Advertisement

Clinical Autonomic Research

, Volume 28, Issue 2, pp 203–209 | Cite as

Cyclic vomiting syndrome: epidemiology, diagnosis, and treatment

  • Sanjay BhandariEmail author
  • Pinky Jha
  • Abhishek Thakur
  • Abhipsa Kar
  • Harrison Gerdes
  • Thangam Venkatesan
Review

Abstract

Cyclic-vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder characterized by recurrent episodes of nausea and vomiting. Although once thought to be a pediatric disorder, there has been a considerable increase in recognition of CVS in adults. The exact pathogenesis is unknown and several theories have been proposed. Migraine and CVS share a similar pathophysiology as suggested by several studies. Since there are no specific biomarkers available for this disorder, physicians should rely on Rome criteria for the diagnosis. Due to the lack of randomized control trials, the treatment of CVS is primarily empirical.

Notes

Funding

None.

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 1.
    Gee S (1882) On fitful or recurrent vomiting. St Bart Hosp Rep 18:1–6Google Scholar
  2. 2.
    Venkatesan T, Prieto T, Barboi A et al (2010) Autonomic nerve function in adults with cyclic vomiting syndrome: a prospective study. Neurogastroenterol Motil 22(1303–1307):e1339Google Scholar
  3. 3.
    Boles RG, Adams K, Li BU (2005) Maternal inheritance in cyclic vomiting syndrome. Am J Med Genet A 133a:71–77CrossRefPubMedGoogle Scholar
  4. 4.
    Zaki EA, Freilinger T, Klopstock T et al (2009) Two common mitochondrial DNA polymorphisms are highly associated with migraine headache and cyclic vomiting syndrome. Cephalalgia 29:719–728CrossRefPubMedGoogle Scholar
  5. 5.
    Venkatesan T, Zadvornova Y, Raff H, Hillard CJ (2016) Endocannabinoid-related lipids are increased during an episode of cyclic vomiting syndrome. Neurogastroenterol Motil 28:1409–1418CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Wasilewski A, Lewandowska U, Mosinska P et al (2017) Cannabinoid receptor type 1 and μ-opioid receptor polymorphisms are associated with cyclic vomiting syndrome. Am J Gastroenterol 112:933–939CrossRefPubMedGoogle Scholar
  7. 7.
    Abell TL, Adams KA, Boles RG et al (2008) Cyclic vomiting syndrome in adults. Neurogastroenterol Motil 20:269–284CrossRefPubMedGoogle Scholar
  8. 8.
    Hasler WL (2013) Pathology of emesis: its autonomic basis. Handb Clin Neurol 117:337–352CrossRefPubMedGoogle Scholar
  9. 9.
    Tache Y (1999) Cyclic vomiting syndrome: the corticotropin-releasing-factor hypothesis. Dig Dis Sci 44:79s–86sCrossRefPubMedGoogle Scholar
  10. 10.
    Li BU, Murray RD, Heitlinger LA, Robbins JL, Hayes JR (1999) Is cyclic vomiting syndrome related to migraine? J Pediatr 134:567–572CrossRefPubMedGoogle Scholar
  11. 11.
    Couch JR (2011) Amitriptyline in the prophylactic treatment of migraine and chronic daily headache. Headache 51:33–51CrossRefPubMedGoogle Scholar
  12. 12.
    Couch JR, Hassanein RS (1979) Amitriptyline in migraine prophylaxis. Arch Neurol 36:695–699CrossRefPubMedGoogle Scholar
  13. 13.
    Cameron C, Kelly S, Hsieh SC et al (2015) Triptans in the acute treatment of migraine: a systematic review and network meta-analysis. Headache 55(Suppl 4):221–235CrossRefPubMedGoogle Scholar
  14. 14.
    Silberstein SD, Lipton RB, Dodick DW et al (2007) Efficacy and safety of topiramate for the treatment of chronic migraine: a randomized, double-blind, placebo-controlled trial. Headache 47:170–180CrossRefPubMedGoogle Scholar
