0
0
Cyclic Vomiting Syndrome (CVS) remains an underdiagnosed condition, according to a recent study published in Neurogastroenterology & Motility. Researchers from the United States suggest that limited awareness and rigid diagnostic criteria contribute to this issue.
Study Findings
The study involved approximately 90 adult patients with CVS who maintained a daily symptom diary for six months. The findings revealed that the current diagnostic criteria, which require a minimum seven-day interval between episodes, do not always align with clinical observations. This discrepancy may lead to an underestimation of the true prevalence of CVS.
The researchers emphasized that episode frequency varies among patients, and relying on fixed diagnostic parameters might exclude individuals who do not fit the standard profile.
Expert Insight
Dr. Claudio Romano, a leading expert in pediatric gastroenterology from the University of Messina, Italy, acknowledged the difficulty in diagnosing CVS. Speaking with Univadis Italy, a Medscape Network platform, he noted that CVS is now recognized as a migraine variant rather than solely a gastrointestinal disorder.
Cyclic Vomiting in Children
According to Dr. Romano, CVS can manifest in two primary forms: pediatric-onset and adult-onset. In children, the syndrome typically presents as severe, episodic vomiting that occurs early in the morning, often accompanied by symptoms such as headaches, abdominal pain, and sensitivity to light. These episodes can last for hours or days but are followed by symptom-free intervals.
Diagnosis is often delayed because CVS is frequently mistaken for viral infections, food allergies, or metabolic disorders. Dr. Romano highlighted that a key distinguishing factor is the presence of symptom-free periods lasting months, unlike chronic vomiting conditions such as brain tumors.
Adult Presentation
In adults, CVS tends to have a later onset and affects women more commonly than men. It is often associated with migraines and neurological symptoms. However, Dr. Romano expressed concerns that gastroenterologists, rather than neurologists, frequently manage these patients, which may not always be the ideal approach.
Effective management includes preventive treatments such as antiserotonergic drugs, migraine medications, and antiepileptics. During acute episodes, antiemetics like ondansetron can help, but they are effective in less than 50% of cases.
Additionally, Dr. Romano warned that recurrent vomiting in adults may sometimes be attributed to cannabinoid hyperemesis syndrome, a condition linked to chronic cannabis use. He advised clinicians to rule out this possibility before diagnosing CVS.
The Need for Better Awareness
Despite its impact, epidemiological data on CVS remains scarce. Existing research, primarily from North America and Asia, estimates a prevalence of about 2% in the general population. Dr. Romano defended the current diagnostic criteria, noting that while some patients experience monthly episodes, weekly vomiting suggests a different condition.
He concluded that healthcare providers should maintain a high index of suspicion for CVS and consider neurological consultation for accurate diagnosis. Collaboration between neurologists and gastroenterologists is crucial in ensuring proper patient care.
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Individuals experiencing recurrent vomiting should consult a qualified healthcare professional for proper evaluation and diagnosis.
