Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions

Area of Science:

• Gastroenterology
• Neurology
• Genetics

Background:

• Cyclic vomiting syndrome (CVS) causes severe episodic emesis in adults and children.
• Cannabinoid hyperemesis syndrome is a recognized CVS-like condition linked to chronic cannabis use.
• Current CVS understanding has significant gaps in pathophysiology, clinical features, comorbidities, and treatment.

Purpose of the Study:

• To review current knowledge of CVS.
• To propose future research directions for effective CVS therapy.
• To highlight the need for a standardized multicenter patient registry.

Main Methods:

• Review of existing literature on CVS.
• Analysis of associated conditions (migraine, mitochondrial disorders, autonomic dysfunction, psychiatric comorbidities) for pathophysiological insights.
• Proposal for establishing a multicenter, standardized CVS patient registry.

Main Results:

• Limited clinical data exists for CVS treatment, with no placebo-controlled trials conducted.
• Associated diseases offer clues to CVS pathophysiology and potential therapeutic targets.
• A standardized patient registry is proposed to drive research, develop outcome measures, and facilitate clinical trials.

Conclusions:

• Establishing a multicenter, standardized CVS patient registry is essential for advancing research.
• Such a registry will enable a better understanding of clinical profiles, facilitate clinical trials, and identify biomarkers.
• Collaboration with government, industry, and patient advocacy groups is crucial for success.