Cyclic Vomiting Syndrome

Cyclic vomiting syndrome (CVS) is a condition where people have recurring bouts of intense vomiting with no clear reason. These vomiting episodes can last for a few hours or even several days, followed by periods where the person feels completely normal. A key characteristic is that the episodes are very similar each time. They often happen around the same time of day, last about the same amount of time, and involve the same symptoms with the same intensity.

CVS can affect people of any age, but it's most commonly diagnosed in children between the ages of 3 and 7. While it's more frequent in kids, there's a growing number of adults being diagnosed with the condition.

Diagnosing CVS can be tricky because vomiting is a symptom of many different illnesses. Doctors have to rule out other possibilities before making a diagnosis. Treatment usually focuses on lifestyle changes to help avoid things that might trigger the vomiting episodes. This could include things like stress management, identifying food triggers, or changes in sleep patterns. Medications, such as those for nausea and migraines, can be used to reduce the severity of the symptoms during an episode.

Cyclic vomiting syndrome (CVS) typically starts with symptoms appearing in the morning. People with CVS experience repeated episodes of vomiting. These episodes usually happen around the same time each time and last about the same amount of time. Between these episodes, people generally feel healthy and have no nausea or other symptoms.

A key sign of CVS is intense nausea and sweating that often happens right before an episode begins.

During a vomiting episode, other symptoms may include:

• Stomach pain: This pain can range from mild discomfort to severe cramping.
• Loose bowel movements (diarrhea): This often accompanies the vomiting.
• Feeling dizzy or lightheaded: This is a common symptom during an episode.
• Sensitivity to light: Some people find bright lights irritating.
• Headaches: These headaches can be severe.
• Retching or gagging: This is the forceful effort to vomit.

These symptoms can vary from person to person, but the recurring pattern of vomiting episodes, the preceding nausea, and the return to a healthy state between episodes are important clues to recognizing CVS.

If you or your child throw up blood, call your doctor right away.

Repeated vomiting can lead to serious dehydration, which could be dangerous. Dehydration happens when your body loses too much fluid. Call your doctor if you or your child have any of these signs of dehydration:

• Feeling very thirsty or having a very dry mouth: This is a key sign your body needs more fluids.
• Not urinating as much as usual: Your body is trying to conserve fluids.
• Dry skin: Skin that feels tight or doesn't look as smooth as usual.
• Sunken eyes or cheeks: This is a more noticeable sign of dehydration.
• No tears when crying: Tears are made of water, so no tears are a sign of fluid loss.
• Feeling very tired or weak: Dehydration can make you feel drained and sluggish.

These symptoms can be serious, so it's important to contact your doctor right away if you or your child are experiencing them.

Cyclic vomiting syndrome (CVS) is a condition where people have repeated bouts of severe vomiting. What causes CVS isn't fully understood, but scientists think it might be related to a combination of things, including:

• Genetics: Some people might be more prone to CVS due to their genes.
• Digestive issues: Problems with how the digestive system works could play a role.
• Nervous system problems: Issues in the body's communication network could be involved.
• Hormonal imbalances: Changes in hormones might contribute to CVS.

While the exact cause is unknown, certain things can often trigger a CVS episode. Knowing these triggers can help people manage their symptoms. These triggers include:

• Illnesses: Colds, allergies, or sinus infections can sometimes set off a vomiting episode.
• Stress and emotions: Stress, excitement, anxiety, and panic attacks can be major triggers, especially in children and adults, respectively.
• Food and drink: Certain foods or drinks like alcohol, caffeine, chocolate, and cheese can cause vomiting in some people. Eating too much, eating close to bedtime, or skipping meals can also be triggers.
• Environmental factors: Hot weather, physical tiredness, and over-exertion can lead to vomiting episodes.
• Other factors: Motion sickness, menstrual cycles, and even strong emotions can sometimes trigger CVS episodes.

By understanding the possible triggers for their CVS episodes, people can better manage the condition and lessen the frequency and severity of vomiting episodes.

Migraines and cyclic vomiting syndrome (CVS) might be linked, but the connection isn't fully understood. Many kids with CVS have a family history of migraines, or they develop migraines later in life. Adults with CVS also sometimes have a personal or family history of migraines.

Using marijuana (cannabis) regularly has been linked to CVS in some cases, because people sometimes use it to ease nausea. However, long-term marijuana use can cause a different problem called cannabis hyperemesis syndrome (CHS). This syndrome causes frequent vomiting, often without the typical breaks seen in CVS. People with CHS sometimes frequently bathe or shower.

CHS can be mistaken for CVS. To figure out if someone has CHS, doctors might ask them to stop using marijuana for a week or two. If the vomiting stops, then CHS is likely the problem. If the vomiting continues, doctors will continue to investigate for CVS.

Cyclic vomiting syndrome can lead to several health problems:

• Dehydration: Frequent and forceful vomiting can quickly remove a lot of water from the body. This can become serious, and in severe cases, a hospital stay might be necessary to restore fluids. Dehydration can lead to weakness, dizziness, and even a fast heartbeat.

