Cyclic vomiting syndrome and functional vomiting in adults: association with cannabinoid use in males

Neurogastroenterol Motil. 2012 Jan;24(1):20-6, e1. doi: 10.1111/j.1365-2982.2011.01791.x. Epub 2011 Sep 27.

Abstract

Background: Cyclic vomiting syndrome (CVS) is characterized by stereotypical episodes of vomiting separated by symptom-free intervals. However, the difficulty encountered in the management of patients with CVS may be a reflection of a deficiency in our understanding of the disorder. We aimed to evaluate whether clinical or gastric emptying (GE) data discriminate patients labeled as having CVS from functional vomiting (FV) or irritable bowel syndrome (IBS).

Methods: The medical records of patients diagnosed with any vomiting (including CVS, FV) over a 13-year period (1993-2006) at our institution were carefully reviewed. Disease controls were age and gender matched subjects with IBS. Gastric emptying was performed by scintigraphy (99mTc-egg meal). The associations of clinical factors and GE data with patient status (CVS vs FV or IBS) were analyzed.

Key results: A total of 82 patients with CVS and 62 FV patients were identified. Younger age [per 10 years, OR = 0.7 (0.5, 0.9)], male gender [OR = 0.4 (0.2, 0.9)], and cannabinoid use [OR = 2.9 (1.2, 7.2)] were significantly associated with CVS compared with FV. However, there were no significant associations between patient status (CVS vs FV) and age, BMI, smoking, alcohol use, gastrointestinal symptoms, or GE. The proportion of cannabinoid users was significantly higher in patients with CVS compared with patients with IBS, whereas proportions for headaches and psychiatric disease were higher in subjects with IBS.

Conclusions & inferences: Cyclic vomiting syndrome (vs FV) was not associated with clinical factors, but was associated with younger age, male gender and cannabinoid use. A larger proportion of CVS (vs IBS) patients had used cannabinoids.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cannabinoids / pharmacology*
  • Female
  • Gastric Emptying / physiology
  • Humans
  • Male
  • Marijuana Smoking / adverse effects*
  • Middle Aged
  • Retrospective Studies
  • Vomiting / chemically induced*
  • Vomiting / physiopathology*
  • Young Adult

Substances

  • Cannabinoids

Supplementary concepts

  • Familial cyclic vomiting syndrome