Cyclic vomiting syndrome in 28 patients

Lee, Lennard Y.; Abbott, Laura; Moodie, S J; Anderson, Simon

doi:10.1097/meg.0b013e328354fc83

Cited by 24 publications

(12 citation statements)

References 22 publications

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“…CHS is a syndrome of cyclic episodes of nausea, vomiting, and abdominal pain associated with chronic cannabis usage. CHS is frequently confused with cyclic vomiting syndrome, which has similar features 76 . An interesting and poorly understood feature of the syndrome is that patients report reduced symptoms following hot baths or showers 75, 77, 78 .…”

Section: Endocannabinoids In the Control Of Nausea And Vomitingmentioning

confidence: 99%

The Role of the Endocannabinoid System in the Brain–Gut Axis

2016

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The actions of cannabis are mediated by receptors that are part of an endogenous cannabinoid system. The endocannabinoid system (ECS) consists of the naturally occurring ligands N-arachidonoylethanolamine (anandamide) and 2-arachidonoylglycerol (2-AG), their biosynthetic and degradative enzymes, and the cannabinoid receptors CB1 and CB2. The ECS is a widely distributed transmitter system that controls gut functions peripherally and centrally. It is an important physiologic regulator of gastrointestinal motility. Polymorphisms in the gene encoding CB1 (CNR1) have been associated with some forms of irritable bowel syndrome. The ECS is involved in the control of nausea and vomiting and visceral sensation. The homeostatic role of the ECS also extends to the control of intestinal inflammation. We review the mechanisms by which the ECS links stress and visceral pain. CB1 in sensory ganglia controls visceral sensation, and transcription of CNR1 is modified through epigenetic processes under conditions of chronic stress. These processes might link stress with abdominal pain. The ECS is also involved centrally in the manifestation of stress, and endocannabinoid signaling reduces the activity of hypothalamic–pituitary–adrenal pathways via actions in specific brain regions—notably the prefrontal cortex, amygdala, and hypothalamus. Agents that modulate the ECS are in early stages of development for treatment of gastrointestinal diseases. Increasing our understanding of the ECS will greatly advance our knowledge of interactions between the brain and gut and could lead to new treatments for gastrointestinal disorders.

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Section: Endocannabinoids In the Control Of Nausea And Vomitingmentioning

confidence: 99%

The Role of the Endocannabinoid System in the Brain–Gut Axis

2016

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“…Each episode can last from a few hours to several days. Between the attacks, the patients are healthy and symptom-free [ 1 – 4 ]. Multiple triggering factors have been proposed for acute emetic episodes.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and duration of treatment with propranolol in children with cyclic vomiting syndrome in southern Iran

Haghighat¹,

Memari²,

Honar³

et al. 2017

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IntroductionCyclic vomiting syndrome is a functional disorder characterised by repeated episodes of nausea and vomiting with symptom-free intervals between the attacks. Cyclic vomiting syndrome is a migraine equivalent; therefore, anti-migraine medications are effective for cyclic vomiting syndrome prophylaxis, but duration of treatment is not clear.AimTo determine the efficacy and duration of drug therapy in cyclic vomiting syndrome.Material and methodsThis study was conducted on 206 cases of cyclic vomiting syndrome, who were treated with propranolol as prophylaxis. After they were symptom-free for at least 9 months, propranolol was tapered and discontinued and then they were followed for at least 6 months after drug withdrawal for evaluation of recurrence.ResultsThe study subjects included 127 boys and 79 girls. The mean age of symptom onset was 3.4 years (range: 3 months to 14.5 years) and the mean age at the time of diagnosis was 5.7 years (range: 8.4 months to 18 years). Among the 206 patients in whom propranolol was discontinued, only 16 (7.8%) subjects developed recurrence of symptoms in the 6-month follow-up period.ConclusionsThere is no need to continue prophylaxis of cyclic vomiting syndrome for a long time. It is also possible to make the duration of drug therapy shorter, which is useful for the convenience of the patients and prevention of drug side effects.

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“…The aetiology is unknown, but it is possibly because of a dysregulation of the neuroendocrine system, exaggerated cardiovascular responses to postural change and other stimuli that may be associated with the onset of gastrointestinal symptoms. 2 A 27-month-old patient reported to the department of paediatric dentistry with symptoms of swollen gums and loose teeth in the lower front teeth region (figure 1). A detailed history revealed that the patient suffered from repeated episodes of fever and vomiting and was diagnosed with CVS.…”

Section: Descriptionmentioning

confidence: 99%