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Rome IV Diagnostic Criteria for Cyclic Vomiting Syndrome
Diagnostic checklist for cyclic vomiting syndrome in adults.
Rome IV Diagnostic Criteria for Cyclic Vomiting Syndrome
Episodes of vomiting are stereotypical in onset (acute) and duration for that patient
Each episode lasts less than 1 week
≥3 discrete episodes in the prior year
≥2 episodes in the past 6 months, occurring at least 1 week apart
Absence of vomiting between episodes (milder symptoms between cycles are allowed)
Criteria fulfilled for the last 3 months with symptom onset ≥6 months before diagnosis
Personal or family history of migraine headaches (supportive, not required)
ResultCriteria not met
CVS requires stereotypical episodes lasting <1 week, ≥3 episodes in the past year with ≥2 in the past 6 months ≥1 week apart, and no vomiting between episodes, for ≥3 months (onset ≥6 months prior).
- Supportive: personal/family migraine history
- Absent
When to use
- Distinguishing cyclic vomiting syndrome from chronic nausea/vomiting syndrome or other causes of episodic vomiting.
Formula
Stereotypical acute-onset episodes lasting <1 week, ≥3 episodes in the prior year with ≥2 in the past 6 months occurring ≥1 week apart, symptom-free between episodes, for the last 3 months with onset ≥6 months before diagnosis.
Pearls and pitfalls
- A personal or family history of migraine supports the diagnosis but is not required.
- Screen for cannabis use — cannabinoid hyperemesis can mimic CVS.