homeopathic treatment of cyclic vomiting syndrome … · lee l, al. the management of cyclic...

Homeopathic Treatment of Cyclic Vomiting Syndrome

ROBERT C . D UMONT, M. D.

P EDI ATRIC I N T EGRAT I VE ME DICI NE

R ABY I NST I TUT E FOR I NT EGRATI VE ME DI CI NE AT NORTHWEST ERN, L LC.

5th International CEDH Conference - June 24-26, 2016

Cyclic Vomiting Syndrome (CVS)

severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. The episodes can last from a few hours to several days. Episodes can be so severe that a person has to stay in bed for days, unable to go to school or work.

Characterized by Recurrent, discrete, self-limited episodes of vomiting

Defined by symptom-based criteria and the absence of positive laboratory, radiographic, and endoscopic testing

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome B U.K. Li, et al. Journal of Pediatric Gastroenterology and Nutrition 47:379–393, 2008.



CVS is an intractable illness

> 40% of patients with headaches/migraines.

Family history of headaches/migraines in 38.9%, (stronger in adult patients)

In adults 30% associated anxiety and depression.

More frequent in adults (5.9 vs. 3.4 days, 14.4 vs. 9.6 episodes/year).

65% female and 29% were pediatric cases.**

Treatment ◦ Sumatriptan is the most effective acute pharmaceutical treatment (in

adults). ◦ Tricyclics effective (both adult 75.5% and paediatric 67.6%) for prophylaxis.

Lee L, al. The management of cyclic vomiting syndrome: a systematic review. Eur J Gastroenterol Hepatol. 2012 Sep;24(9):1001-6. **Kumar N, Bashar Q, Reddy N, et al. Cyclic vomiting syndrome (CVS): is there a difference based on onset of symptoms – pediatric versus adult? BMC Gastroenterol. 2012;12:52.


Cyclic Vomiting Syndrome (CVS): Potential pathology

• Dysautonomia

•Association with Migraine Headaches

•Mitochondrial disorder

Charles Darwin (CD), “father of modern biology,” suffered from multisystem illness from early adulthood. The most disabling manifestation was cyclic vomiting syndrome (CVS). Finsterer J, Hayman J Mitochondrial disorder caused Charles Darwin’s cyclic vomiting syndrome. International Journal of General Medicine 2014:7 59–70



30 (out of 42) were treated on a loose protocol consisting of fasting avoidance, co-enzyme Q10 and L-carnitine, and amitriptyline (or cyproheptadine in those < 5 years) in refractory cases.

Vomiting episodes resolved in 23 cases, and improved by > 75% and > 50% in three and one additional case respectively.

Boles RG High degree of efficacy in the treatment of cyclic vomiting syndrome with combined co-enzyme Q10, L-carnitine and amitriptyline, a case series. BMC Neurol. 2011 Aug 16;11:102.


Cyclic Vomiting Syndrome (CVS): Case 1

3 year old with VSD, PDA, horseshoe kidney, hydronephrosis, low tone, microcephaly and GE reflux with partial Nissan wrap and a probable diagnosis of Noonan's syndrome

Violent retching episodes lasting 2 days -2 weeks

On going treatment: Ondansetron

Homeopathic treatment: Colchicum, 12C, sublingual, 5 pellets, as needed for episodes

Relief of symptoms

Follow up 2 years later – had had occasional episodes of nausea/vomiting relived with Colchicum



10Y 6M developmental delay, hydrocephaly with shunt with no shunt revisions.

Recurrent episodes of severe vomiting – he break out in a cold sweat when this happens and looks pale.

Ongoing treatment – Ondansetron and Emergency depart. Visits.

veratrum album, 9C as needed, alternating with Nux vomica as needed

Subsequent episodes – vomiting would stop with homeopathic medicines.

He had an episode the day of visit. He didn't respond but had the pellets given to babysitter in plastic bag, “Once given out of the vial he responded and came back to life.”



6 years old with periodic episodes of nausea, vomiting. 10 weeks apart, then 6 weeks apart and “now” 2-3 weeks. It comes on quickly possibly preceded by hours with "not feeling well" or stomach hurts.

She starts with headache or stomach hurts. Then nausea/vomiting, weak (lethargic wanting to sleep), (sometimes fevers on the last day). The vomiting can occur up to 12 x an hour. It lasts 2.5 - 3 days. Her breath is bile (bitter) like. She gets vertigo.

Homeopathic Treatment: Sulphur 30C weekly and Cocculus 30C daily and then as often as needed should she have an episode.

“Cocculus clearly works” as she improves after taking it. She is recovering much faster 24 hours (down from 72 hours).

Subsequently she tapered down the Cocculus to weekly and then off.

Episode stopped within one year.



15 year old with monthly episodes of vomiting (up to 12 x hour), fatigue and abdominal pain. Episodes would last over 18 hours requiring ER visits or hospitalization.

Medical options: Hospitalization, Hydration, Ondansetron (other antinausea medicines), Ativan.

Colchicum: Cyclic vomiting episodes stopped within 90 minutes (after 6 doses).


Cyclic Vomiting Syndrome: Case 4 - 15 year old continued.

Off of all Medications for 2 years when episodic nausea began to recur. Colchicum was helping but nausea was persistent during episodes.

Time to choose a Chronic Reactional Mode Medicine

More about CVS ◦ ¾ of patients have a close family member with

migraine headaches

◦ Some patients develop migraines as the CVS wanes


Chronic Reactional Mode Medicines for Migraines NUX VOMICA

◦ Sthenic, hyperactive but sedentary patients

◦ Headaches due to overeating, frontal, in the morning > upon waking

◦ Prone to digestive spasms

SEPIA

◦ (HAs) often occur during PMS

◦ Venous congestion

◦ Genital and urinary disorders

◦ Visceral ptosis

◦ Prone to depression

SULPHUR

◦ Robust (congested) patients

◦ Inflammatory response

LYCOPODIUM

◦ migraine in the right supra-orbital area

◦ migraine can occur if a meal is delayed

◦ Heat sensitive

◦ Hepatic, urinary, dermatological disorders and allergies

PSORINUM

◦ periodic migraines sensation of “well-being” the day before

◦ Periodic eruptions are long – seasonal or annual – weeks or months)

◦ > by heat (and eating)

◦ Asthenia, cold-sensitive


Cyclic Vomiting Syndrome: Case 4 - 15 year old continued.

Chronic Terrain Medicine chosen – Sepia 30C 10 pellets weekly

Episodes resolved and eventually able to come off of Sepia (and Colchicum)

Follow up – over 7 years


Homeopathic Treatment of Cyclic Vomiting Syndrome: Summary (used in 10 patients)

Pathogenic approach can be very successful

Useful Medicines ◦ Nux vomica

◦ Colchicum

◦ Cocculus

◦ Veratrum album

May also need to treat based on Terrain medicine: Chronic Reactional mode/Sensitive Type


homeopathic treatment of cyclic vomiting syndrome … · lee l, al. the management of cyclic...

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