Cyclic vomiting syndrome

Cyclic vomiting syndrome (CVS) is a condition where you experience sudden, severe and recurrent vomiting and nausea episodes that can last for several hours or days. With no apparent cause, the episodes are similar in length, symptoms and intensity.

After an episode, you may feel better for a while before getting sick again. Episodes could occur once or twice a month, or a few times a year.

Although rare in adults, anyone can be affected by CVS, especially children. Cyclic vomiting syndrome symptoms usually appear between the ages of 3-7 years old and continue through adolescence.

Causes of cyclic vomiting syndrome

There is no exact cause of cyclic vomiting syndrome, and vomiting can be an underlying cause of many gastrointestinal issues and conditions. CVS could be related to migraine headaches, and many children who have CVS experience migraine symptoms as adults.

Four phases of cyclic vomiting syndrome

1. Prodrome phase: The signal that an episode is about to start. This phase could last minutes or hours, with CVS symptoms including intense nausea, sweating, sensitivity to light, stomach pain or headache.
2. Episode phase: This phase includes vomiting, retching and nausea that can last for many hours or even days. It may be hard to keep any food or liquids down, or even get out of bed.
3. Recovery phase: Once vomiting and retching has stopped, the recovery phase has begun. It is important to rest and replenish your body in recovery.
4. Symptom-free phase: Life resumes as normal with no symptoms of CVS and otherwise perfect health. Weeks or months may pass before another episode.

Cyclic vomiting symptoms

The most common symptoms of CVS include cycles of sudden and intense nausea and vomiting, usually in the morning and when no other illness is present.

Other signs and CVS symptoms during an episode may include:

• Abdominal pain
• Diarrhea
• Headache
• Lethargy
• Sensitivity to light
• Retching or gagging

Cyclic vomiting syndrome diagnosis

Cyclic vomiting syndrome can be difficult to diagnosis, and there is no test to confirm you have CVS. Your doctor will review your medical and family history, review the cycle of symptoms and may order tests to rule out other diseases and conditions with similar CVS symptoms, such as gastroesophageal reflux disease (GERD) and irritable bowel syndrome.

Tests may include:

• Routine exam: Your doctor will ask you questions about your potential CVS symptoms and perform a physical exam. This may include a blood or urine test.
• CT scan: This test produces images of your abdomen and digestive system that might rule out other causes of your symptoms.
• Upper GI endoscopy: A flexible tube equipped with a light and a tiny camera (endoscope) is inserted down the throat to see inside the esophagus and stomach. If needed, a tissue sample (biopsy) can be done during an endoscopy.

Cyclic vomiting treatment

Unfortunately, there is no cure for cyclic vomiting syndrome. Once diagnosed, there are ways to help alleviate your cyclic vomiting syndrome symptoms depending on the phase you are in. In times of severe vomiting, you may need to seek medical attention if you have signs of dehydration and need IV fluids and nutrition.

Ways to manage cyclic vomiting syndrome

• Anti-nausea drugs
• Anti-seizure medications
• Antidepressants
• Medications that suppress stomach acid
• Migraine medications
• Pain-relieving medications

Identifying cyclic vomiting syndrome triggers

In some cases, you may find that certain foods or situations can trigger your CVS. Finding triggers won’t cure CVS, but it may help you avoid an onset.

CVS triggers could include:

• Allergies
• Exhaustion
• Foods
• Lack of sleep
• Menstrual period
• Stress or excitement
• Viral infections

Treatment for children with cyclic vomiting syndrome

Many children outgrow cyclic vomiting syndrome by the time they reach adolescence. It’s important to monitor your child while they are in a CVS episode, especially if they’re young and can’t communicate their needs. Your child will need to maintain fluids.

Contact your doctor if your child needs medical attention and watch for these signs of dehydration:

• Less urination
• Excess thirst or dry mouth
• No tears while crying
• Sunken eyes or cheeks
• Dry skin

Once severe vomiting begins, your child may need to visit the hospital to receive medicine to stop the vomiting or get IV fluids and nutrition.

Cyclic vomiting syndrome life expectancy

Recurrent vomiting in adults or children is an unpleasant and often debilitating symptom to manage, but most can lead normal lives, especially between CVS episodes. Children typically outgrow CVS, but some could experience episodes into adulthood.

 

With no cure, it’s important to learn your CVS triggers so you can curb episodes. Proper rest, avoiding anxiety-inducing situations and talking to your doctor about medications can also help you manage life with CVS.