title: Rapid or normal gastric emptying as new supportive criteria for diagnosing cyclic vomiting syndrome in adults.
abstract: BACKGROUND
  Cyclic vomiting syndrome (CVS) in adults is a disorder characterized by recurrent and stereotypic episodes of severe nausea, vomiting and abdominal pain separated by symptom-free intervals. Our goal was to investigate gastric emptying (GE) in CVS patients.
  
  
  METHODS
  This was a retrospective study of 30 adult patients who met Rome III diagnostic criteria for CVS. Rapid GE was defined using two different predefined criteria as either <50% isotope retention or <65% isotope retention at 1st hour and/or <20% at 2nd hour.
  
  
  RESULTS
  Of the 30 patients (25 had 4-hr GE) diagnosed with CVS, 22 were females and 8 males with a mean age of 39 years. Overall, 20 (80%) of the 25 CVS patients met the predefined criteria of <50% retention for rapid GE in the first hour. Fifteen (60%) met the 2-hour criteria for rapid emptying of <20% retention. Five (16.6%) patients of the 25 had a normal GE with a mean retention at the first hour of 65% (52-78%). Nine (36%) also met another predefined criteria of <35% retention for rapid GE in the first hour. Sixteen (64%) met criteria for normal GE.
  
  
  CONCLUSIONS
  (1) In adult CVS patients, GE is either rapid or normal, clearly distinguishing this entity from gastroparesis. (2) Cyclic vomiting syndrome is an important new etiology to explain the finding of rapid GE on a radionuclide test. (3) We suggest that rapid gastric emptying should be added as supportive criteria for diagnosing CVS in adults.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Cooper
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Sarmad
authors.initials: S
authors.lastname: Said
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Bizet
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Haider
authors.initials: H
authors.lastname: Alkahateeb
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Sarosiek
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014839:Vomiting / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult