Cyclic Vomiting Syndrome: A Functional Disorder

Pediatric Gastroenterology, Hepatology & Nutrition
Ajay Kaul, Kanwar K Kaul

Abstract

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatm...Continue Reading

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Citations

Dec 7, 2019·Journal of Child and Adolescent Mental Health·Mehak Sikand, Pragya Sharma
Mar 12, 2017·Current Neurology and Neuroscience Reports·Samantha IrwinAmy Gelfand
Nov 24, 2020·Frontiers in Neurology·Umberto RaucciPasquale Parisi
Nov 24, 2020·Global Pediatric Health·Toshiyuki HikitaMasakazu Mimaki

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