https://wikem.org/w/index.php?action=history&feed=atom&title=Cyclic_vomiting_syndrome%2Fen 2026-04-20T00:02:31Z Revision history for this page on the wiki MediaWiki 1.38.2 https://wikem.org/w/index.php?title=Cyclic_vomiting_syndrome/en&diff=381890&oldid=prev 2026-01-14T13:02:06Z

<p>Updating to match new version of source page</p> <p><b>New page</b></p><div>&lt;languages/&gt;<br /> <br /> <br /> ==Background==<br /> <br /> *Recurrent episodes of [[Special:MyLanguage/vomiting|vomiting]], otherwise normal health in between<br /> *32% of patients disabled by illness by time of diagnosis&lt;ref&gt;Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.&lt;/ref&gt;<br /> *Pathophysiology not well understood<br /> *Average age at onset ~21yo<br /> *Females slightly more affected than males<br /> *[[Special:MyLanguage/Marijuana|Marijuana]] use is risk factor<br /> <br /> <br /> <br /> ==Clinical Features==<br /> <br /> *Pediatric diagnostic criteria&lt;ref&gt;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 Sep. 47(3):379-93.&lt;/ref&gt;<br /> **At least 5 episodes or minimum of 3 over 6 mo<br /> **[[Special:MyLanguage/Nausea and vomiting (peds)|Nausea/vomiting]]episodes lasting 1hr-10d, with 1 week in between<br /> **Stereotypical pattern and symptoms <br /> **Return to baseline health in between<br /> **Symptoms not due to another condition<br /> *Adult – Rome III criteria &lt;ref&gt;Venkatasubramani N, Venkatesan T, Li BUK. Extreme Emesis: Cyclic Vomiting Syndrome. Practical Gastroenterology. September 2007. 31:21-34.&lt;/ref&gt;<br /> **Stereotypical episodes of [[Special:MyLanguage/vomiting|vomiting]] with acute onset lasting less than 1 week. <br /> **At least 3 episodes per year. <br /> **No nausea/vomiting between episodes. <br /> **Symptoms not due to another cause<br /> *Symptoms usually begin in early morning or upon waking<br /> *Prodrome of nausea--&gt; vomiting<br /> *Episodes peak/decline over ~8h<br /> *Nausea typically not relieved by vomiting<br /> *+/-<br /> **[[Special:MyLanguage/Abdominal pain|Abdominal pain]]<br /> **[[Special:MyLanguage/Diarrhea|Diarrhea]]<br /> **[[Special:MyLanguage/Fever|Fever]]<br /> **[[Special:MyLanguage/Headache|Headache]]<br /> **[[Special:MyLanguage/Vertigo|Vertigo]]<br /> <br /> <br /> <br /> ==Differential Diagnosis==<br /> <br /> {{Nausea and vomiting DDX}}<br /> <br /> <br /> <br /> ==Evaluation==<br /> <br /> *Clinical diagnosis of exclusion<br /> *Evaluate for alternate etiologies<br /> *Assess for [[Special:MyLanguage/dehydration|dehydration]], [[Special:MyLanguage/electrolyte abnormalities|electrolyte abnormalities]] if clinically warranted<br /> <br /> <br /> <br /> ==Management==<br /> <br /> *Avoid triggers<br /> **Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection. <br /> *May be on medications typically used for migraine prophylaxis<br /> *Abortive [[Special:MyLanguage/antiemetics|antiemetics]] therapy<br /> **[[Special:MyLanguage/Ondansetron|Ondansetron]]- works better with [[Special:MyLanguage/benzos|benzos]] or [[Special:MyLanguage/diphenhydramine|diphenhydramine]]<br /> **[[Special:MyLanguage/Promethazine|Promethazine]], [[Special:MyLanguage/prochlorperazine|prochlorperazine]]<br /> **Triptans (e.g. [[Special:MyLanguage/sumatriptan|sumatriptan]])<br /> *Supportive therapy<br /> **[[Special:MyLanguage/IVF|IVF]] with [[Special:MyLanguage/dextrose|dextrose]]<br /> **Place in quiet, dark room +/- sedative<br /> <br /> <br /> <br /> ==Disposition==<br /> <br /> *If symptoms can be controlled, may discharge<br /> *For intractable vomiting unable to be controlled with medications, admit<br /> <br /> <br /> <br /> ==See Also==<br /> <br /> *[[Special:MyLanguage/Cannabinoid hyperemesis syndrome|Cannabinoid hyperemesis syndrome]]<br /> <br /> <br /> <br /> ==External Links==<br /> <br /> <br /> ==References==<br /> <br /> &lt;references/&gt;<br /> [[Category:GI]]</div>

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