Nausea Is Not The Same For Everyone

7-26-96
Hershey, Pa. - A woman calls her doctor and reports feeling nauseous; she has the morning sickness of pregnancy. A second woman calls her doctor with nausea accompanied by eye pain; she has a migraine headache.

Does the nausea feel the same to both women?

New research at Penn State University suggests that it probably doesn't. Nausea can be caused by a host of conditions and situations -- pregnancy, motion sickness, chemotheraphy, migraines, to name a few. The data show that the experience varies widely from one individual to the next.

Nausea, a topic of fascination for writers and philosophers, including existentialist philosopher Jean-Paul Sartre who immortalized it in his novel by the same name, is also of great interest in medical and psychological evaluation. Now it has been scientifically investigated and defined by researchers at Penn State University in a multi-year study of 1,695 students.

The research shows that nausea means different things to different people, thus an accurate description is central to the diagnosis and treatment of the disease or condition. Researchers have discovered 17 descriptors that define -- in a specific and statistically significant way -- the feelings that come under the umbrella of nausea.

The first descriptive study of nausea, "Assessment of the Multiple Dimensions of Nausea: The Nausea Profile," was published in the June 1996 issue of the Journal of Psychomatic Research.

Investigators discovered that the term nausea may indicate a wide array of conditions and feelings, depending on the individual. Nausea may mean stomach sickness to one person, but another may use it to describe dizzyness or lightheadedness.

Lead author Eric Muth, a graduate student in experimental psychology, is conducting his doctoral research at Penn State's Milton S. Hershey Medical Center. He studies gastrointestinal psychophysiology, or how the brain and gut interact. He calls the stomach the "root of many of our joys and problems."

He said careful communication is important in the diagnosis of disease, and therefore a precise definition is an essential tool for treating patients. Before this research, the condition of nausea had not been quantitatively analyzed. Although a scale assessing the nausea and vomiting of chemotherapy patients was introduced in 1992, until now there was no precise tool to evaluate the feeling of nausea.

Extensive testing and statistical studies resulted in a list of 17 descriptors to define nausea. Each of these was rated on a scale of 0 to 9. Based on these ratings, the descriptors were clustered into three groups: somatic or body distress; gastrointestinal distress and emotional distress.

Subjects reported somatic distress as feeling: fatigue, weak, hot, sweaty, lightheaded, shakiness. Gastrointestinal distress was reported as feeling: sick, stomach awareness or discomfort, a feeling as if he or she might vomit, ill, queasy. Emotional distress was reported as feeling: nervous, scared or afraid, worried, upset, panic, hopeless.

The article concludes by characterizing nausea as a "syndrome including complex reactions of different physiological and psychological systems to a change in autonomic activity as a result of some nausea-evoking stimulus."

The authors point out that "The ability to quantify nausea and its dimensions using the nausea profile will allow researchers and clinicians to differentiate what was previously assumed to be a homogeneous state or condition and to focus on appropriate treatments."

Muth collaborated in this study with Kenneth Koch, M.D., professor of gastroenterology at Penn State's College of Medicine in Hershey, and Robert Stern, Ph.D., professor of psychology at Penn State. Koch and Stern are leaders in the study of nausea and motion sickness.

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Contacts:
Gail Brown (o) (717) 531-8606 (h) (717) 531-3158 e-mail: gxg14@psu.edu
Deborah S. Saline (o) (717) 531-8606