Research article

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

David R Fleisher¹ , Blake Gornowicz² , Kathleen Adams³ , Richard Burch⁴ and Edward J Feldman^5,6

¹Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, USA

²Department of Medicine, University of Missouri Hospitals and Clinics, Columbia, Missouri, USA

³Cyclic Vomiting Syndrome Association, Milwaukee, Wisconsin, USA

⁴Department of Psychiatry, University of Missouri School of Medicine, Columbia, Missouri, USA

⁵Department of Medicine, Geffen School of Medicine at UCLA, Los Angeles, California, USA

⁶Department of Pediatrics, Geffen School of Medicine at UCLA, Los Angeles, California, USA

author email corresponding author email

BMC Medicine 2005, 3:20doi:10.1186/1741-7015-3-20

Published:	21 December 2005

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.