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Cyclic vomiting syndrome is, by definition, a syndrome with episodic bouts of uncontrollable vomiting, separated by periods of relative wellness. These attacks are often accompanied by other symptoms including intense nausea, abdominal pain, headaches, photo- and phonophobia, and several autonomic symptoms similar to those observed in migraine Over the past 10 years, there have been several reports of gabapentin also having anti-nausea and anti-emetic effects in conditions including postoperative nausea and vomiting (PONV), chemotherapy-induced nausea and vomiting (CINV), and hyperemesis gravidarum (HG). Compare the effectiveness of gabapentin vs. morphine sulfate for cyclic vomiting syndrome based on the experiences of 59 members of the cyclic vomiting syndrome research community. The 21st century dawns with new hope for affected children and adolescents. Collaborative research promises improved understanding and evidence-based treatment of CVS, and an international support group, the Cyclic Vomiting Syndrome Association (with 29 international chapters), has been formed to help families cope with this disruptive disorder (for contact information, see below). Cyclic vomiting syndrome (CVS) is a chronic functional gastrointes-tinal disorder that is being increasingly recognized in adults.1,2 It is characterized by episodic nausea and vomiting and is associated with significant morbidity. In a recent meta-analysis of 8 trials, gabapentin reduced PONV as a primary endpoint with a relative risk of 0.60 (99% CI, 0.50–0.72) including nausea with an RR of 0.34 (99% CI, 0.20–0.56) and vomiting with an RR of 0.34 (99% CI, 0.19–0.61). This therapy is associated with sedation as a side effect. 1. Evaluate nausea, vomiting, and other supporting symptoms to differentiate between acute, chronic, and cyclic causes of vomiting. 2. Design appropriate treatment for nausea/vomiting on the basis of the underlying cause. 3. Develop a treatment plan for cyclic vomiting syndrome to include abortive and prophylactic therapy, when indicated. 4. C V S A U S A / C a n a d a P.O. Box 270341, Milwaukee, WI 53227 P: 414-342-7880 Email: cvsa@cvsaonline.org Website: www.cvsaonline.org EMPIRIC GUIDELINES FOR TREATMENT OF CYCLIC VOMITING SYNDROME Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome. Risk factors. The relationship between migraines and cyclic vomiting syndrome isn't clear. But many children with cyclic vomiting syndrome have a family history of migraines or have migraines themselves when they get older. Up to 3% of the population will report symptoms of vomiting in cross-sectional surveys. 1 Cyclic vomiting syndrome (CVS) is an uncommon condition characterised by stereotypical acute episodes of severe nausea and vomiting, interspersed by periods of days to months during which the patient is symptom-free. Recognizing CVS in adults is critical, as there are several fairly effective prophylactic and abortive therapies to treat the disorder. Cyclic vomiting syndrome (CVS) is an idiopathic disorder characterized by recurrent, stereotypical bouts of vomiting with intervening periods of normal or baseline health [1]. Both children and adults are affected, although the clinical presentation and natural history vary somewhat with age [2-6]. CVS was first described in the late 1800s [7,8]. In particular, cyclic vomiting syndrome and cannabinoid hyperemesis syndrome need to be differentiated from nausea/vomiting predominant gastroparesis. Management options depend on the degree of patient-reported symptoms and/or the degree of gastric emptying delay (mild, moderate, and severe) on a 4-hour gastric emptying scan. Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. These Evidence‐Based Guidelines on the Management of CVS in Adults are based on the GRADE (Grading of ecommendations, Assessment, Development and Evaluation) framework and recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis and overall management of CVS are made. Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender Cyclic vomiting syndrome (CVS) is a chronic disorder of gut–brain interaction characterized by acute episodes of nausea, vomiting, and retching, separated in time by episode-free periods. Individuals with CVS can identify a stereotypic pattern of symptoms that present during both the prodromal and emetic phases. Out of 33 clinical trials reviewed, 12 assessed nausea and/or vomiting (N/V) associated with gabapentin therapy as primary outcome measures. These 12 studies provided a Grade A recommendation Cyclic vomiting syndrome (CVS) is a functional brain-gut disorder characterized by recurrent severe prolonged episodes of nausea and vomiting in otherwise healthy people. 1-3 These episodes can be excruciating and last for days. They are frightening for the patient and family and may lead to serious complications. Open-label gabapentin treatment in hyperemesis gravidarum was associated with reduced nausea and vomiting and improved oral nutrition. Objective: This study aimed to determine whether gabapentin is more effective than standard-of-care therapy for treating hyperemesis gravidarum.
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