Cyclic vomiting syndrome

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

Episodes could occur once or twice a month, or a few times a year. In between, you may feel perfectly healthy before becoming sick again.

Cyclic vomiting syndrome affects adults but is more common in children. Symptoms usually appear between the ages of 3-7 years old and continue through adolescence.

The four phases of cyclic vomiting syndrome

1. Prodrome phase: This phase signals that an episode is about to begin and could last minutes or hours. Symptoms include intense nausea, sweating, sensitivity to light, stomach pain or headache.
2. Episode phase: Vomiting, retching and nausea begins and doesn’t let up for 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 you get sick again.

Cyclic vomiting syndrome symptoms

The main symptoms include sudden and intense nausea and vomiting, usually in the morning and when no other illness is present.

Other signs and symptoms during a CVS episode include:

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

Cyclic vomiting syndrome causes

What causes CVS is still unknown, 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.

Cyclic vomiting syndrome diagnosis

There is no specific test to confirm cyclic vomiting syndrome. 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 symptoms and perform a physical exam. This may include a blood or urine test.
  
• 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.
  
• CT scan: This test produces images of your abdomen and digestive system that might rule out other causes of your symptoms.

Cyclic vomiting treatment

There is no cure for cyclic vomiting syndrome, but there are ways to help alleviate your 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.

Medications 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

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:

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

Treatment for children with cyclic vomiting syndrome

Most children outgrow cyclic vomiting syndrome by the time they reach adolescence. It’s important to monitor your child while they’re 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 you believe your child needs medical attention and watch for these signs of dehydration:

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

If severe vomiting begins, your child may need to visit the hospital to receive medicine to stop the vomiting or to receive 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 episodes. Children normally outgrow CVS, but some could experience episodes into adulthood.

It’s important to learn your CVS triggers so you can attempt to avoid or curb episodes. Proper rest, avoiding anxiety-inducing situations and talking to your doctor about medications can also help you manage life with CVS.