Cyclic vomiting syndrome
Cyclic vomiting syndrome
Cyclic vomiting syndrome is characterized by episodes of severe vomiting that have no apparent cause. Episodes can last for hours or days and alternate with relatively symptom-free periods of time. Each episode is similar to previous ones, meaning that episodes tend to start at the same time of day, last the same length of time and occur with the same symptoms and level of intensity.
Once thought to affect only children, cyclic vomiting syndrome occurs in all age groups. Research suggests that cyclic vomiting syndrome may affect almost 2 percent of school-age children and that the number of cases diagnosed in adults is increasing.
Cyclic vomiting syndrome may be related to migraines. Episodes can be so severe that the person has to stay in bed for days.
The syndrome is difficult to diagnose because vomiting is a symptom of many disorders. Treatment generally involves managing symptoms and lifestyle changes to help prevent the events that can trigger vomiting episodes. Medications, including anti-nausea and migraine therapies, may help lessen symptoms.
The symptoms of cyclic vomiting syndrome include:
Other symptoms during a vomiting episode may include:
The intervals between vomiting episodes are generally symptom-free. But some people experience mild to moderate nausea or abdominal or limb pain between episodes.
Continued vomiting may cause severe dehydration that can be life threatening. Symptoms of dehydration include:
The cause of cyclic vomiting syndrome is unknown. But the bouts of vomiting that characterize the syndrome can be triggered by:
Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.
The relationship between migraines and cyclic vomiting syndrome isn't clear. But many children with cyclic vomiting syndrome have a family history of migraines or have migraines themselves when they get older. In adults, the association between cyclic vomiting syndrome and migraine may be lower.
Chronic use of marijuana (cannabis sativa) also has been associated with cyclic vomiting syndrome.
Cyclic vomiting syndrome can cause these complications:
Preparing for your appointment
You're likely to start by seeing your primary care doctor or your child's pediatrician. But you may be referred immediately to a digestive diseases specialist (gastroenterologist). If you or your child is in the middle of a severe vomiting episode, the doctor may recommend immediate medical care.
Here's some information to help you get ready for your appointment and know what to expect from the doctor.
What you can do
Questions to ask the doctor
Don't hesitate to ask other questions.
What to expect from the doctor
What you can do in the meantime
Tests and diagnosis
Cyclic vomiting syndrome can be difficult to diagnose. There's no specific test that will confirm the diagnosis, and vomiting is a sign of many diseases and disorders that must first be ruled out.
The doctor will start by asking about your child's or your medical history and conducting a physical exam.
After that, the doctor may recommend:
Treatments and drugs
There's no cure for cyclic vomiting syndrome, so treatment focuses on controlling the signs and symptoms. You or your child may be prescribed:
The same types of medications used for migraines can sometimes help stop or even prevent episodes of cyclic vomiting. These medications may be recommended for people whose episodes are frequent and long-lasting.
Lifestyle and home remedies
Lifestyle changes can help control the signs and symptoms of cyclic vomiting syndrome. People with cyclic vomiting syndrome generally need to get adequate sleep. Once vomiting begins, it may help to stay in bed and sleep in a dark, quiet room.
When the vomiting phase has stopped, it's very important to drink water and replace lost electrolytes. Some people may feel well enough to begin eating a normal diet soon after they stop vomiting. But if you don't or your child doesn't feel like eating right away, you might start with clear liquids and then gradually add solid food.
If vomiting episodes are triggered by stress or excitement, try during a symptom-free interval to find ways to reduce stress and stay calm. Eating three small meals and three snacks daily, instead of three large meals, also may help.
Alternative and complementary treatments may help prevent vomiting episodes, although none of these treatments has been well studied. These treatments include:
L-carnitine and coenzyme Q10 may work by helping your body overcome difficulty in converting food into energy (mitochondrial dysfunction). Some researchers believe mitochondrial dysfunction may be a factor causing both cyclic vomiting syndrome and migraine.
Always check with your doctor before taking any supplements to be sure you or your child is taking a safe dose and that the supplement won't adversely interact with any medications you're taking. Some people may experience side effects from L-carnitine and Coenzyme Q10 that are similar to the symptoms of cyclic vomiting syndrome, including nausea, diarrhea and loss of appetite.
Coping and support
Because you never know when the next episode might occur, cyclic vomiting syndrome can be difficult for the whole family. Children may be especially concerned, and may worry constantly that they'll be with other children when an episode happens.
You or your child may benefit from connecting with others who understand what it's like to live with the uncertainty of cyclic vomiting syndrome. Ask your doctor about support groups in your area.
Many people know what triggers their cyclic vomiting episodes. Avoiding those triggers can reduce the frequency of episodes.
If episodes occur more than once a month or require hospitalization, your doctor may recommend preventive medicine. Lifestyle changes also may help, including:
Last Updated: 2013-04-19
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