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cyclic vomiting syndrome

Sanjay Bhandari, Thangam Venkatesan
Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder that is characterized by episodic nausea and vomiting. Initially thought to only affect children, CVS in adults was often misdiagnosed with significant delays in therapy. Over the last decade, there has been a considerable increase in recognition of CVS in adults but there continues to be a lack of knowledge about management of this disorder. This paper seeks to provide best practices in the treatment of CVS and also highlight some novel therapies that have the potential in better treating this disorder in the future...
October 18, 2016: Current Treatment Options in Gastroenterology
Ingeborg P M Hermus, Stacey J B Willems, Aimée C C F Bogman, Paddy K C Janssen, Leonie Brabers, Jan N M Schieveld
OBJECTIVE: This article presents an update on cyclic vomiting syndrome, a potentially exhausting disorder that can occur in children, adolescents, and adults and and has a huge impact on the quality of life. A structured literature search was conducted to explore the current knowledge about antipsychotics in the treatment of cyclic vomiting syndrome. A case report is presented of a 15-year-old boy with refractory cyclic vomiting syndrome (ICD-10 criteria), who finally responded to a unique combination of risperidone and amitriptyline...
2016: Primary Care Companion to CNS Disorders
Marlena Schoenberg Fejzo, Ronny Myhre, Lucia Colodro-Conde, Kimber Macgibbon, Janet S Sinsheimer, M V Prasad Linga Reddy, Päivi Pajukanta, Dale R Nyholt, Margaret J Wright, Nicholas G Martin, Stephanie M Engel, Sarah E Medland, Per Magnus, Patrick M Mullin
Hyperemesis Gravidarum (HG), severe nausea/vomiting in pregnancy (NVP), can cause poor maternal/fetal outcomes. Genetic predisposition suggests the genetic component is essential in discovering an etiology. We performed whole-exome sequencing of 5 families followed by analysis of variants in 584 cases/431 controls. Variants in RYR2 segregated with disease in 2 families. The novel variant L3277R was not found in any case/control. The rare variant, G1886S was more common in cases (p = 0.046) and extreme cases (p = 0...
September 20, 2016: Molecular and Cellular Endocrinology
Jennifer L Jones, Karen E Abernathy
Chronic use of cannabis can result in a syndrome of hyperemesis characterized by cyclical vomiting without any other identifiable causes. Cannabinoid hyperemesis syndrome (CHS) is seldom responsive to traditional antiemetic therapies. Despite frequent nausea and vomiting, patients may be reluctant to discontinue use of cannabis. We report a case of severe, refractory CHS with complete resolution of nausea and vomiting after treatment with haloperidol in the outpatient setting. After review of the literature, we believe this is the first reported successful outpatient treatment of CHS and suggests a potential treatment for refractory patients...
2016: Case Reports in Psychiatry
Sally E Tarbell, Amanda Millar, Mark Laudenslager, Claire Palmer, John E Fortunato
This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C)...
August 16, 2016: Autonomic Neuroscience: Basic & Clinical
Vidyut Bhatia, Shivani Deswal, Swati Seth, Akshay Kapoor, Anupam Sibal, Sarath Gopalan
BACKGROUND: Functional gastrointestinal diseases (FGIDs) are emerging as an important cause of morbidity in adolescents globally. The prevalence of FGIDs among Indian children or adolescents is not clear. METHODS: A cross-sectional school-based survey conducted in 1115 children aged 10-17 years attending four semi urban government schools of National capital territory (NCT) of Delhi. Rome III questionnaire was translated into Hindi and was filled by the students under supervision...
July 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Shanthan Mettu, Dwitha Animireddy, Pratej Kiran Kanumuri, Radhika Muppa
No abstract text is available yet for this article.
2016: BMJ Case Reports
Álvaro Sánchez-Larsen, Tomás Segura, Susana García-Muñozguren, Javier Peinado-Ródenas, Joaquín Zamarro, Francisco Hernández-Fernández
BACKGROUND: Magnesium has a regulatory role in the excitability of cell membranes, and is also a cofactor in the phosphorylation of thiamine. Hypomagnesemia has been associated with coronary vasospasm, but its role in cerebrovascular pathology is controversial, and cerebral vasospasm exclusively attributable to hypomagnesemia has not been reported in humans. CASE PRESENTATION: We report the case of a 51-year-old man in whom uncontrollable vomiting, treatment with omeprazole and thiazide, and renal impairment lead to a severe hypomagnesemia (magnesium below the level of detection in blood tests), which secondarily caused Wernicke's encephalopathy and vasospasm in multiple cerebral arteries (seen with cerebral angiography and CT angiography) that presented with a complete right hemisphere neurological deficit...
2016: BMC Neurology
Fanny Pélissier, Isabelle Claudet, Peggy Gandia-Mailly, Amine Benyamina, Nicolas Franchitto
BACKGROUND: Chronic cannabis users may experience cyclical episodes of nausea and vomiting and learned behavior of hot bathing. This clinical condition, known as cannabis hyperemesis syndrome, was first reported in 2004. OBJECTIVE: Our aim was to promote early recognition of this syndrome in emergency departments (EDs) and to increase referral to addiction specialists. METHODS: Cannabis abusers were admitted to the ED for vomiting or abdominal pain from June 1, 2014 to January 1, 2015 and diagnosed with cannabis hyperemesis syndrome by a specialized addiction team...
July 30, 2016: Journal of Emergency Medicine
Silvia Salvatore, Salvatore Barberi, Osvaldo Borrelli, Annamaria Castellazzi, Dora Di Mauro, Giuseppe Di Mauro, Mattia Doria, Ruggiero Francavilla, Massimo Landi, Alberto Martelli, Vito Leonardo Miniello, Giovanni Simeone, Elvira Verduci, Carmen Verga, Maria Assunta Zanetti, Annamaria Staiano
BACKGROUND: Functional gastrointestinal disorders (FGIDs) are chronic or recurrent gastrointestinal symptoms without structural or biochemical abnormalities. FGIDs are multifactorial conditions with different pathophysiologic mechanisms including altered motility, visceral hyperalgesia, brain-gut disturbance, genetic, environmental and psychological factors. Although in most cases gastrointestinal symptoms are transient and with spontaneous resolution in infancy multiple dietary changes and pharmacological therapy are often started despite a lack of evidence-based data...
2016: Italian Journal of Pediatrics
Srinivasan Ramadurai, Sowmya Gopalan, Preetam Arthur
No abstract text is available yet for this article.
April 2016: Indian Journal of Psychiatry
Michael Camilleri
BACKGROUND: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. KEY MESSAGES: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating...
2016: Digestive Diseases
Oya Balci Sezer, Taner Sezer
Background/Aims: The aim of this study was to compare the efficacy and tolaribility of topiramate and propranolol in preventing pediatric cyclic vomiting syndrome. Methods: A retrospective medical-record review of patients who underwent prophylaxis after receiving a diagnosis of cyclic vomiting syndrome was performed. Patients who completed at least 12 months of treatment were included in the analysis. Responder rate, and adverse-event rates were also calculated from all patients...
June 13, 2016: Journal of Neurogastroenterology and Motility
Jillian Casey, Allan Jenkinson, Alex Magee, Sean Ennis, Ahmad Monavari, Andrew Green, Sally A Lynch, Ellen Crushell, Joanne Hughes
We report a female child from an Irish Traveller family presenting with severe intellectual disability, dysmorphic features, renal anomalies, dental caries and cyclical vomiting. Current health issues include global developmental delay, mild concentric left ventricular hypertrophy, dental malocclusion and caries and a single duplex left kidney. The proband and her mother also have multiple epiphyseal dysplasia. Whole-exome sequencing was performed to identify the underlying genetic cause. DNA from the proband was enriched with the Agilent Sure Select v5 Exon array and sequenced on an Illumina HiSeq...
October 2016: Clinical Dysmorphology
Inderpreet Grover, Richard Kim, Danielle C Spree, Christopher J Lahr, Archana Kedar, Shivangi Kothari, David Fleisher, Thomas L Abell
Background/Aims: Cyclic vomiting syndrome (CVS) is a disabling migraine variant manifesting as severe episodes of nausea and vomiting and often refractory to many therapies. Gastric electrical stimulation (GES), which can reduce nausea and vomiting in gastroparesis, may provide symptomatic relief for drug-refractory CVS. This study assessed the utility GES in reducing the symptoms of CVS and improving quality of life. Methods: A one-year, non-randomized, clinical study was conducted...
May 30, 2016: Journal of Neurogastroenterology and Motility
Vincenzo Stanghellini, Francis K L Chan, William L Hasler, Juan R Malagelada, Hidekazu Suzuki, Jan Tack, Nicholas J Talley
Symptoms that can be attributed to the gastroduodenal region represent one of the main subgroups among functional gastrointestinal disorders. A slightly modified classification into the following 4 categories is proposed: (1) functional dyspepsia, characterized by 1 or more of the following: postprandial fullness, early satiation, epigastric pain, and epigastric burning, which are unexplained after a routine clinical evaluation; and includes 2 subcategories: postprandial distress syndrome that is characterized by meal-induced dyspeptic symptoms and epigastric pain syndrome that does not occur exclusively postprandially; the 2 subgroups can overlap; (2) belching disorders, defined as audible escapes of air from the esophagus or the stomach, are classified into 2 subcategories, depending on the origin of the refluxed gas as detected by intraluminal impedance measurement belching: gastric and supragastric belch; (3) nausea and vomiting disorders, which include 3 subcategories: chronic nausea and vomiting syndrome; cyclic vomiting syndrome; and cannabinoid hyperemesis syndrome; and (4) rumination syndrome...
May 2016: Gastroenterology
Vincenzo Stanghellini, Nicholas J Talley, Francis Chan, William L Hasler, Juan Malagelada, Hidekazu Suzuki, Jan Tack
Symptoms that can be attributed to the gastroduodenal region represent one of the main subgroups among functional gastrointestinal disorders. A slightly modified classification into four categories is proposed. B1) Functional dyspepsia (FD), characterized by one or more of: postprandial fullness, early satiation, epigastric pain, epigastric burning that are unexplained after a routine clinical evaluation, includes two subcategories: Postprandial Distress Syndrome (PDS) that is characterized by meal-induced dyspeptic symptoms and Epigastric Pain Syndrome (EPS) that does not occur exclusively postprandially...
February 15, 2016: Gastroenterology
Phillip Gregoire, Michael Tau, David Robertson
Cannabinoid hyperemesis syndrome is a rare, recently described, clinically diagnosed condition that is characterised by a chronic history of cannabis use, cyclic nausea and vomiting, symptomatic relief with hot water bathing, and resolution with cessation of use. We present a case of this syndrome concurrent in a patient with bipolar mania. We suggest that a 3-week period of vomiting in the context of this syndrome contributed to the precipitation of a manic episode by lowering mood stabiliser serum levels, and that this syndrome will have significant consequences for the patient's mental health...
2016: BMJ Case Reports
T Venkatesan, Y Zadvornova, H Raff, C J Hillard
BACKGROUND: The endocannabinoid system and the hypothalamic-pituitary-adrenal axis are important neuromodulators of nausea and vomiting. This led us to hypothesize that patients with cyclic vomiting syndrome (CVS) have lower serum endocannabinoids (eCBs) and higher salivary cortisol and alpha amylase. METHODS: Serum eCBs and related lipids, N-oleoylethanolamine (OEA) and N-palmitoylethanolamide (PEA), and salivary cortisol, and alpha amylase (index of sympathetic nervous system activity) were measured in 22 CVS patients (age 40 ± 11, female = 17) in the well and sick phases and 12 matched controls (age 37 ± 12, female = 10)...
September 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
N Desjardins, C Stheneur
Cannabis is the most widely used illicit drug in the world. In France, cannabis use has been increasing among youth since 2011, in both experimental use and regular consumption. A distinct syndrome, characterized by recurrent vomiting associated with abdominal pain and compulsive bathing, has been increasingly recognized in adult chronic users. Cannabinoid hyperemesis syndrome (CHS) is still underdiagnosed in adults and even more so among adolescents. Classically, CHS progresses into three distinct phases: prodromal, hyperemetic, and recovery...
June 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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