Cyclic vomiting syndrome is a prevalent and under-recognized condition in the gastroenterology outpatient clinic

Neurogastroenterol Motil. 2018 Jan;30(1). doi: 10.1111/nmo.13174. Epub 2017 Jul 26.

Abstract

Background: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder (FGID) characterized by intermittent episodes of nausea and vomiting. Our aim was to report its prevalence and associated features.

Methods: Data concerning demographics, symptoms, and psychiatric comorbidity were collected. Symptoms compatible with CVS were classified as per Rome III criteria. We recorded whether a diagnosis of CVS was considered in patients after negative investigation. We compared demographics and association with other FGIDs in patients with and without CVS.

Key results: 920 of 1002 patients provided data. Of the 920 patients, 112 (12.2%) had symptoms compatible with CVS. Thirteen (11.6%) of these had an organic cause for their symptoms, but 99 patients (88.4%) were deemed to have CVS (prevalence=10.8%). Organic causes for symptoms compatible with CVS included gastroparesis, large hiatus hernia, achalasia, and small bowel obstruction. Only 39.4% of patients with CVS were asked about vomiting symptoms at their initial consultation, and a diagnosis of CVS was considered in only four (4.0%) of the 99 patients. CVS was associated with younger age, tobacco smoking, never having married, psychiatric comorbidity, and presence of symptoms compatible with other FGIDs (P≤.01).

Conclusions and inferences: Prevalence of CVS in this outpatient gastroenterology adult population was 10.8%. Identified associations included younger age, tobacco smoking, psychiatric comorbidity, and symptoms compatible with other FGIDs. The condition was considered as a possible diagnosis in <5% of patients who met the diagnostic criteria.

Keywords: functional gastrointestinal disorders; prevalence; vomiting.

MeSH terms

  • Adult
  • Ambulatory Care Facilities / statistics & numerical data
  • Female
  • Gastroenterology
  • Humans
  • Male
  • Middle Aged
  • Outpatients
  • Prevalence
  • Vomiting / diagnosis
  • Vomiting / epidemiology*

Supplementary concepts

  • Familial cyclic vomiting syndrome