Cyclic vomiting syndrome (CVS) is a condition in which children have repeated or cycles of vomiting with periods of being completely symptom-free in between the episodes. Parents often have mistaken the vomiting episodes as a “stomach bug” or “food poisoning.” The vomiting episodes are extremely intense and can occur six to twenty times in a row before the episode ends.
Symptoms of CVS
CVS occurs in all age groups and may affect as much as 2% of school-aged children. Each attack of vomiting appears to be very similar to the previous episode; that is, they begin at the same time of the day, last about the same length of time, and have the same severity and type of symptoms. Most children will complain of the following symptoms:
- Abnormal drowsiness or lethargy (91%)
- Paleness or pallor (87%)
- Abdominal pain (80%)
- Headache (40%)
- Diarrhea (36%)
- Occasional fever (29%)
Once the attack of vomiting is over, the child is usually tired and wants to sleep. Once awake, the child is eager to eat and is back to normal health.
CVS can be difficult to diagnose because the symptoms of nausea and vomiting can occur with many health issues. The cause of CVS is not completely known, but there are several triggers that have been found to cause an attack of vomiting:
- Infections, such as sinusitis and upper respiratory infections
- Emotional changes that cause excitement
- Certain foods, such as chocolate
- Long periods of not eating
- Lack of sleep
- Menstruation periods
Many children with CVS have a history of migraine headaches or abdominal migraines. Identifying the triggers for the cyclic vomiting episodes may help in managing the syndrome.
Treatment for CVS
Treatment consists of three main goals:
- Abort the episode (try and stop an attack after it starts)
- Rescue therapy (try to keep the child as comfortable as possible if the attack is unable to be stopped)
- Prophylactic medicine (try and prevent any future attacks)
Complications can occur if CVS is left untreated, including:
- Injury to the esophagus (the main food pipe connecting the mouth to the stomach)
- Loss of dental enamel from the stomach acid
- Dehydration from persistent vomiting
To prepare for your visit, you can keep records of the triggers, time, and length of the vomiting episodes. Write down your child’s dietary habits, stressors, and life changes and bring a list of all medications, vitamins, and supplements.