Understanding Cyclic Vomiting Syndrome (CVS): Causes, Symptoms, and Management

What is it?

Cyclic vomiting syndrome is a disorder that causes recurrent episodes of nausea, vomiting, and tiredness. For most people suffering from the disease, episodes are similar, they tend to start at the same time of day, last the same amount of time, and occur with the same kind of symptoms and intensity. Each episode is divided into four phases: inter-episodic, prodrome, vomiting, and recovery. During the inter-episodic phase (lasting from a week to a month) symptoms are not yet present and the person function. The prodrome phase (pre-emetic phase) is which the patient feels an upcoming. Emetic or vomiting phase is characterized as severe persistent nausea, and repeated vomiting typically lasting hours to days. In the recovery phase the vomiting stops and appetite returns. The pathogenesis of this disorder is yet unknown but there thought to be a connection to migraines. Cyclic vomiting syndrome often begins in children around 3 to 7 years old. It is more common in children, however adult diagnosis is quite common.

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Additional names

This group contains additional names:
- Cyclical vomiting
- Hyperemesis
- Intractable cyclical vomiting syndrome

Signs & symptoms

The symptoms of cyclic vomiting syndrome often begin in the morning and include three or more recurrent episodes of vomiting that start around the same time and last for a similar length of time. In between the episodes there are varying intervals when the person feels well. Before the begging of an episode, there usually an intense nausea and sweating. During an episode symptoms may include abdominal pain, diarrhead, dizziness, photophobia, headache and retching or gagging.

Diagnosis

There is no specific test that can be done to diagnose this disorder and vomiting is a common symptom in many medical conditions. Therefore, the diagnosis is mainly done by a medical history and physical exam as well as studies and tests to rule out other disorder, such as imaging studies (endoscopy, CT scans, Us), digestive tract motility test and some lab tests that include thyroid gland function and metabolic conditions.

Treatment

Treatment depends on the phase of the disorder. In the prodrome phase, prophylactic migraine medications, anti-inflammatory drugs and anti-emetic drugs can be helpful. In the vomiting phase, the most important thing is to keep hydrated by appropriate intravenous fluids. Potent anti-emetic drugs may be helpful.
Lifestyle changes may be recommended, such as rest, stress avoidance, eating regularly small meals, avoiding allergens.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital