What is cyclic vomiting syndrome?
Cyclic vomiting syndrome, sometimes referred to as CVS, is an increasingly recognized disorder with sudden, repeated attacks—also called episodes—of severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. The episodes can last from a few hours to several days. Episodes can be so severe that a person has to stay in bed for days, unable to go to school or work. A person may need treatment at an emergency room or a hospital during episodes. After an episode, a person usually experiences symptom-free periods lasting a few weeks to several months. To people who have the disorder, as well as their family members and friends, cyclic vomiting syndrome can be disruptive and frightening.
The disorder can affect a person for months, years, or decades. Each episode of cyclic vomiting syndrome is usually 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.
How common is cyclic vomiting syndrome?
Cyclic vomiting syndrome can occur 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. Please discuss with your doctor for further information.
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
- Sensitivity to light
- 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.
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
- Motion sickness
Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.
What increases my risk for 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 because some people use marijuana to treat their symptoms.
However, cannabis can lead to a condition called cannabis hyperemesis syndrome, which typically leads to persistent vomiting without normal intervening periods. People with this syndrome often demonstrate frequent showering or bathing behavior.
Cannabis hyperemesis syndrome can be confused with cyclic vomiting syndrome. To rule out cannabis hyperemesis syndrome, you need to stop using marijuana for at least one to two weeks to see if vomiting lessens. If it doesn’t, your doctor will continue testing for cyclic vomiting syndrome.
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?
A specific test to diagnose cyclic vomiting syndrome does not exist; instead, a health care provider will rule out other conditions and diagnose the syndrome based upon
- A Medical and family history
- A physical exam
- A pattern or cycle of symptoms
- Blood tests
- Urine tests
- Imaging tests
- Upper gi endoscopy
- A gastric emptying test
Often, it is suspected that one of the following is causing their symptoms:
- Gastroparesis—a disorder that slows or stops the movement of food from the stomach to the small intestine
- Gastroenteritis—inflammation of the lining of the stomach, small intestine, and large intestine
A diagnosis of cyclic vomiting syndrome may be difficult to make until the person sees a health care provider. A health care provider will suspect cyclic vomiting syndrome if the person suffers from repeat episodes of vomiting.
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
- 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 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
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. 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.
Cyclic vomiting syndrome. http://www.mayoclinic.org/diseases-conditions/cyclic-vomiting-syndrome/home/ovc-20345469. Accessed August 11, 2017.
Cyclic Vomiting Syndrome. https://www.niddk.nih.gov/health-information/digestive-diseases/cyclic-vomiting-syndrome. Accessed August 11, 2017.
Review Date: August 10, 2017 | Last Modified: September 13, 2019