 patients, ages 8 to 17 years, were assessed. Nausea was reported by 78% and was equally prevalent in those with FD alone, those with IBS alone, and those with both FD and IBS. Nausea was associated with increased mean (21.4 vs. 17.5) and peak (26.2 vs. 22.9) duodenal mast cell densities as compared those without nausea. Nausea was also associated with a wide variety of individual gastrointestinal symptoms, as well as headaches, fatigue, and dizziness. Lastly, nausea was associated with elevated self-report scores for anxiety (55.2 vs. 50.0), depression (50.2 vs. 46.1), and somatization (70.3 vs. 61.8). CONCLUSIONS: Nausea is common in children and adolescents with pain-associated FGIDs as defined by Rome IV and is not unique to either FD or IBS. Nausea is associated with increased mucosal mast cell density, non-gastrointestinal somatic symptoms, and psychologic dysfunction.

Food-symptom diaries can generate personalized lifestyle advice for managing gastrointestinal symptoms: A pilot study.

BACKGROUND: Gastrointestinal (GI) symptoms have a heterogeneous pathophysiology. Yet, clinical management uses group-level strategies. There is a need for studies exploring personalized management options in patients with GI symptoms. From diaries of GI symptoms, food intake, and psychological distress, we extracted and validated personalized lifestyle advice. Secondly, we investigated group-level GI symptom triggers using meta-analysis. METHODS: We collected 209 diaries of GI symptoms, food intake, and psychological distress, coming from 3 cohorts of patients with GI symptoms (n = 20, 26, and 163, median lengths 24, 17, and 38 days). Diaries were split into training and test data, analyzed, and the triggers emerging from the training data were tested in the test data. In addition, we did a random effects meta-analysis on the full data to establish the most common GI symptom triggers. KEY RESULTS: Analysis of the training data allowed us to predict symptom triggers in the test data (r = 0.27, P < .001), especially in the subset of patients with a strong global association between lifestyle factors and symptoms (r = 0.45, P < .001). Low exposure to these triggers in the test data was associated with symptom reduction (P = .043). Meta-analysis showed that caloric intake in the late evening or night predicted an increase in GI symptoms, especially bloating. Several food-symptom associations were found, whereas psychological distress did not clearly lead to more severe GI symptoms. CONCLUSIONS & INFERENCES: Diaries of GI symptoms, food intake, and psychological distress can lead to meaningful personalized lifestyle advice in subsets of patients.