Cyclical Vomiting Syndrome (CVS)

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CVS

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Cyclical vomiting syndrome (CVS)
-Hx of CVS and multiple workup with no known organic cause of nausea and vomiting, except hx of marijuana use.
-DDx includes: Gastroenteritis, gallbladder/ peptic ulcer disease, appendicitis, pancreatitis obstruction, IBS, psychiatric causes, neurological causes, and pregnancy.
-Per ROME criteria, meets diagnosis.
-Exclude pregnancy with a pregnancy test.
-Follow CBC, CMP, lipase, urinalysis, urine drug screen, gallbladder ultrasound, +/- CT scan of abdomen and pelvis.
-Treat for dehydration, counselled on CBD cessation.
-Antiemetic w/wo Lorazepam or Diphenhydramine.
-Sumatriptan, if concerns for headache.
-Will consider low dose Amitriptyline, if recurrent admission for CVS.
-Close f/u with PCP on discharge.

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