Management of Adult Cyclic Vomiting Syndrome, Including the Use of Opiates

Abstract

Cyclic Vomiting Syndrome is a functional vomiting disorder characterized by recurrent, stereotypic episodes of overwhelming nausea and vomiting lasting hours or days, separated by intervals of relative wellness lasting weeks or months. Samuel Gee first described the condition in the English language literature in 1882. He reported a series of 9 children ranging in age from 4 to 8 years. For more than a century thereafter, CVS was viewed as a pediatric disorder with the result that it was nearly unknown by physicians practicing adult medicine. The fact that CVS is prevalent in adults has been recognized only in the past few years. There are no evidence‐based guidelines for the management of CVS in children or adults and it is my hope that this essay might contribute to further thought and clinical investigation that will lead to a way out of a therapeutic wilderness.