Design and created by Guideline Central in participation with the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Karrento K, Rosen JM, Gelfand AA, Parikh S, Tarbell SE, Issenman RM, Gamboa H, Adams K, Wiercioch W, Li BUK. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition 2025 guidelines on the diagnosis of cyclic vomiting syndrome in children. J Pediatr Gastroenterol Nutr. 2025 Nov;81(5):1346-1359. doi: 10.1002/jpn3.70193. Epub 2025 Aug 20. PMID: 40836301.
Cyclic vomiting syndrome (CVS) is characterized by distinct clinical features and symptom overlap with migraine disorders. Cannabinoid hyperemesis syndrome (CHS) is a related condition with similar symptom expression. Due to a lack of diagnostic biomarkers, there is a need for optimal symptom-based diagnostic criteria. These evidence-based guidelines from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) were formulated to assist clinicians in the diagnosis of pediatric CVS. The panel recommends screening serum and urine laboratory testing and an upper gastrointestinal radiographic series for all patients with symptoms suggestive of CVS. The panel concluded that there is low yield and cost-effectiveness of other diagnostic screening tests. A set of recommended diagnostic criteria for CVS was formulated based on the characteristics of vomiting attack frequency, duration, and associated symptoms.
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