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Cyclic Vomiting Syndrome: A Functional Disorder.

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Area of Science:

  • Gastroenterology
  • Neurology
  • Pediatrics

Background:

  • Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder characterized by recurrent, stereotypical episodes of intense nausea and vomiting.
  • CVS commonly affects children aged 3-7 years, with no gender predilection.
  • The pathophysiology is unclear, but associations with migraine headaches suggest a potential mitochondriopathy or autonomic neuropathy.

Purpose of the Study:

  • To provide a comprehensive overview of cyclic vomiting syndrome (CVS).
  • To discuss the pathophysiology, triggers, clinical presentation, and management of CVS.
  • To highlight potential complications and long-term outcomes associated with CVS.

Main Methods:

  • Review of existing literature on cyclic vomiting syndrome.
  • Analysis of clinical characteristics, diagnostic considerations, and treatment strategies.
  • Discussion of potential underlying mechanisms, including genetic and neurological factors.

Main Results:

  • CVS episodes are preceded by a prodrome, followed by vomiting, recovery, and an asymptomatic phase.
  • Potential triggers are identified in many individuals, and avoidance can aid prevention.
  • Severe cases may lead to complications like dehydration and esophageal tears (Mallory-Weiss).

Conclusions:

  • Management involves abortive treatments (e.g., ondansetron, sumatriptan) and prophylactic therapies (e.g., cyproheptadine, propranolol).
  • Many children outgrow CVS, and no direct mortality is reported.
  • A subset of patients may develop other functional disorders, such as irritable bowel syndrome and migraine headaches.