  15. 15.
    Diener HC, Bussone G, Van Oene JC, Lahaye M, Schwalen S, Goadsby PJ (2007) Topiramate reduces headache days in chronic migraine: a randomized, double-blind, placebo-controlled study. Cephalalgia 27:814–823CrossRefPubMedGoogle Scholar
  16. 16.
    Kelley NE, Tepper DE (2012) Rescue therapy for acute migraine, part 2: neuroleptics, antihistamines, and others. Headache 52:292–306CrossRefPubMedGoogle Scholar
  17. 17.
    Orr SL, Aube M, Becker WJ et al (2015) Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia 35:271–284CrossRefPubMedGoogle Scholar
  18. 18.
    Bachur RG, Monuteaux MC, Neuman MI (2015) A comparison of acute treatment regimens for migraine in the emergency department. Pediatrics 135:232–238CrossRefPubMedGoogle Scholar
  19. 19.
    Hejazi RA, Reddymasu SC, Namin F, Lavenbarg T, Foran P, McCallum RW (2010) Efficacy of tricyclic antidepressant therapy in adults with cyclic vomiting syndrome: a two-year follow-up study. J Clin Gastroenterol 44:18–21CrossRefPubMedGoogle Scholar
  20. 20.
    Hikita T, Kodama H, Kaneko S et al (2011) Sumatriptan as a treatment for cyclic vomiting syndrome: a clinical trial. Cephalalgia 31:504–507CrossRefPubMedGoogle Scholar
  21. 21.
    Hejazi RA, McCallum RW (2014) Cyclic vomiting syndrome: treatment options. Exp Brain Res 232:2549–2552CrossRefPubMedGoogle Scholar
  22. 22.
    Bhandari S, Venkatesan T (2016) Novel treatments for cyclic vomiting syndrome: beyond ondansetron and amitriptyline. Curr Treat Options Gastroenterol 14:495–506CrossRefPubMedGoogle Scholar
  23. 23.
    Lee LY, Abbott L, Mahlangu B, Moodie SJ, Anderson S (2012) The management of cyclic vomiting syndrome: a systematic review. Eur J Gastroenterol Hepatol 24:1001–1006CrossRefPubMedGoogle Scholar
  24. 24.
    Stanghellini V, Chan FK, Hasler WL et al (2016) Gastroduodenal disorders. Gastroenterology 150:1380–1392CrossRefPubMedGoogle Scholar
  25. 25.
    Hejazi RA, McCallum RW (2011) Review article: cyclic vomiting syndrome in adults—rediscovering and redefining an old entity. Aliment Pharmacol Ther 34:263–273Google Scholar
  26. 26.
    Sagar RC, Sood R, Gracie DJ et al (2018) Cyclic vomiting syndrome is a prevalent and under-recognized condition in the gastroenterology outpatient clinic. Neurogastroenterol Motil.  https://doi.org/10.1111/nmo.13174 PubMedGoogle Scholar
  27. 27.
    Fleisher DR, Matar M (1993) The cyclic vomiting syndrome: a report of 71 cases and literature review. J Pediatr Gastroenterol Nutr 17:361–369CrossRefPubMedGoogle Scholar
  28. 28.
    Abu-Arafeh I, Russell G (1995) Cyclical vomiting syndrome in children: a population-based study. J Pediatr Gastroenterol Nutr 21:454–458CrossRefPubMedGoogle Scholar
  29. 29.
    Kumar N, Bashar Q, Reddy N et al (2012) Cyclic vomiting syndrome (CVS): is there a difference based on onset of symptoms-pediatric versus adult? BMC Gastroenterol 12:52Google Scholar
  30. 30.
    Bhandari S, Venkatesan T (2017) Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Dig Dis Sci 62:2035–2044CrossRefPubMedGoogle Scholar
  31. 31.
    Prakash C, Staiano A, Rothbaum RJ, Clouse RE (2001) Similarities in cyclic vomiting syndrome across age groups. Am J Gastroenterol 96:684–688CrossRefPubMedGoogle Scholar
  32. 32.
    Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ (2005) Cyclic vomiting syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med 3:20CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Venkatesan T, Sengupta J, Lodhi A et al (2014) An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS). Exp Brain Res 232:2563–2570CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Kraemer RR, La Hoz RM, Willig JH (2013) Some like it hot: erythema ab igne due to cannabinoid hyperemesis. J Gen Intern Med 28:1522CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Pareek N, Fleisher DR, Abell T (2007) Cyclic vomiting syndrome: what a gastroenterologist needs to know. Am J Gastroenterol 102:2832–2840CrossRefPubMedGoogle Scholar
  36. 36.
    Boles RG, Zaki EA, Lavenbarg T et al (2009) Are pediatric and adult-onset cyclic vomiting syndrome (CVS) biologically different conditions? Relationship of adult-onset CVS with the migraine and pediatric CVS-associated common mtDNA polymorphisms 16519T and 3010A. Neurogastroenterol Motil 21:e936–e972CrossRefGoogle Scholar
  37. 37.
    Bhandari S, Venkatesan T (2017) Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Dig Dis Sci 62(8):2035–2044.  https://doi.org/10.1007/s10620-016-4432-7
  38. 38.
    Hejazi RA, Lavenbarg TH, McCallum RW (2010) Spectrum of gastric emptying patterns in adult patients with cyclic vomiting syndrome. Neurogastroenterol Motil 22(1298–1302):e1338Google Scholar
  39. 39.
    Boles RG (2011) High degree of efficacy in the treatment of cyclic vomiting syndrome with combined co-enzyme Q10, l-carnitine and amitriptyline, a case series. BMC Neurol 11:102CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Clouse RE, Sayuk GS, Lustman PJ, Prakash C (2007) Zonisamide or levetiracetam for adults with cyclic vomiting syndrome: a case series. Clin Gastroenterol Hepatol 5:44–48CrossRefPubMedGoogle Scholar
  41. 41.
    Olmez A, Kose G, Turanli G (2006) Cyclic vomiting with generalized epileptiform discharges responsive to topiramate therapy. Pediatr Neurol 35:348–351CrossRefPubMedGoogle Scholar
  42. 42.
    Cristofori F, Thapar N, Saliakellis E et al (2014) Efficacy of the neurokinin-1 receptor antagonist aprepitant in children with cyclical vomiting syndrome. Aliment Pharmacol Ther 40:309–317CrossRefPubMedGoogle Scholar
  43. 43.
    Boles RG, Lovett-Barr MR, Preston A, Li BU, Adams K (2010) Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study. BMC Neurol 10:10CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Van Calcar SC, Harding CO, Wolff JA (2002) l-carnitine administration reduces number of episodes in cyclic vomiting syndrome. Clin Pediatr (Phila) 41:171–174CrossRefGoogle Scholar
  45. 45.
    Hee W (1978) Acupuncture in the treatment of hysterica mutism and functional vomiting. Med J Malaysia 33:162–164PubMedGoogle Scholar
  46. 46.
    Werntoft E, Dykes AK (2001) Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. J Reprod Med 46:835–839PubMedGoogle Scholar
  47. 47.
    Frey UH, Scharmann P, Lohlein C, Peters J (2009) P6 acustimulation effectively decreases postoperative nausea and vomiting in high-risk patients. Br J Anaesth 102:620–625CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of General Internal MedicineMedical College of WisconsinMilwaukeeUSA
  2. 2.Quinnipiac University Frank H. Netter MD School of MedicineNorth HavenUSA
  3. 3.Medical College of WisconsinWisconsinUSA
  4. 4.Division of Gastroenterology and HepatologyMedical College of WisconsinMilwaukeeUSA
  5. 5.Division of General Internal Medicine, Clinical Cancer CenterMedical College of WisconsinMilwaukeeUSA

Personalised recommendations