Cyclic vomiting syndrome
Cyclic vomiting syndromeArticle Sections
DefinitionCyclic vomiting syndrome causes bouts of severe nausea and vomiting that can last for days. The disorder has no known cause. Symptoms of cyclic vomiting syndrome typically begin between the ages of 3 and 7 years. While the disorder occurs most often in children, cyclic vomiting syndrome can begin at any age. Adult episodes tend to occur less often than do episodes in children, but adult episodes usually last longer. Cyclic vomiting syndrome appears to be associated with migraines in some cases. Most children outgrow cyclic vomiting syndrome when they're teenagers. However, children with this condition are at increased risk of developing migraines. SymptomsCyclic vomiting syndrome causes:
These signs and symptoms may occur an average of six times an hour. Episodes in children generally last only a day or two, but adults can have symptoms for almost a week. Adults tend to have about four episodes a year, while children may have 10 or more. Episodes typically begin late at night or early in the morning. In addition, some people with cyclic vomiting syndrome may develop:
CausesThe cause of cyclic vomiting syndrome is unknown, but the bouts of vomiting that characterize the condition can be triggered by:
Risk factorsMany children who have cyclic vomiting syndrome have a family history of migraines or begin having migraines themselves when they get older. Abdominal migraine — a type of migraine more common in children — causes abdominal pain but not the severe vomiting associated with cyclic vomiting syndrome. ComplicationsCyclic vomiting syndrome can cause these complications:
Preparing for your appointmentIf your child or you have signs and symptoms of cyclic vomiting, you're likely to start by seeing your child's pediatrician or your primary care doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to a digestive disorders specialist called a gastroenterologist. If you or your child is in the middle of a severe vomiting episode, your doctor may recommend immediate medical care. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared. Here's some information to help you get ready and what to expect from the doctor. What you can do
Your time with your child's doctor is limited, so preparing a list of questions may help you make the most of your time together. List your questions from most important to least important in case time runs out. For cyclic vomiting syndrome, some basic questions to ask the doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime Tests and diagnosisThe doctor will ask you about your or your child's medical history and will conduct a physical exam. To be diagnosed with cyclic vomiting syndrome, a person must have experienced at least three episodes in the past year of intense nausea and unremitting vomiting or retching — lasting hours or days. These episodes must be separated by weeks or months of symptom-free intervals. There's no specific test that will confirm the diagnosis of cyclic vomiting syndrome. But, doctors must rule out other conditions that can produce vomiting, such as:
Treatments and drugsThere's no cure for cyclic vomiting syndrome. To control the signs and symptoms, you or your child may need:
In many cases, the same types of medications used for migraines often help stop or even prevent episodes of cyclic vomiting. These medications include:
Lifestyle and home remediesPeople 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 with fruit juices or sports drinks. You or your child might not feel like eating right away. Some people need to start with clear liquids and then gradually add solid food back into their diet. But, others may feel well enough to begin eating a normal diet soon after they stop vomiting. Alternative medicineSeveral alternative treatments may help prevent vomiting episodes, though none have been well studied. These treatments include:
Always check with your doctor before taking any supplements to be sure you or your child are taking a safe dose of the supplement, and that it won't adversely interact with any medications you're taking. Coping and supportBecause you never know when the next episode might occur, cyclic vomiting syndrome can be difficult on the whole family. Children may be especially concerned about when the next episode may come, and they may worry constantly that they'll be with other children when it 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, or contact the Cyclic Vomiting Syndrome Association at 414-342-7880. PreventionMany 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, doctors typically recommend daily preventive medicine. Commonly used drugs to prevent cyclic vomiting episodes include amitriptyline and propranolol (Inderal). In addition to taking preventive medications, lifestyle changes may help prevent future vomiting episodes, including:
RelatedLast Updated: 2010-11-24 © 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
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