Cyclic vomiting syndrome
- David J Desilets, MD, PhD
David J Desilets, MD, PhD
- Assistant Professor of Clinical Medicine
- Tufts University School of Medicine
- Section Editors
- Nicholas J Talley, MD, PhD
Nicholas J Talley, MD, PhD
- Section Editor — Motility Disorders
- Professor of Medicine, University of Newcastle, Australia
- Adjunct Professor of Medicine and Epidemiology and Consultant, Mayo Clinic, Rochester, MN
- Adjunct Professor, University of North Carolina
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
- George D Ferry, MD
George D Ferry, MD
- Section Editor — Pediatric Gastroenterology
- Professor of Pediatrics
- Baylor College of Medicine
Cyclic vomiting syndrome (CVS) is an idiopathic disorder characterized by recurrent, stereotypical bouts of vomiting with intervening periods of normal health . Although it appears to primarily affect children, it is being recognized increasingly in adults.
●Three or more recurrent discrete episodes of vomiting
●Varying intervals of completely normal health between episodes
●Episodes are stereotypical with regard to timing of onset, symptoms, and duration
- Li BU. Cyclic vomiting syndrome: light emerging from the black box. J Pediatr 1999; 135:276.
- Lombard HC. Evrose de la digestion, caracteriseo par des crises periodiques de vomissements et une profonde modification de l'assimilation. Gazette Medicale de Paris 1861:312.
- Gee S. On fitful or recurrent vomiting. St Bartholomew Hospital Reports 1882; 18:1.
- Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr 2008; 47:379.
- Abu-Arafeh I, Russell G. Cyclical vomiting syndrome in children: a population-based study. J Pediatr Gastroenterol Nutr 1995; 21:454.
- Lucarelli S, Corrado G, Pelliccia A, et al. Cyclic vomiting syndrome and food allergy/intolerance in seven children: a possible association. Eur J Pediatr 2000; 159:360.
- Prakash C, Staiano A, Rothbaum RJ, Clouse RE. Similarities in cyclic vomiting syndrome across age groups. Am J Gastroenterol 2001; 96:684.
- Withers GD, Silburn SR, Forbes DA. Precipitants and aetiology of cyclic vomiting syndrome. Acta Paediatr 1998; 87:272.
- HOYT CS, STICKLER GB. A study of 44 children with the syndrome of recurrent (cyclic) vomiting. Pediatrics 1960; 25:775.
- Lee WS, Kaur P, Boey CC, Chan KC. Cyclic vomiting syndrome in South-East Asian children. J Paediatr Child Health 1998; 34:568.
- Haan J, Kors EE, Ferrari MD. Familial cyclic vomiting syndrome. Cephalalgia 2002; 22:552.
- Prakash C, Clouse RE. Cyclic vomiting syndrome in adults: clinical features and response to tricyclic antidepressants. Am J Gastroenterol 1999; 94:2855.
- Scobie BA. Recurrent vomiting in adults. A syndrome? Med J Aust 1983; 1:329.
- Abell TL, Kim CH, Malagelada JR. Idiopathic cyclic nausea and vomiting--a disorder of gastrointestinal motility? Mayo Clin Proc 1988; 63:1169.
- Fleisher DR, Matar M. The cyclic vomiting syndrome: a report of 71 cases and literature review. J Pediatr Gastroenterol Nutr 1993; 17:361.
- Boles RG, Zaki EA, Lavenbarg T, et al. 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 2009; 21:936.
- Welch KM. Scientific basis of migraine: speculation on the relationship to cyclic vomiting. Dig Dis Sci 1999; 44:26S.
- Jernigan SA, Ware LM. Reversible quantitative EEG changes in a case of cyclic vomiting: evidence for migraine equivalent. Dev Med Child Neurol 1991; 33:80.
- Li BU, Murray RD, Heitlinger LA, et al. Is cyclic vomiting syndrome related to migraine? J Pediatr 1999; 134:567.
- To J, Issenman RM, Kamath MV. Evaluation of neurocardiac signals in pediatric patients with cyclic vomiting syndrome through power spectral analysis of heart rate variability. J Pediatr 1999; 135:363.
- Chelimsky TC, Chelimsky GG. Autonomic abnormalities in cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr 2007; 44:326.
- Li BU, Balint JP. Cyclic vomiting syndrome: evolution in our understanding of a brain-gut disorder. Adv Pediatr 2000; 47:117.
- Boles RG, Chun N, Senadheera D, Wong LJ. Cyclic vomiting syndrome and mitochondrial DNA mutations. Lancet 1997; 350:1299.
- Boles RG, Adams K, Li BU. Maternal inheritance in cyclic vomiting syndrome. Am J Med Genet A 2005; 133A:71.
