A systematic review on functional emesis disorders
Recommended Citation
Singh B, Kaur G, Grover P, Ethakota J. A systematic review on functional emesis disorders. Neurogastroenterol Motil 2025; 37.
Document Type
Conference Proceeding
Publication Date
11-15-2025
Publication Title
Neurogastroenterol Motil
Keywords
antiemetic agent, aprepitant, ondansetron, sumatriptan, topiramate, tricyclic antidepressant agent, cannabinoid hyperemesis, cannabis use, conference abstract, cyclic vomiting syndrome, diagnosis, drug therapy, family history, human, Italy, migraine, remission, side effect, systematic review, therapy, treatment guideline, vomiting
Abstract
Objectives: Functional emesis disorders are based on altered gut-brain relationships. Due to overlapping symptoms, and unclear treatment guidelines, people often get misdiagnosed and treated wrong leading to underwhelming results. The review focuses on pre-existing literature on diagnosis and treatment of Cyclic vomiting syndrome (CVS) and Cannabis hyperemesis syndrome (CHS). It compiles guidelines diagnosis and treatment recommendations. It also looks into stereotypic hot shower behavior generally associated with CHS. Methods: The authors reviewed databases including PubMed, Cochrane, and Google Scholar to look at literature published in the last 5 years in the field of CHS and CVS treatment and diagnosis. 3 articles were ultimately included. Results and Discussion: Rome criterion for CVS includes acute stereotypical vomiting episodes and relative symptom-free intervals, supported by personal or family history of migraines. The patient should have had 3 episodes in the last year with 2 in the last 6 months. For CHS, it includes CVS-like episodes, cannabis use, and improvement with cessation in criterion with hot showers as support. A more refined criterion includes at least one year of > 4 times/ week cannabis use and 6 months of cessation has been proposed by Thangam et al. Thangam et al, also proposes treatment including, anti-emetics including ondansetron, and even aprepitant. Sumatriptan has beneficial as well. For maintenance of remission, tricyclic antidepressants and topiramate has shown promise. Conclusions: Diagnosis and treatment for CHS and CVS are difficult and less defined but pre-existing literature can be used to diagnose including Rome and Thangam et al criterion. There are studies showing the efficacy of abortive and maintenance agents. Definitive trials are lacking but these studies can guide treatment in the interim.
Volume
37
