{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Board Pearls","title":"Chapter 8, Ep 2 of 2: CVS Pseudo FD","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/ee6532dc\"></iframe>","width":"100%","height":180,"duration":924,"description":"Episode two of the Gastric and Small Bowel Motility chapter covers the episodic and functional presentations where the structural workup comes back clean and the pattern carries the diagnosis: cyclic vomiting syndrome, cannabinoid hyperemesis, chronic intestinal pseudo-obstruction, and functional dyspepsia. Reading dilated bowel or delayed emptying as mechanical disease misleads you every time. Each condition is answered by naming the pattern, not by another motility drug.\n \nTopics covered\n\nCyclic vomiting syndrome and migraine biology\nCannabinoid hyperemesis and hot-water bathing\nRumination and chronic nausea/vomiting syndrome\nAcute colonic pseudo-obstruction (Ogilvie)\nChronic intestinal pseudo-obstruction\nNeuropathic vs myopathic manometry\nParaneoplastic pseudo-obstruction (anti-Hu, SCLC)\nFunctional dyspepsia subtypes and alarm features\n \n \nKey decisions\n\nStereotyped four-phase episodic vomiting with well intervals and migraine history: bedtime low-dose tricyclic to prevent, triptan to abort.\nSame cycle with daily cannabis and compulsive hot-water bathing: stop cannabis; capsaicin, haloperidol, benzodiazepine for active episodes, not a tricyclic.\nChronic pseudo-obstruction manometry: neuropathic shows normal-strength disorganized contractions; myopathic shows low-amplitude contractions with pattern preserved; late scleroderma and amyloid read myopathic.\nOlder smoker with rapidly progressive dysmotility and weight loss out of proportion: chest CT and oncologic workup for anti-Hu paraneoplastic small cell lung cancer, PET if chest CT unrevealing.\nFunctional dyspepsia under sixty with no alarm features: H. pylori test-and-treat then empiric acid trial; sixty or older or any alarm feature, scope first.\nNormal emptying with impaired accommodation and fullness-type dyspepsia: buspirone; thin patient with early satiety and weight loss: mirtazapine.\n \n \nThis is an AI-generated podcast, and some pronunciations may be imperfect. Thank you for your understanding, and we...","thumbnail_url":"https://img.transistorcdn.com/-FuAdDBcPDLhEoUmroZKtOBRvuBn_FHPpYlh41hOnU4/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9iNzlh/ZTU4Y2MzNWExMjQ5/MjA5OWMwMmI3ZTk5/NGFiZS5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}