Cyclic vomiting syndrome shares features with cannabinoid hyperemesis but has deeper roots in migraine and mitochondrial disorders
Cyclic vomiting syndrome (CVS) is associated with migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, while cannabinoid hyperemesis syndrome is an increasingly recognized CVS-like illness linked to chronic cannabis use.
Quick Facts
What This Study Found
CVS is characterized by severe episodic emesis with no randomized controlled trials to guide treatment. CHS is an increasingly recognized CVS-like condition associated with chronic cannabis use. Associations with migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric conditions provide pathophysiologic clues.
Key Numbers
No placebo-controlled randomized trials for CVS exist. Associated conditions: migraine, mitochondrial disorders, autonomic dysfunction, psychiatric comorbidities. A multicenter registry is proposed as the foundation for future research.
How They Did This
Expert review of CVS pathophysiology, comorbidities, and future research directions, proposing a multicenter registry approach to advance understanding and treatment development.
Why This Research Matters
CVS and CHS are frequently confused, with different treatment implications. Understanding their shared and distinct features helps clinicians distinguish between them and choose appropriate management. CHS resolves with cannabis cessation; CVS requires different approaches.
The Bigger Picture
As cannabis use increases, distinguishing CHS from CVS becomes more important. Both cause cyclic vomiting, but the treatments diverge completely. Building a registry and developing CVS-specific outcome measures would benefit patients with either condition.
What This Study Doesn't Tell Us
Review article without systematic methodology. CVS lacks standardized diagnostic criteria and outcome measures. The overlap between CVS and CHS is not fully characterized. Treatment recommendations based on limited clinical data.
Questions This Raises
- ?What percentage of CVS cases are actually unrecognized CHS?
- ?Could mitochondrial dysfunction explain why some cannabis users develop CHS while others don't?
- ?Would biomarkers help distinguish CVS from CHS?
Trust & Context
- Key Stat:
- Zero randomized trials for cyclic vomiting syndrome despite increasing recognition
- Evidence Grade:
- Moderate: expert review covering pathophysiology and comorbidities, though based on limited clinical trial data.
- Study Age:
- Published in 2019.
- Original Title:
- Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.
- Published In:
- Neurogastroenterology and motility, 31 Suppl 2(Suppl 2), e13607 (2019)
- Authors:
- Hasler, William L(3), Levinthal, David J(2), Tarbell, Sally E(2), Adams, Kathleen A, Li, B U K, Issenman, Robert M, Sarosiek, Irene, Jaradeh, Safwan S, Sharaf, Ravi N, Sultan, Shahnaz, Venkatesan, Thangam
- Database ID:
- RTHC-02066
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
What's the difference between CVS and CHS?
Both cause cyclic vomiting, but CHS is specifically associated with chronic cannabis use and resolves when cannabis stops. CVS occurs independently of cannabis use and is linked to migraine, mitochondrial disorders, and autonomic dysfunction.
How is cyclic vomiting syndrome treated?
No randomized controlled trials guide CVS treatment. Current recommendations are based on limited clinical data and are informed by associated conditions like migraine. A multicenter registry has been proposed to improve treatment development.
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Cite This Study
https://rethinkthc.com/research/RTHC-02066APA
Hasler, William L; Levinthal, David J; Tarbell, Sally E; Adams, Kathleen A; Li, B U K; Issenman, Robert M; Sarosiek, Irene; Jaradeh, Safwan S; Sharaf, Ravi N; Sultan, Shahnaz; Venkatesan, Thangam. (2019). Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.. Neurogastroenterology and motility, 31 Suppl 2(Suppl 2), e13607. https://doi.org/10.1111/nmo.13607
MLA
Hasler, William L, et al. "Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.." Neurogastroenterology and motility, 2019. https://doi.org/10.1111/nmo.13607
RethinkTHC
RethinkTHC Research Database. "Cyclic vomiting syndrome: Pathophysiology, comorbidities, an..." RTHC-02066. Retrieved from https://rethinkthc.com/research/hasler-2019-cyclic-vomiting-syndrome-pathophysiology
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.