About childhood cyclic vomiting
What is childhood cyclic vomiting?
Cyclic vomiting syndrome (CVS) is a rare disorder characterized by recurrent, similar episodes of severe nausea and vomiting. An episode may last for a few hours to several days and then is followed by a period of time during which affected individuals are free of severe nausea and vomiting. This alternating pattern of disease and disease-free periods distinguishes cyclic vomiting syndrome from other similar disorders. Also, in cyclic vomiting syndrome, within each sufferer the episodes are similar. The associated nausea and vomiting can be severe enough to be incapacitating (e.g., individuals may be unable to walk or talk and/or be bedridden). Additional symptoms that are often present during an episode including dizziness, paleness of the skin (pallor), lack of energy (lethargy), abdominal pain and headaches. Oftentimes, nausea is the most disturbing symptom, and vomiting is infrequent. In some cases as children grow older, they may outgrow these episodes, although many of these children eventually develop migraines. Cyclic vomiting syndrome may affect children more often than adults. The exact cause of cyclic vomiting syndrome is unknown.
What are the symptoms for childhood cyclic vomiting?
Signs and symptoms during a Vomiting episode may include:
- Abdominal pain
- Sensitivity to light
- Retching or gagging
What are the causes for childhood cyclic vomiting?
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
- Certain foods and drinks, such as alcohol, 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 are the treatments for childhood cyclic vomiting?
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 a cyclic vomiting episode, treatment focuses on controlling the signs and symptoms.
What are the risk factors for childhood cyclic vomiting?
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, cyclic vomiting syndrome is also associated with a personal or family history of migraines.
Chronic use of marijuana (Cannabis sativa) also has been associated with cyclic vomiting syndrome because some people use marijuana to relieve their nausea. However, chronic marijuana use 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.
Is there a cure/medications for childhood cyclic vomiting?
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.