Growing research .... 2019 Shaping CVS dx

GROWING RESEARCH TREND 

ABOUT CYCLIC VOMITING SYNDROME

        According to Up to Date Cyclic Vomiting Syndrome (B UK Li) Updated March 2018  there are 7 emerging parthenogenesis that are emerging as a result of the last 10 years of study in over 70 published studies. ( Document by subscription or ask your child's PCP for a copy of it. below is just  highlights)

1. CVS and Migraine-  many have strong family history of migraine and progress to migraine as                                 they get older. about 80% of children respond positively to anti migraine therapy.
2. Mitochondrial disorders-  disorders of fatty acid oxidation, MELAS and mitochondrial deletions                             can cause metabolic crisis and vomiting when fasting.
3. Autonomic dysfunction- many also show signs of low tone and meet criteria for postural                                         orthostatic tachycardia syndrome (POTS)
4. Hypothalamus-pituitary adrenal axis hyperactivity- known as Sato variant with hypertension and                            prolonged episodes
5. Endocrine (catamenial CVS)- similar to menstrual headaches during onset of period and its                                     treated with low dose estrogen or progesterone.
6. Food allergy- Sensitivity to cows milk, soy and egg white protein may trigger episodes in                                          children. This relationship is still uncertain.
7. Chronic Cannabis use- Cessation of prolonged high -dose cannabis has been associated with                                    episodic vomiting suggesting a casual link ( THIS IS NOT TOPIC FOR                                        THIS PARTICULAR POST AT THIS TIME)

  These differences can make a difference and knowledge can help choose appropriate treatments.

             Meeting basic criteria is the foundation piece of leading to better treatments and a cure. Patients need to understand the criteria and discuss with their providers what might be their underlying parthenogenesis. If you do not meet the criteria you might another condition or similar one not mentioned that MIGHT respond to similar treatments.

              Adults see this more than kids currently... patient says they have CVS and do not fit the dx criteria.... and Dr know this ... and tell patient CVS is not real.... Well CVS is real .... the question is ...... IS IT THE CAUSE OF YOUR SYMPTOMS you are presenting with...given your presentation, and other related conditions..... Some Dr use CVS as a distinct condition... other use it for any intense vomiting or pain that they cannot explain.  Hopefully new studies that are currently underway will clarify this ... In the FALL 2018 or early 2019  this is to be clarified with new adult guidelines being published with the help of Cyclic Vomiting Syndrome Association.

Hopefully for adults these clarifications and proper use of them will lead to better quality of life.. But again not all intense vomiting or intense pain is CVS.