• Esophageal damage: The stomach acid that comes up with the vomit can irritate and damage the esophagus, the tube that carries food from your mouth to your stomach. This irritation can sometimes cause bleeding. Painful swallowing (dysphagia) is another possible symptom.

• Dental problems: The acidic nature of vomit can erode the protective enamel on your teeth. This erosion can lead to tooth sensitivity, pain, and even cavities. It's important to take care of your teeth and maintain good oral hygiene if you experience frequent vomiting.

Cyclic vomiting syndrome (CVS) is a condition where people experience recurring episodes of severe vomiting. Many people who have CVS know what situations or things tend to start these episodes. If you can avoid these triggers, you can likely make the episodes happen less often. Even when you feel healthy between episodes, it's crucial to take any medicine your doctor prescribes exactly as directed.

If you have more than one episode a month, or if your episodes require a trip to the hospital, your doctor might suggest taking medicine to help prevent future episodes. Some examples of these preventive medications are amitriptyline, propranolol (often called Inderal), cyproheptadine, and topiramate.

Making changes to your daily life can also help. These lifestyle changes might include:

• Getting enough sleep: A good night's rest is important for overall health and can help keep CVS symptoms under control.
• Managing stress, especially in children: For children with CVS, downplaying the importance of upcoming events or activities can help. Excitement or high stress levels can sometimes start an episode.
• Avoiding specific foods: Some foods, like alcohol, caffeine, cheese, and chocolate, can trigger CVS episodes in some people. It's a good idea to talk to your doctor about which foods might be a problem for you.
• Eating regularly: Eating small, regular meals and low-fat snacks throughout the day can help keep your blood sugar stable. This can sometimes help to prevent CVS episodes.

Remember, it's essential to work closely with your doctor to manage cyclic vomiting syndrome. They can help you identify your personal triggers and recommend the best treatment plan for you.

Diagnosing cyclic vomiting syndrome (CVS) can be tricky. There's no single test to say for sure if someone has it. Vomiting is a symptom of many different illnesses, so doctors need to rule out other possibilities first.

To figure out if it's CVS, the doctor will start by asking questions about your or your child's health history. They'll also do a physical exam. It's important to tell the doctor exactly how often and how severely the vomiting happens, and what other symptoms are present. This detailed information helps the doctor narrow down the cause.

Next, the doctor might suggest some tests:

• Imaging tests: These might include procedures like an endoscopy (looking inside the digestive tract with a tiny camera), an ultrasound (using sound waves to create images), or a CT scan (using X-rays to create detailed images). These tests can help find blockages or other problems in the digestive system.

• Motility studies: These tests track how quickly food moves through the digestive system. They can help identify problems with the muscles and nerves that control this process.

• Lab tests: Blood tests can check for thyroid issues, imbalances in the body's chemicals (metabolism), or other medical problems that might be causing the symptoms.

These tests help rule out other conditions with similar symptoms, leading to a more accurate diagnosis of CVS.

Cyclic vomiting syndrome (CVS) doesn't have a cure, but many children grow out of the episodes by the time they're adults. If someone is having a CVS attack, the goal of treatment is to manage the symptoms.

Doctors may use several approaches to help:

• Medications: Similar medicines used to treat migraines can sometimes help stop or prevent CVS episodes. This is especially true for people who have frequent or prolonged episodes, or who have a family history of migraines. There are several types of medications that might be prescribed, including:

  • Anti-nausea medications: These help reduce feelings of nausea and vomiting.
  • Pain relievers: These can help ease the pain associated with CVS.
  • Medications to reduce stomach acid: These can sometimes help calm the stomach and reduce discomfort.
  • Antidepressants: In some cases, antidepressants can help manage the symptoms.
  • Anti-seizure medications: These can be helpful in some situations.

• IV fluids: If someone is vomiting a lot, they might need intravenous (IV) fluids to prevent dehydration. This is especially important if they're losing a lot of fluids through vomiting.

The specific treatment plan will be different for each person, depending on how severe and long the symptoms are, and whether there are any complications. The doctor will tailor the treatment to the individual needs of the patient.

Cyclic vomiting syndrome (CVS) can be managed with lifestyle changes. A key part of managing CVS is getting enough sleep. If vomiting starts, resting in a dark, quiet room can help.

Once the vomiting stops, it's crucial to replace lost fluids. A good way to do this is with an oral electrolyte solution like Pedialyte, or a sports drink like Gatorade or Powerade. Just mix one ounce of water with one ounce of sports drink to dilute it.

After vomiting stops, some people feel ready to eat a normal diet right away. But if you or your child aren't hungry, start with clear liquids like water, broth, or juice. Then slowly add soft, easy-to-digest foods back into your diet.

If stress or excitement triggers CVS episodes, work on managing stress during times when you're not experiencing symptoms. This might include relaxation techniques, meditation, or deep breathing exercises. Also, eating smaller meals and low-fat snacks throughout the day instead of three big meals can sometimes help.