Skip to main content

Cyclic Vomiting Syndrome

  • Chapter
  • First Online:
Gastrointestinal Motility Disorders

Abstract

Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder (FGID) that is seen in both children and adults. Despite being first described more than a century ago, there is a lack of knowledge about CVS amongst the medical community. Further, patients often use marijuana to alleviate symptoms, which has only compounded the problem and has led to a term called cannabinoid hyperemesis syndrome (CHS). This chapter discusses salient features of both CVS and CHS and also current knowledge about the pathophysiology of CVS. A portion of this chapter is dedicated to discussing the recommended workup and available therapies for managing CVS.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Boles RG, Zaki EA, Kerr JR, et al. Increased prevalence of two mitochondrial DNA polymorphisms in functional disease: are we describing different parts of an energy-depleted elephant? Mitochondrion. 2015;23:1–6.

    Article  CAS  PubMed  Google Scholar 

  3. Boles RG, Adams K, Ito M, et al. Maternal inheritance in cyclic vomiting syndrome with neuromuscular disease. Am J Med Genet A. 2003;120A:474–82.

    Article  PubMed  Google Scholar 

  4. Venkatesan T, Zaki EA, Kumar N, et al. Quantitative pedigree analysis and mitochondrial DNA sequence variants in adults with cyclic vomiting syndrome. BMC Gastroenterol. 2014;14:181.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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–e72.

    Article  CAS  PubMed  Google Scholar 

  6. Gee S. On fitful or recurrent vomiting. St Bart Hosp Rep. 1882;18:1–6.

    Google Scholar 

  7. Russell G, Abu-Arafeh I. Cyclic vomiting syndrome in children: a population based study. J Pediatr Gastroenterol Nutr. 1995;21:454–8.

    Article  PubMed  Google Scholar 

  8. Samuel EAKM, Siwiec RM, Babaei A, Nencka AS, Venkatesan T, Shaker R. Resting and guided thinking state functional connectivity of the thalamus with the Insula and cingulate cortex in cyclic vomiting syndrome. Gastroenterology. 2014;146:S-847–8.

    Article  Google Scholar 

  9. Venkatesan T, Prieto T, Barboi A, et al. Autonomic nerve function in adults with cyclic vomiting syndrome: a prospective study. Neurogastroenterol Motil. 2010;22:1303–7. e339

    Article  CAS  PubMed  Google Scholar 

  10. Tache Y. Cyclic vomiting syndrome: the corticotropin-releasing-factor hypothesis. Dig Dis Sci. 1999;44:79S–86S.

    Article  CAS  PubMed  Google Scholar 

  11. Allen JH, de Moore GM, Heddle R, et al. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut. 2004;53:1566–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Wallace EA, Andrews SE, Garmany CL, et al. Cannabinoid hyperemesis syndrome: literature review and proposed diagnosis and treatment algorithm. South Med J. 2011;104:659–64.

    Article  PubMed  Google Scholar 

  13. Stanghellini V, Talley NJ, Chan F, et al. Rome IV - gastroduodenal disorders. Gastroenterology. 2016; doi:10.1053/j.gastro.2016.02.011.

  14. Venkatesan T, Sengupta J, Lodhi A, et al. An internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS). Exp Brain Res. 2014;232:2563–70.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Simonetto DA, Oxentenko AS, Herman ML, et al. Cannabinoid hyperemesis: a case series of 98 patients. Mayo Clin Proc. 2012;87:114–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hayman JA. Darwin's illness revisited. BMJ. 2009;339:b4968.

    Article  PubMed  Google Scholar 

  17. Sharkey KA, Wiley JW. The role of the endocannabinoid system in the brain-gut axis. Gastroenterology. 2016;151:252–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Venkatesan T, Zadvornova Y, Raff H, et al. Endocannabinoid-related lipids are increased during an episode of cyclic vomiting syndrome. Neurogastroenterol Motil. 2016;28:1409–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. 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;47:379–93.

    Article  CAS  PubMed  Google Scholar 

  20. Olson AD, Li BU. The diagnostic evaluation of children with cyclic vomiting: a cost-effectiveness assessment. J Pediatr. 2002;141:724–8.

    Article  PubMed  Google Scholar 

  21. Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and motility Society and the Society of Nuclear Medicine. Am J Gastroenterol. 2008;103:753–63.

    Article  PubMed  Google Scholar 

  22. Hejazi RA, Reddymasu SC, Namin F, et al. Efficacy of tricyclic antidepressant therapy in adults with cyclic vomiting syndrome: a two-year follow-up study. J Clin Gastroenterol. 2010;44:18–21.

    Article  PubMed  Google Scholar 

  23. Kumar N, Bashar Q, Reddy N, et al. Cyclic Vomiting Syndrome (CVS): is there a difference based on onset of symptoms--pediatric versus adult? BMC Gastroenterol. 2012;12:52.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Clouse RE, Sayuk GS, Lustman PJ, et al. Zonisamide or levetiracetam for adults with cyclic vomiting syndrome: a case series. Clin Gastroenterol Hepatol. 2007;5:44–8.

    Article  CAS  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thangam Venkatesan M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Dang-Vu, G., Venkatesan, T. (2018). Cyclic Vomiting Syndrome. In: Bardan, E., Shaker, R. (eds) Gastrointestinal Motility Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-59352-4_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59352-4_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59350-0

  • Online ISBN: 978-3-319-59352-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics