Applying Nutrient Drink Test in Understanding Pathophysiology of CVS
| Status: | Enrolling by invitation |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/14/2019 |
| Start Date: | February 1, 2018 |
| End Date: | December 2019 |
Applying Nutrient Drink Test in Understanding Pathophysiology of Cyclic Vomiting Syndrome
Cyclic vomiting syndrome is a disorder characterized by nausea and vomiting, separated by
periods without any symptoms. There is very little research on this field at this point and
most doctors do not fully understand the disorder. The goal of this study is to assess how
the stomach empties food. Participants will be asked to participate in this study because
either (a) they have been diagnosed and/or treated for cyclic vomiting syndrome in the past,
or (b) they are physically healthy. The study seeks to compare how a healthy person's stomach
empties to how the stomach of someone with cyclic vomiting disorder empties.
periods without any symptoms. There is very little research on this field at this point and
most doctors do not fully understand the disorder. The goal of this study is to assess how
the stomach empties food. Participants will be asked to participate in this study because
either (a) they have been diagnosed and/or treated for cyclic vomiting syndrome in the past,
or (b) they are physically healthy. The study seeks to compare how a healthy person's stomach
empties to how the stomach of someone with cyclic vomiting disorder empties.
Up to 14% of unexplained vomiting in adults is attributed to an under recognized and often
misdiagnosed disorder termed cyclic vomiting syndrome (CVS). As CVS is better understood,
gastroenterologists are increasingly recognizing the importance of timely diagnosis and early
management for this chronic and debilitating disorder. Currently, the only gold standard
diagnostic strategy involves evaluating clinical criteria set by the Rome Foundation, such as
vomiting frequency and duration of episodes. Outside of these subjective criteria, no
definitive and objective diagnostic strategy for cyclic vomiting syndrome exists.
Developing diagnostic strategies has been difficult given the exact etiology of CVS is still
unknown. One physiologic theory includes rapid gastric emptying (GE)—or a dumping-like
syndrome related to impaired gastric accommodation. A retrospective analysis observed rapid
gastric emptying by standard 4-hour scintigraphic gastric emptying study in 80% of subjects,
suggesting a relationship with CVS and rapid GE. In turn, rapid emptying has been
hypothesized to relate with abnormal gastric accommodation - the reflex allowing storage of
food through increased fundic volume. This physiologic abnormality can be readily and easily
measured using non-invasive tools, but have never been tested in CVS. To explore this
further, we aim to determine if CVS patients have abnormal gastric accommodation measured by
nutrient drink test.
misdiagnosed disorder termed cyclic vomiting syndrome (CVS). As CVS is better understood,
gastroenterologists are increasingly recognizing the importance of timely diagnosis and early
management for this chronic and debilitating disorder. Currently, the only gold standard
diagnostic strategy involves evaluating clinical criteria set by the Rome Foundation, such as
vomiting frequency and duration of episodes. Outside of these subjective criteria, no
definitive and objective diagnostic strategy for cyclic vomiting syndrome exists.
Developing diagnostic strategies has been difficult given the exact etiology of CVS is still
unknown. One physiologic theory includes rapid gastric emptying (GE)—or a dumping-like
syndrome related to impaired gastric accommodation. A retrospective analysis observed rapid
gastric emptying by standard 4-hour scintigraphic gastric emptying study in 80% of subjects,
suggesting a relationship with CVS and rapid GE. In turn, rapid emptying has been
hypothesized to relate with abnormal gastric accommodation - the reflex allowing storage of
food through increased fundic volume. This physiologic abnormality can be readily and easily
measured using non-invasive tools, but have never been tested in CVS. To explore this
further, we aim to determine if CVS patients have abnormal gastric accommodation measured by
nutrient drink test.
Inclusion Criteria:
- Diagnosed with Cyclic Vomiting (or Healthy Volunteer)
- Age 18 or greater
Exclusion Criteria:
- Age Under 18
- History of gastric surgery
- History of marijuana use
- History of Gastroparesis
- History of Diabetes mellitus II
- Upper endoscopy with known obstructive gastric disease
- Current pregnancy or lactation
- Active inflammatory bowel disease (Crohn's disease, Ulcerative colitis)
- Severe renal disease (GFR <15/dialysis dependent)
- Active malignancy (diagnosed in last 5 years)
- Allergy/intolerance to liquid Ensure®
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