- Wang Q, Ito M, Adams K, et al. Mitochondrial DNA control region sequence variation in migraine headache and cyclic vomiting syndrome. Am J Med Genet A 2004; 131:50.
- Boles RG, Adams K, Ito M, Li BU. Maternal inheritance in cyclic vomiting syndrome with neuromuscular disease. Am J Med Genet A 2003; 120A:474.
- Boles RG, Lovett-Barr MR, Preston A, et al. Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study. BMC Neurol 2010; 10:10.
- Boles RG. 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 2011; 11:102.
- Van Calcar SC, Harding CO, Wolff JA. L-carnitine administration reduces number of episodes in cyclic vomiting syndrome. Clin Pediatr (Phila) 2002; 41:171.
- Zaki EA, Freilinger T, Klopstock T, et al. Two common mitochondrial DNA polymorphisms are highly associated with migraine headache and cyclic vomiting syndrome. Cephalalgia 2009; 29:719.
- Sato T, Igarashi N, Minami S, et al. Recurrent attacks of vomiting, hypertension and psychotic depression: a syndrome of periodic catecholamine and prostaglandin discharge. Acta Endocrinol (Copenh) 1988; 117:189.
- Taché Y. Cyclic vomiting syndrome: the corticotropin-releasing-factor hypothesis. Dig Dis Sci 1999; 44:79S.
- Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut 2004; 53:1566.
- Roche E, Foster PN. Cannabinoid hyperemesis: not just a problem in Adelaide Hills. Gut 2005; 54:731.
- Sontineni SP, Chaudhary S, Sontineni V, Lanspa SJ. Cannabinoid hyperemesis syndrome: clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse. World J Gastroenterol 2009; 15:1264.
- Simonetto DA, Oxentenko AS, Herman ML, Szostek JH. Cannabinoid hyperemesis: a case series of 98 patients. Mayo Clin Proc 2012; 87:114.
- Fleisher DR, Gornowicz B, Adams K, et al. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med 2005; 3:20.
- Li BU, Issenman RM, Sarna SK. Consensus statement--2nd International Scientific Symposium on CVS. The Faculty of The 2nd International Scientific Symposium on Cyclic Vomiting Syndrome. Dig Dis Sci 1999; 44:9S.
- Hikita T, Kodama H, Ogita K, et al. Cyclic Vomiting Syndrome in Infants and Children: A Clinical Follow-Up Study. Pediatr Neurol 2016; 57:29.
- Symon DN, Russell G. Abdominal migraine: a childhood syndrome defined. Cephalalgia 1986; 6:223.
- Fitzpatrick E, Bourke B, Drumm B, Rowland M. Outcome for children with cyclical vomiting syndrome. Arch Dis Child 2007; 92:1001.
- Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal Disorders. Gastroenterology 2016; 150:1380.
- Schulte-Bockholt A, Kugathasan S, Mesrobian HG, Werlin SL. Ureteropelvic junction obstruction: an overlooked cause of cyclic vomiting. Am J Gastroenterol 2002; 97:1043.
- Olson AD, Li BU. The diagnostic evaluation of children with cyclic vomiting: a cost-effectiveness assessment. J Pediatr 2002; 141:724.
- Vanderhoof JA, Young R, Kaufman SS, Ernst L. Treatment of cyclic vomiting in childhood with erythromycin. J Pediatr Gastroenterol Nutr 1993; 17:387.
- Andersen JM, Sugerman KS, Lockhart JR, Weinberg WA. Effective prophylactic therapy for cyclic vomiting syndrome in children using amitriptyline or cyproheptadine. Pediatrics 1997; 100:977.
- Benson JM, Zorn SL, Book LS. Sumatriptan in the treatment of cyclic vomiting. Ann Pharmacother 1995; 29:997.
- Pasricha PJ, Schuster MM, Saudek CD, et al. Cyclic vomiting: association with multiple homeostatic abnormalities and response to ketorolac. Am J Gastroenterol 1996; 91:2228.
- Boyle CA. Management of menstrual migraine. Neurology 1999; 53:S14.
- Clouse RE, Sayuk GS, Lustman PJ, Prakash C. Zonisamide or levetiracetam for adults with cyclic vomiting syndrome: a case series. Clin Gastroenterol Hepatol 2007; 5:44.
- http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2014/39943a-eng.php (Accessed on June 16, 2014).
- Pareek N, Fleisher DR, Abell T. Cyclic vomiting syndrome: what a gastroenterologist needs to know. Am J Gastroenterol 2007; 102:2832.
- CVS and migraines
- Metabolic disorders
- Hypothalamic-pituitary-adrenal axis defects
- Food allergy
- Catamenial CVS
- Chronic cannabis use
- CLINICAL MANIFESTATIONS
- NATURAL HISTORY
- Rome IV criteria
- North American Society for Pediatric Gastroenterology Hepatology and Nutrition
- Warning signs
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS