Cyclic vomiting syndrome - Revision history

Ostermayer: Marked this version for translation

2026-01-14T12:55:11Z

Marked this version for translation

← Older revision		Revision as of 12:55, 14 January 2026
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	==Background==		==Background== <!--T:1-->

			<!--T:2-->
	*Recurrent episodes of [[Special:MyLanguage/vomiting\|vomiting]], otherwise normal health in between		*Recurrent episodes of [[Special:MyLanguage/vomiting\|vomiting]], otherwise normal health in between
	*32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.</ref>		*32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.</ref>
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	==Clinical Features==		==Clinical Features== <!--T:3-->

			<!--T:4-->
	*Pediatric diagnostic criteria<ref>Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008 Sep. 47(3):379-93.</ref>		*Pediatric diagnostic criteria<ref>Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008 Sep. 47(3):379-93.</ref>
	**At least 5 episodes or minimum of 3 over 6 mo		**At least 5 episodes or minimum of 3 over 6 mo
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	==Differential Diagnosis==		==Differential Diagnosis== <!--T:5-->

	</translate>		</translate>
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	==Evaluation==		==Evaluation== <!--T:6-->

			<!--T:7-->
	*Clinical diagnosis of exclusion		*Clinical diagnosis of exclusion
	*Evaluate for alternate etiologies		*Evaluate for alternate etiologies
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	==Management==		==Management== <!--T:8-->

			<!--T:9-->
	*Avoid triggers		*Avoid triggers
	**Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection.		**Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection.
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	==Disposition==		==Disposition== <!--T:10-->

			<!--T:11-->
	*If symptoms can be controlled, may discharge		*If symptoms can be controlled, may discharge
	*For intractable vomiting unable to be controlled with medications, admit		*For intractable vomiting unable to be controlled with medications, admit
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	==See Also==		==See Also== <!--T:12-->

			<!--T:13-->
	*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome\|Cannabinoid hyperemesis syndrome]]		*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome\|Cannabinoid hyperemesis syndrome]]



	==External Links==		==External Links== <!--T:14-->


	==References==		==References== <!--T:15-->

			<!--T:16-->
	<references/>		<references/>
	[[Category:GI]]		[[Category:GI]]

	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T22:47:26Z

Prepared the page for translation

← Older revision		Revision as of 22:47, 4 January 2026
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	<languages/>		<languages/>
	<translate>		<translate>


	==Background==		==Background==
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	*Females slightly more affected than males		*Females slightly more affected than males
	*[[Special:MyLanguage/Marijuana\|Marijuana]] use is risk factor		*[[Special:MyLanguage/Marijuana\|Marijuana]] use is risk factor



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	**[[Special:MyLanguage/Headache\|Headache]]		**[[Special:MyLanguage/Headache\|Headache]]
	**[[Special:MyLanguage/Vertigo\|Vertigo]]		**[[Special:MyLanguage/Vertigo\|Vertigo]]



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	{{Nausea and vomiting DDX}}		{{Nausea and vomiting DDX}}
	<translate>		<translate>



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	*Evaluate for alternate etiologies		*Evaluate for alternate etiologies
	*Assess for [[Special:MyLanguage/dehydration\|dehydration]], [[Special:MyLanguage/electrolyte abnormalities\|electrolyte abnormalities]] if clinically warranted		*Assess for [[Special:MyLanguage/dehydration\|dehydration]], [[Special:MyLanguage/electrolyte abnormalities\|electrolyte abnormalities]] if clinically warranted



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	**[[Special:MyLanguage/IVF\|IVF]] with [[Special:MyLanguage/dextrose\|dextrose]]		**[[Special:MyLanguage/IVF\|IVF]] with [[Special:MyLanguage/dextrose\|dextrose]]
	**Place in quiet, dark room +/- sedative		**Place in quiet, dark room +/- sedative



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	*If symptoms can be controlled, may discharge		*If symptoms can be controlled, may discharge
	*For intractable vomiting unable to be controlled with medications, admit		*For intractable vomiting unable to be controlled with medications, admit



Line 74:		Line 81:

	*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome\|Cannabinoid hyperemesis syndrome]]		*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome\|Cannabinoid hyperemesis syndrome]]



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	<references/>		<references/>
	[[Category:GI]]		[[Category:GI]]

	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T21:59:36Z

Prepared the page for translation

← Older revision		Revision as of 21:59, 4 January 2026
Line 1:		Line 1:
			<languages/>
			<translate>

	==Background==		==Background==
	*Recurrent episodes of [[vomiting]], otherwise normal health in between
			*Recurrent episodes of [[Special:MyLanguage/vomiting\|vomiting]], otherwise normal health in between
	*32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.</ref>		*32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.</ref>
	*Pathophysiology not well understood		*Pathophysiology not well understood
	*Average age at onset ~21yo		*Average age at onset ~21yo
	*Females slightly more affected than males		*Females slightly more affected than males
	*[[Marijuana]] use is risk factor		*[[Special:MyLanguage/Marijuana\|Marijuana]] use is risk factor


	==Clinical Features==		==Clinical Features==

	*Pediatric diagnostic criteria<ref>Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008 Sep. 47(3):379-93.</ref>		*Pediatric diagnostic criteria<ref>Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008 Sep. 47(3):379-93.</ref>
	**At least 5 episodes or minimum of 3 over 6 mo		**At least 5 episodes or minimum of 3 over 6 mo
	**[[Nausea and vomiting (peds)\|Nausea/vomiting]]episodes lasting 1hr-10d, with 1 week in between		**[[Special:MyLanguage/Nausea and vomiting (peds)\|Nausea/vomiting]]episodes lasting 1hr-10d, with 1 week in between
	**Stereotypical pattern and symptoms		**Stereotypical pattern and symptoms
	**Return to baseline health in between		**Return to baseline health in between
	**Symptoms not due to another condition		**Symptoms not due to another condition
	*Adult – Rome III criteria <ref>Venkatasubramani N, Venkatesan T, Li BUK. Extreme Emesis: Cyclic Vomiting Syndrome. Practical Gastroenterology. September 2007. 31:21-34.</ref>		*Adult – Rome III criteria <ref>Venkatasubramani N, Venkatesan T, Li BUK. Extreme Emesis: Cyclic Vomiting Syndrome. Practical Gastroenterology. September 2007. 31:21-34.</ref>
	**Stereotypical episodes of [[vomiting]] with acute onset lasting less than 1 week.		**Stereotypical episodes of [[Special:MyLanguage/vomiting\|vomiting]] with acute onset lasting less than 1 week.
	**At least 3 episodes per year.		**At least 3 episodes per year.
	**No nausea/vomiting between episodes.		**No nausea/vomiting between episodes.
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	*Nausea typically not relieved by vomiting		*Nausea typically not relieved by vomiting
	*+/-		*+/-
	**[[Abdominal pain]]		**[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]
	**[[Diarrhea]]		**[[Special:MyLanguage/Diarrhea\|Diarrhea]]
	**[[Fever]]		**[[Special:MyLanguage/Fever\|Fever]]
	**[[Headache]]		**[[Special:MyLanguage/Headache\|Headache]]
	**[[Vertigo]]		**[[Special:MyLanguage/Vertigo\|Vertigo]]


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Nausea and vomiting DDX}}		{{Nausea and vomiting DDX}}
			<translate>


	==Evaluation==		==Evaluation==

	*Clinical diagnosis of exclusion		*Clinical diagnosis of exclusion
	*Evaluate for alternate etiologies		*Evaluate for alternate etiologies
	*Assess for [[dehydration]], [[electrolyte abnormalities]] if clinically warranted		*Assess for [[Special:MyLanguage/dehydration\|dehydration]], [[Special:MyLanguage/electrolyte abnormalities\|electrolyte abnormalities]] if clinically warranted


	==Management==		==Management==

	*Avoid triggers		*Avoid triggers
	**Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection.		**Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection.
	*May be on medications typically used for migraine prophylaxis		*May be on medications typically used for migraine prophylaxis
	*Abortive [[antiemetics]] therapy		*Abortive [[Special:MyLanguage/antiemetics\|antiemetics]] therapy
	**[[Ondansetron]]- works better with [[benzos]] or [[diphenhydramine]]		**[[Special:MyLanguage/Ondansetron\|Ondansetron]]- works better with [[Special:MyLanguage/benzos\|benzos]] or [[Special:MyLanguage/diphenhydramine\|diphenhydramine]]
	**[[Promethazine]], [[prochlorperazine]]		**[[Special:MyLanguage/Promethazine\|Promethazine]], [[Special:MyLanguage/prochlorperazine\|prochlorperazine]]
	**Triptans (e.g. [[sumatriptan]])		**Triptans (e.g. [[Special:MyLanguage/sumatriptan\|sumatriptan]])
	*Supportive therapy		*Supportive therapy
	**[[IVF]] with [[dextrose]]		**[[Special:MyLanguage/IVF\|IVF]] with [[Special:MyLanguage/dextrose\|dextrose]]
	**Place in quiet, dark room +/- sedative		**Place in quiet, dark room +/- sedative


	==Disposition==		==Disposition==

	*If symptoms can be controlled, may discharge		*If symptoms can be controlled, may discharge
	*For intractable vomiting unable to be controlled with medications, admit		*For intractable vomiting unable to be controlled with medications, admit


	==See Also==		==See Also==
	*[[Cannabinoid hyperemesis syndrome]]
			*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome\|Cannabinoid hyperemesis syndrome]]


	==External Links==		==External Links==
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	==References==		==References==

	<references/>		<references/>
	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Disposition */

2024-03-06T19:49:42Z

Disposition

← Older revision		Revision as of 19:49, 6 March 2024
Line 51:		Line 51:

	==Disposition==		==Disposition==
			*If symptoms can be controlled, may discharge
			*For intractable vomiting unable to be controlled with medications, admit

	==See Also==		==See Also==

ClaireLewis: /* Management */

2019-09-05T15:30:43Z

Management

← Older revision		Revision as of 15:30, 5 September 2019
Line 43:		Line 43:
	*May be on medications typically used for migraine prophylaxis		*May be on medications typically used for migraine prophylaxis
	*Abortive [[antiemetics]] therapy		*Abortive [[antiemetics]] therapy
	**[[Ondansetron]]- works better with a [[~~benzo~~]] or [[diphenhydramine]]		**[[Ondansetron]]- works better with [[benzos]] or [[diphenhydramine]]
	**[[Promethazine]], [[prochlorperazine]]		**[[Promethazine]], [[prochlorperazine]]
	**Triptans (e.g. [[sumatriptan]])		**Triptans (e.g. [[sumatriptan]])

ClaireLewis: Created page with "==Background== Recurrent episodes of vomiting, otherwise normal health in between 32% of patients disabled by illness by time of diagnosisFleisher DR, Gornowicz B,..."

2019-09-05T15:30:30Z

Created page with "==Background== *Recurrent episodes of vomiting, otherwise normal health in between *32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B,..."

New page

==Background==
*Recurrent episodes of [[vomiting]], otherwise normal health in between
*32% of patients disabled by illness by time of diagnosis<ref>Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dec 21. 3:20.</ref>
*Pathophysiology not well understood
*Average age at onset ~21yo
*Females slightly more affected than males
*[[Marijuana]] use is risk factor

==Clinical Features==
*Pediatric diagnostic criteria<ref>Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2008 Sep. 47(3):379-93.</ref>
**At least 5 episodes or minimum of 3 over 6 mo
**[[Nausea and vomiting (peds)|Nausea/vomiting]]episodes lasting 1hr-10d, with 1 week in between
**Stereotypical pattern and symptoms
**Return to baseline health in between
**Symptoms not due to another condition
*Adult – Rome III criteria <ref>Venkatasubramani N, Venkatesan T, Li BUK. Extreme Emesis: Cyclic Vomiting Syndrome. Practical Gastroenterology. September 2007. 31:21-34.</ref>
**Stereotypical episodes of [[vomiting]] with acute onset lasting less than 1 week.
**At least 3 episodes per year.
**No nausea/vomiting between episodes.
**Symptoms not due to another cause
*Symptoms usually begin in early morning or upon waking
*Prodrome of nausea--> vomiting
*Episodes peak/decline over ~8h
*Nausea typically not relieved by vomiting
*+/-
**[[Abdominal pain]]
**[[Diarrhea]]
**[[Fever]]
**[[Headache]]
**[[Vertigo]]

==Differential Diagnosis==
{{Nausea and vomiting DDX}}

==Evaluation==
*Clinical diagnosis of exclusion
*Evaluate for alternate etiologies
*Assess for [[dehydration]], [[electrolyte abnormalities]] if clinically warranted

==Management==
*Avoid triggers
**Many patients have known triggers, such as diet, psychological stressors, sleep deprivation, cannabis, or infection.
*May be on medications typically used for migraine prophylaxis
*Abortive [[antiemetics]] therapy
**[[Ondansetron]]- works better with a [[benzo]] or [[diphenhydramine]]
**[[Promethazine]], [[prochlorperazine]]
**Triptans (e.g. [[sumatriptan]])
*Supportive therapy
**[[IVF]] with [[dextrose]]
**Place in quiet, dark room +/- sedative

==Disposition==

==See Also==
*[[Cannabinoid hyperemesis syndrome]]

==External Links==

==References==
<references/>
[[Category:GI]]

Cyclic vomiting syndrome - Revision history

Ostermayer: Marked this version for translation

Ostermayer: Prepared the page for translation

Ostermayer: Prepared the page for translation

Rossdonaldson1: /* Disposition */

ClaireLewis: /* Management */

ClaireLewis: Created page with "==Background== *Recurrent episodes of vomiting, otherwise normal health in between *32% of patients disabled by illness by time of diagnosisFleisher DR, Gornowicz B,..."

ClaireLewis: Created page with "==Background== Recurrent episodes of vomiting, otherwise normal health in between 32% of patients disabled by illness by time of diagnosisFleisher DR, Gornowicz B,..."