CVS Diagnosis

Submitted by Thiruvelan on Tue, 04/09/2013
CVS Diagnosis

Diagnosing CVS is a difficult task; there are no definite diagnosing tests such as a blood test or x ray, which can establish a diagnosis of CVS.

Although there is no definite test available for CVS, there are established criteria to help diagnosis of CVS.

Diagnostic criteria for cyclic vomiting syndrome

All the below criteria a patient should be met for CVS diagnosis, otherwise they do not have CVS.

  • At least there should be five attacks in any interval or a minimum of three attacks over a six-month period.
  • Episodes of intensive nausea and vomiting, which is extending from one hour to ten days and re-occur at least one week apart.
  • There are a specific stereotypical pattern and symptoms.
  • Vomiting during an episode occurs at least four times per hour, which lasts for a minimum one hour.
  • There is a normal health in between episodes.
  • Look to be pallor, dehydration, fever, excessive salivation and social withdrawal.

There is no specific test to confirm the cyclic vomiting syndrome diagnosis. However, your doctors must rule out other conditions that can produce vomiting, such as:

  • Metabolic disorders
  • Intestinal blockage
  • Brain's tumors
  • Pregnancy
  • Eating disorders

Cyclic vomiting syndrome diagnosis

If have an attack with bilious emesis (forcible vomit contains pile), abdominal pain or tenderness (unusual sensitivity to touch or pressure) and in severe cases with hematemesis (blood vomit). Take at any time; ultrasound of the abdomen and pelvis, amylase & lipase, esophagogastroduodenoscopy and take during an attack; ALT/GGT, lipase +/- amylase. This test helps to rule out intestinal obstruction, intermittent upper gastrointestinal obstruction.

Has an episodic vomiting induced by fasting, inter-current illness and high-protein meal? Take glucose, electrolytes for anion gap, urine ketones, lactate, ammonia, serum amino acids, urine organic acids, plasma carnitine and acylcarnitine. These tests help to rule out mitochondrial or metabolic problems.

If having an altered mental status or gait, abnormal eye movements, papilledema, take brain MRI to rule out subtentorial neoplasm, chiari's malformation.

If all the above has ruled out and having CVS symptoms without suggesting of another disorder has confirmed as CVS.