Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management

BMC Med. 2005 Dec 21:3:20. doi: 10.1186/1741-7015-3-20.

Abstract

Background: Cyclic Vomiting Syndrome (CVS) is a disorder characterized by recurrent, stereotypic episodes of incapacitating nausea, vomiting and other symptoms, separated by intervals of comparative wellness. This report describes the clinical features, co-morbidities and problems encountered in management of 41 adult patients who met the diagnostic criteria for CVS.

Methods: This is a retrospective study of adults with CVS seen between 1994 and 2003. Follow-up data were obtained by mailed questionnaires.

Results: Age of onset ranged from 2 to 49 years. The duration of CVS at the time of consultation ranged from less than 1 year to 49 years. CVS episodes were stereotypic in respect of their hours of onset, symptomatology and length. Ninety-three percent of patients had recognizable prodromes. Half of the patients experienced a constellation of symptoms consisting of CVS episodes, migraine diathesis, inter-episodic dyspeptic nausea and a history of panic attacks. Deterioration in the course of CVS is indicated by coalescence of episodes in time. The prognosis of CVS is favorable in the majority of patients.

Conclusion: CVS is a disabling disorder affecting adults as well as children. Because its occurrence in adults is little known, patients experience delayed or mis-diagnosis and ineffectual, sometimes inappropriately invasive management.

MeSH terms

  • Adult
  • Anxiety
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / complications
  • Panic Disorder / complications
  • Periodicity*
  • Retrospective Studies
  • Syndrome
  • Vomiting* / physiopathology
  • Vomiting* / psychology
  • Vomiting* / therapy