Wednesday, April 6, 2016

Cyclic vomiting syndrome

emDocs - April 6, 2016 - Author: Long B - Edited by: Koyfman A and Alerhand S
CVS is defined by stereotypical, recurrent episodes of emesis. Patients will often experience abdominal pain associated with the episodes. Evaluation for red flags is key including severe headache, gait abnormality or other focal neurologic deficit, confusion, GI bleeding, localized abdominal pain, weight loss, progressive worsening, or a change in the typical episode pattern. There is no established diagnostic workup including labs and imaging, and evaluation should be tailored to the patient and presentation. Treatment includes avoidance of triggers, aborting the acute episode, and supportive therapy.
What about cannabis hyperemesis syndrome?
This condition is characterized by patients who smoke large amounts of marijuana chronically, endure daily vomiting episodes, and have improvement of symptoms with bathing/showering using hot water. If trying to differentiate CVS and cannabis hyperemesis, the patient must stop using marijuana for at least one week. If symptoms resolve, cannabis hyperemesis is likely."