Pediatric Nausea—a Review of Current Management

Purpose of Review: Nausea is a common symptom in children for a variety of reasons ranging from intestinal, extraintestinal, and functional. Defining it is challenging as some children may not be able to verbalize the symptoms and it is often associated with functional gastrointestinal disorders (FGIDs). The burden of nausea amongst children has been demonstrated by its association with anxiety, depression, and impaired school performance. This review will discuss the pathophysiology of childhood nausea along with established and new treatment options. Recent Findings: By exploring the biopsychosocial model, namely the interplay between peripheral chemoreceptors, central neuronal pathways, and the environment, we can improve diagnosis and management. The diagnosis of nausea is mainly clinical and it is important to identify alarm symptoms, such as weight loss, bilious emesis, and neurologic symptoms, that would prompt further evaluation. There are numerous causes of nausea to consider, including both intestinal and extraintestinal pathologies. A detailed history and physical exam frequently help to narrow the diagnosis. The treatment options for nausea are expanding and include pharmacologic and non-pharmacologic therapies, but further research is imperative. Summary: This review focuses on the current treatment opinions in the management of pediatric nausea based on the biopsychosocial model and focuses on newer therapies and includes non-pharmacological approaches to childhood nausea.