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Cyclic Vomiting Syndrome

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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Abstract

Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder characterized by stereotypical, severe episodes of vomiting punctuating symptom-free periods or baseline health. Frequent misdiagnoses often lead to years of unexplained recurrent vomiting. Similarities in the clinical features of children with CVS link it to migraines. Various psychological (excitement) and physical (infections, lack of sleep) stressors commonly precipitate episodes of CVS. Although the precise pathophysiology remains unclear, there is mounting evidence of involvement of the stress axis, autonomic nervous system, and mitochondrial dysfunction. Numerous comorbidities (anxiety, limited stamina, postural orthostatic tachycardia syndrome) impair the daily quality of life in between episodes. At present, the diagnosis rests primarily upon the clinical criteria in the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) consensus statement. Association with migraines has been useful in developing pharmacologic treatment strategies for both prophylactic and abortive approaches during episodes. Current management can be divided into supportive or rescue therapy during episodes, lifestyle modifications and prophylactic (daily treatment to prevent future episodes), and abortive therapy (to terminate episodes in progress). The goals of treatment are to reduce the frequency and severity of episodes, enhance functionality, and improve quality of life. Although most children outgrow CVS during adolescence, the majority will transition to migraine headaches as adults.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Mount Kisco Medical Group, 110 South Bedford Road, 10549, Mount Kisco, NY, USA

    Bhanu Sunku

  2. Division of Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, Milwaukee, WI, USA

    B U. K. Li

Authors
  1. Bhanu Sunku
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  2. B U. K. Li
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Corresponding author

Correspondence to Bhanu Sunku .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Chicago, Chicago, Illinois, USA

    Stefano Guandalini

  2. Clinical Director Child Health King’s College Hospital, Professor and Director Pediatric Liver, GI and Nutrition Center, London, United Kingdom

    Anil Dhawan

  3. Department of Pediatrics, Hebrew University Hadassah Hospital, Jerusalem, Israel

    David Branski

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Sunku, B., Li, B. (2016). Cyclic Vomiting Syndrome. In: Guandalini, S., Dhawan, A., Branski, D. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-319-17169-2_25

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  • DOI: https://doi.org/10.1007/978-3-319-17169-2_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17168-5

  • Online ISBN: 978-3-319-17169-2

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