Cyclical Vomiting Syndrome

Cyclic vomiting syndrome (CVS) is a disorder marked by recurrent and unexplained episodes of severe nausea and vomiting.

These can last for several hours to even days and are followed by symptom free periods. Each episode or “attack” can be similar—starting at the same time of day and even lasting for the same amount of time--and the hallmark of the disorder is the presence of the “free days” without symptoms.

Traditionally seen more commonly in children, we are seeing a significant rise in adults presenting with symptoms of this disorder.

While challenging to diagnose as it can sometimes mimic other motility disorders, a careful history and exam are essential to shorten the time to diagnosis and, ultimately, therapy. We can often identify subtle triggers and assist with medications and strategies

Symptoms

The most common symptoms of CVS include:

  • Recurrent bouts of vomiting, gagging and retching, which are sometimes preceded by significant nausea, abdominal pain, or sweating.

  • Periods in between episodes without symptoms and overall “normal” health.

  • Patients can also experience diarrhea, dizziness, headaches, or discomfort with bright lights or loud sounds.

Causes

CVS is not yet fully understood as the underlying causes remain unknown. There may be a genetic, hormonal, or neurological component. There also may be overlap with other digestive disorders.

Some possible triggers include physical exhaustion, dehydration (which can be worsened by bouts of vomiting), high stress or anxiety, overheating, and certain foods/drinks, or environmental allergens.

Prevention

Avoidance of the possible triggers—once discovered—can be very helpful in reducing the frequency of the episodes. There are also certain medications that we employ to reduce the “chemical imbalance” thought to be playing a role in this syndrome. Lifestyle changes can be equally important with an emphasis on adequate sleep, hydration, and stress management.

Complications

The complications from CVS are mainly related to the vomiting episodes. These include irritation to the esophageal lining from stomach acid and disruption from the sometimes violent retching. Dehydration can become quite severe and even lead to some degree of renal failure, low blood pressure, dizziness, and even syncope (fainting). Dental erosion from stomach acid can also be seen, particularly when the attacks are frequent. For more information please click on the link below.

Consultations

If you have signs or symptoms suggestive of CVS, please contact your physician or the Neurogastroenterology and Motility Center at 475.210.4727 for a consultation.

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Our specialists

Name Specialties Location
Masoud, Amir E., MD 475.210.4727
  • Gastroenterology
  • Internal Medicine
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  • Fairfield
Sanchez, Mayra J., MD 475.210.4727
  • Gastroenterology
  • Fairfield

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