Comparison of the prevalence of meal‐related nausea in different functional dyspepsia subgroups

Background: Nausea can coexist in functional dyspepsia (FD) but the literature is poor in reporting whether this symptom is mainly triggered by meal ingestion. Moreover, the prevalence of nausea in FD is understudied. Methods: Adult patients with a disorder of gut–brain interaction (DGBI) recruited in secondary and tertiary care facilities completed the enhanced Asian Rome IV questionnaire with additional questions to address the relationship between nausea and food intake. A comparison of nausea and the prevalence of meal-related nausea was made among FD subgroups and with chronic nausea and vomiting syndrome (CNVS), both according to Rome IV criteria. Key Results: Of the 1075 DGBI patients that completed the survey, 443 were classified as having FD and 44 other patients fulfilled diagnostic criteria for CNVS. The PDS-EPS overlap group had a higher prevalence of nausea compared to PDS and EPS patients. In PDS patients with nausea, nausea was significantly more often meal-related (than in PDS-EPS overlap, EPS, and CNVS patients). All patients with meal-related nausea reported that nausea started mostly (> 85% of times) within 60 min after the meal. When comparing western and eastern participating centers, nausea was more prevalent in patients from western sites. Conclusions and Interferences: Nausea is a highly prevalent symptom in FD with a higher prevalence in the PDS–EPS overlap group. However, meal-related nausea is more common in PDS. The pathophysiology of nausea in FD and its implication for medical treatment require further studies.