Definition

What is 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 symptom-free periods. Episodes are similar, meaning that they tend to start at the same time of day, last the same length of time, and occur with the same symptoms and intensity.

Cyclic vomiting syndrome occurs in all age groups, though it often begins in children around 3 to 7 years old. Although more common in children, the number of cases diagnosed in adults is increasing.

The syndrome is difficult to diagnose because vomiting is a symptom of many disorders. Treatment often involves lifestyle changes to help prevent the events that can trigger vomiting episodes. Medications, including anti-nausea and migraine therapies, may help lessen symptoms.

How common is cyclic vomiting syndrome?

Cyclic vomiting syndrome is more common in children than adults, although reports of the syndrome in adults have increased in recent years. Usually, children are about 5 years old when diagnosed with cyclic vomiting syndrome, which occurs in every three out of 100,000 children. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of cyclic vomiting syndrome?

The common symptoms of cyclic vomiting syndrome are:

  • Severe vomiting that occurs several times an hour, continues for hours to days, but lasts less than one week
  • Three or more separate episodes of vomiting with no apparent cause in the past six months, or five or more episodes occurring at any time
  • Severe nausea
  • Intense sweating

Other signs and symptoms during a vomiting episode may include:

  • Abdominal pain
  • Diarrhea
  • Fever
  • Dizziness
  • Sensitivity to light
  • Headache
  • Retching or gagging

The time between vomiting episodes is usually symptom-free

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes cyclic vomiting syndrome?

The underlying cause of cyclic vomiting syndrome is unknown. Some possible causes include genes, digestive difficulties, nervous system problems and hormone imbalances. Specific bouts of vomiting may be triggered by:

  • Colds, allergies or sinus problems
  • Emotional stress or excitement, especially in children
  • Anxiety or panic attacks, especially in adults
  • Foods, such as caffeine, chocolate or cheese
  • Overeating, eating right before going to bed or fasting
  • Hot weather
  • Physical exhaustion
  • Exercising too much
  • Menstruation
  • Motion sickness

Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.

Risk factors

What increases my risk for cyclic vomiting syndrome?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is cyclic vomiting syndrome diagnosed?

Cyclic vomiting syndrome can be difficult to diagnose. There’s no specific test to confirm the diagnosis, and vomiting is a sign of many conditions that must be ruled out first.

The doctor will start by asking about your child’s or your medical history and conducting a physical exam. The doctor will also want to know about the pattern of symptoms that you or your child experiences.

After that, the doctor may recommend:

  • Imaging studies — such as endoscopy, ultrasound or a CT scan — to check for blockages in the digestive system or signs of other digestive conditions
  • Motility tests to monitor the movement of food through your digestive system and to check for digestive disorders
  • Laboratory tests to check for thyroid problems and other metabolic conditions

How is cyclic vomiting syndrome treated?

There’s no cure for cyclic vomiting syndrome, though many children no longer have vomiting episodes by the time they reach adulthood. For those experiencing cyclic vomiting episode, treatment focuses on controlling the signs and symptoms. You or your child may be prescribed:

  • Anti-nausea drugs
  • Pain-relieving medications
  • Medications that suppress stomach acid
  • Antidepressants
  • Anti-seizure medications

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, or for people with a family history of migraine.

IV fluids may need to be given to prevent dehydration. Treatment is individualized based on the severity and duration of symptoms as well as the presence of complications.

Alternative medicine

Alternative and complementary treatments may help prevent vomiting episodes, although none of these treatments has been well-studied. These treatments include:

  • Coenzyme Q10 (ubiquinone), a natural substance made in the body that is available as a supplement. Coenzyme Q10 assists with the basic functions of cells.
  • L-carnitine, a natural substance that is made in the body and is available as a supplement. L-carnitine helps your body turn fat into energy.

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.

Be sure to see a doctor and have the diagnosis of cyclic vomiting syndrome confirmed before starting any supplements. 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.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage cyclic vomiting syndrome?

The following lifestyles and home remedies might help you cope with cyclic vomiting syndrome:

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 fluids, such as an oral electrolyte solution (Pedialyte) or a sports drink (Gatorade, Powerade, others) diluted with 1 ounce of water for every ounce of sports drink. 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 small meals and small carbohydrate-containing snacks daily, instead of three large meals, also may help.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 28, 2017 | Last Modified: August 28, 2017

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