From the Guidelines
Approximately 15% of patients with cyclic vomiting syndrome (CVS), a condition related to dysautonomia, experience chronic nausea, as noted in the 2024 study published in Gastroenterology 1. This percentage is derived from the study's discussion on the temporal patterns of CVS episodes and the distinction between mild and moderate-severe forms of the condition. The study highlights that patients with coalescent CVS, a severe form of the condition, often experience chronic nausea, which poses a major diagnostic challenge due to the lack of asymptomatic periods and/or episodic vomiting patterns.
Key points to consider:
- The 2024 study 1 provides the most recent and highest quality evidence on the topic, focusing on the diagnosis and management of cyclic vomiting syndrome.
- The study emphasizes the importance of distinguishing between mild and moderate-severe forms of CVS, with the latter being characterized by a greater number of episodes and longer episode duration.
- Patients with coalescent CVS, a subset of those with severe CVS, often experience chronic nausea, which can be challenging to diagnose and manage.
- The study's findings are relevant to the management of dysautonomia, as CVS is a condition related to autonomic nervous system dysfunction.
In terms of management, patients with dysautonomia and chronic nausea may benefit from a combination of dietary modifications, hydration, medications such as antiemetics (ondansetron, promethazine), and prokinetics (metoclopramide), as well as treatments aimed at regulating the autonomic nervous system, as noted in the context of managing CVS and other related conditions 1.
From the Research
Dysautonomia and Chronic Nausea
- The provided studies do not directly address the percentage of individuals with dysautonomia who experience chronic nausea 2, 3, 4, 5, 6.
- However, one study mentions that gastrointestinal symptoms, including nausea, are common in patients with familial dysautonomia, a rare hereditary sensory and autonomic neuropathy 5.
- The study found that gastrointestinal symptoms affect nearly all patients with familial dysautonomia, but the severity of these symptoms is less than in the general US adult population 5.
- Another study discusses the clinical spectrum and outcomes of dysautonomia in Guillain-Barré Syndrome, but does not specifically mention chronic nausea as a symptom 6.
- The study on dysautonomia in chronic fatigue syndrome mentions that dysautonomia can manifest as disordered regulation of cardiovascular responses to stress, but does not provide information on the prevalence of chronic nausea in these patients 4.