Cyclic vomiting syndrome (CVS) is a gastrointestinal condition. It’s also called abdominal migraine or periodic vomiting.
The disorder involves recurring, sudden episodes of nausea and vomiting without any specific cause. The symptoms can be severe, lasting for hours or days.
These episodes can cause serious complications, like severe dehydration. However, there is no cure, so the goal of treatment is symptom management.
CVS is also uncommon. It affects approximately
Read on to learn about the symptoms, causes, and treatment of CVS.
The main symptom of CVS is recurrent episodes of severe vomiting and nausea. The nausea, along with dry heaving, usually persists after vomiting.
These episodes often happen randomly. But in some cases, they’re triggered by factors like excitement or allergies.
Children with CVS often experience these episodes for several hours or days. Adults typically have less frequent episodes. However, the cycle of episodes may last longer. It can last for about a week.
Other symptoms of CVS include:
- pale skin in people with lighter complexions
- abdominal pain
- sensitivity to light (photophobia) or sound
- heightened sensitivity to smell (hypersomnia)
Some people might develop nausea and sweating just before an episode of vomiting.
The exact cause of CVS is unknown.
The condition may be related to the following factors:
- Genetics. People who have relatives with CVS or migraine are more likely to develop CVS. This suggests genetics might play a role.
- Migraine. CVS may be a variant of migraine. In fact, more than 80 percent of children with CVS have migraine or a family history of migraine.
- Brain-gut disorder. The neurons, or nerve cells, in the brain interact with the neurons in the gut. CVS might be caused by a problem with this interaction.
- Autonomic nervous system (ANS) dysfunction. The ANS regulates involuntary functions, like bladder and bowel control. If the ANS is unable to function properly, it may cause CVS.
- Increased stress hormones. People with CVS might have higher levels of corticotrophin-releasing factor (CRF), a stress hormone. CRF might affect the function of your stomach.
- Atypical energy metabolism. Mitochondria produce energy for cells. If mitochondria are unable to produce enough energy in stressful scenarios, like excitement, it may result in CVS.
Risk factors for CVS include people who are:
- children between 3 and 7 years old
However, CVS can affect anyone of any age. It can also develop in adults even if they never had episodes during childhood.
There are several risks and complications associated with having CVS.
- dehydration due to recurrent vomiting
- kidney problems
- panic disorder
- difficulty performing daily tasks, like going to work and school
- Mallory-Weiss syndrome, which are tears in the lower esophagus
CVS is also commonly misdiagnosed. This increases the risk of having unnecessary procedures to treat other conditions. These procedures may have their own set of complications.
There’s no cure for CVS, but some treatments can help manage the condition.
This may include:
You can use medication to manage the symptoms of CVS:
- Antiemetics. Antiemetics are drugs that prevent vomiting. These are taken before or during an episode of vomiting.
- Pain relievers. Over-the-counter pain relievers, like ibuprofen and acetaminophen, may help ease abdominal pain.
- Gastric acid suppressants. These medications reduce the acidity of your stomach contents, which limits the damage to your esophagus and teeth.
- Antimigraine medications. If you have a family history of migraine, antimigraine medications might help manage CVS.
- Anticonvulsant medications. In some cases, antiseizure drugs can prevent CVS episodes.
The best combination of medications will be different for each person.
In severe cases, you might need intravenous hydration.
During a CVS episode, it may help to lie down in a room that’s quiet and dim. This can help reduce stress and manage the episode.
The best way to prevent episodes is to avoid your CVS triggers.
Common CVS triggers include:
- physical or emotional stress and anxiety
- physical overexertion
- emotional excitement
- lack of sleep
- certain foods
- exposure to extreme temperatures
- prolonged periods without eating
For certain triggers, like menstruation, medication and reducing other triggers may help.
There’s no single test that can diagnose CVS. Instead, a doctor may use various tests to rule out other disorders.
Diagnosing CVS may involve:
- Medical history. A doctor will ask questions about the severity and frequency of your symptoms.
- Urine ketone testing. CVS may cause urine ketonuria, or high levels of ketones in your urine, early in an episode.
- Gastroenterology tests. Depending on your symptoms, a doctor may order tests to rule out similar conditions, like pancreatitis or intestinal blockages. This may involve blood or imaging tests.
Contact a doctor if you have vomiting or nausea that fails to improve with home remedies.
You should also seek medical help if you:
- have frequent vomiting or nausea
- have a fever
- experience recurring headaches or migraine episodes
- have signs of dehydration, like rapid heart rate and excessive thirst
- have persistent fatigue
- are vomiting blood
- experience persistent dizziness
- have new sensitivities to light, sound, or smell
- experience fainting
CVS can make it difficult to attend work or school. However, many people are able to function as expected in between episodes.
Additionally, since there’s no cure, your outlook depends on symptom management. This involves:
- avoiding your triggers
- taking medication as directed
- regularly visiting your doctor
Routine checkups will allow your doctor to monitor your symptoms and adjust your medication as needed.
It’s possible for children to outgrow CVS as they get older. Sometimes, they might outgrow CVS but develop migraine.
CVS involves recurring episodes of vomiting and nausea. These symptoms can be severe and cause serious complications, like dehydration.
The exact cause is unclear, but it may be related to:
- problems with brain-gut communication, energy metabolism, or stress hormone levels
Another possible cause is ANS dysfunction.
Although CVS cannot be cured, you can manage it with medication and by avoiding triggers whenever possible.