A condition in which a person experiences multiple episodes of severe vomiting, often without an obvious cause, is called cyclic vomiting syndrome. Usually, an episode lasts between hours and days, then alternates with a symptom-free period. In most cases, the episodes of this syndrome are similar. It means they start at the same time of the day, last the same length, and happen with the same symptoms and intensity.
This syndrome may affect anyone, but is mostly diagnosed in children between 3 to 7 years old. While it mostly occurs in children, the cases among adults are increasing.
Generally, it is difficult to diagnose this syndrome because vomiting is a symptom of multiple health problems. The goal of the treatment is to prevent cyclic vomiting syndrome episodes, lessen the symptoms, and improve your quality of life. Treatment often includes lifestyle changes, medicines (such as anti-nausea), migraine therapies, and others.
Symptoms
Commonly, the symptoms of this syndrome appear in the morning. Check below some symptoms that people with this syndrome experience:
- Normal health without nausea between episodes
- Sweating and nausea before an episode begins
- 3 or more recurrent episodes of vomiting that often begin at the same time of day
- Abdominal (belly) pain
- Increased sensitivity to light
- Headaches
- Retching or gagging
- Dizziness
- Diarrhea
If you notice blood either in your or your child’s vomit, immediately contact your healthcare professional. Seek emergency help if you notice dehydration symptoms. For example:
- Dry skin or mouth
- Reduced or lack of urination
- Excessive thirst
- Sunken eyes or cheeks
- Extreme tiredness
Causes
While experts do not fully understand why cyclic vomiting syndrome occurs, they think a combination of factors causes the condition. These include certain genes, digestive or nervous system problems, and hormonal imbalances. Certain vomiting bouts are often caused by the following factors. Examples include:
- Allergies, colds, or sinus issues
- Emotional distress or excitement (usually in children)
- Anxiety
- Panic attacks
- Some foods and drinks, including caffeine, alcohol, chocolate, or cheese
- Overeating, especially before bedtime
- Hot weather
- Heavy training
- Physical exhaustion
- Menstruation
- Motion sickness
The symptoms can be managed if you identify what triggers them.
Risk Factors
Physicians cannot determine the exact cause of the condition, but have identified some factors that could increase the risk of triggering the condition.
Healthcare professionals do not fully understand the connection between migraines and cyclic vomiting syndrome. However, most children with this condition have a family history of migraines. Generally, cyclic vomiting syndrome is often linked with a personal or family history of migraines in adults.
Another factor that may increase the risk of cyclic vomiting syndrome is chronic (long-term) use of marijuana (cannabis). There is a condition that may appear in people who use marijuana for a prolonged time. It is called cannabis hyperemesis syndrome, and it causes persistent vomiting without normal intervening periods. Furthermore, people with cannabis hyperemesis syndrome demonstrate frequent showering or bathing behavior.
In some cases, cannabis hyperemesis syndrome can be mistaken for cyclic vomiting syndrome. Doctors often recommend stopping the use of marijuana for at least 2 weeks to see if vomiting lessens. If it does not, your doctor will continue to test you for cyclic vomiting syndrome.
What Are The Potential Complications of Cyclic Vomiting Syndrome?
People with this syndrome may experience some complications, especially if they do not find the triggers and do not get treatment. Check below some examples:
- Tooth decay – The vomit contains acid from the stomach. It can cause damage to the tooth enamel, which often leads to tooth decay.
- Damage to the esophagus – The Esophagus is a tube that carries food and drinks from the mouth to the stomach. Recurrent vomiting can cause damage to the esophagus.
- Dehydration – People who experience multiple episodes of this syndrome usually lose water and minerals quite quickly. Furthermore, severe dehydration is often treated in a hospital.
How to Prevent Cyclic Vomiting Syndrome?
Most people with this syndrome know what triggers the episodes. So, it is recommended to find and avoid triggers because it helps reduce the frequency of the cyclic vomiting syndrome episodes. Sometimes, doctors may recommend some medicines between episodes to prevent damage to the esophagus and dehydration.
People with more than one episode per month are usually hospitalized. In the hospital, you may receive a prescription of Amitriptyline, Propranolol, Cyproheptadine, or Topiramate. Check below some lifestyle changes that may help lessen the symptoms and reduce the frequency of cyclic vomiting syndrome episodes:
- Healthy sleep
- Dismiss the importance of future events to prevent excitement in children because it may trigger an episode
- Avoid foods and drinks such as alcohol, caffeine, cheese, and chocolate
- Eat small meals and low-fat snacks every day at regular times
Diagnosis
Sometimes, it is challenging to diagnose this syndrome because there are no specific tests that can confirm it, and vomiting is a symptom of many health conditions. That’s why physicians often perform a physical examination and some tests to rule out other conditions. For example:
- Imaging tests – For example, endoscopy, ultrasound, a CT (computerized tomography) scan, and others to check for blockages in the digestive system.
- Motility tests – These tests are done to check the movement of food through the digestive system. They help diagnose digestive disorders.
- Laboratory tests – These include blood tests used to check for metabolic disorders (such as thyroid disease).
Treatment
Unfortunately, there is no way to cure the syndrome, but with early detection and proper treatment, you can reduce the symptoms and improve your quality of life. Many people with cyclic vomiting syndrome get long-term remission. Healthcare professionals usually recommend the following medicines for people with this syndrome. For example:
- Anti-nausea mediicnes
- Painkillers
- Antidepressants
- Anti-seizure drugs
- Medicines to reduce stomach acid production
Previous medicines can be used to treat migraines and reduce the frequency of cyclic vomiting syndrome episodes. In most cases, doctors prescribe previous medicines for people with multiple episodes of the disease or a family history of migraines.
People with severe dehydration are usually hospitalized. Treatment often includes IV (intravenous) fluids and electrolytes.
Frequently Asked Questions
What is the cause of cyclic vomiting syndrome?
While the exact cause of this syndrome is not known, experts think a combination of factors causes the disease. Examples include certain genes, emotional distress, a family history of migraines, and others.
What foods trigger cyclic vomiting syndrome?
These include chocolate, cheese, alcohol, and foods with monosodium glutamate (MSG). Avoid previous foods once you are diagnosed with cyclic vomiting syndrome.
What can be mistaken for cyclic vomiting syndrome?
There are certain conditions that can be mistaken for cyclic vomiting syndrome. These include gastroenteritis, gastroesophageal reflux disease (GERD), food poisoning, recurrent flu, or eating disorders (such as binge eating). If you have additional questions, ask your healthcare professional.
