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Genetic and Rare Diseases Information Center (GARD)

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Cyclic vomiting syndrome


Other Names for this Disease

  • CVS
  • Familial cyclic vomiting syndrome (subtype)
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

My adult son has cyclic vomiting syndrome. Although he has been taking medication, his symptoms continue to escalate. How might this condition be managed? Is there a place where we can find other people who have severe symptoms as a result of this condition? 

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is cyclic vomiting syndrome?

Cyclic vomiting syndrome (CVS) is a disorder with recurrent episodes of severe nausea and vomiting interspersed with symptom free periods.[1][2] The cycles of severe nausea and vomiting can last for hours or even days. Each episode is similar to the previous ones. The episodes tend to start at about the same time of day, last the same length of time, and present the same symptoms at the same level of intensity.[2] Although cyclic vomiting syndrome can begin at any age in children and adults, it usually starts between the ages of 3 and 7. Although the underlying cause of cyclic vomiting syndrome is not known, some cases appear to be to be linked to migraines. Treatment with migraine medications often helps.[2][3] 

 

    
Last updated: 12/19/2013

What are the characteristics of adult cyclic vomiting syndrome?

Cyclic vomiting syndrome causes severe vomiting, nausea and gagging — sometimes as often as 12 times an hour.[3] In adults, episodes tend to occur less often than they do in children, but they last longer.[2][3] 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 have about 12. Episodes typically begin at night or first thing in the morning.[3]

Other common symptoms include pallor and exhaustion. Some people also become sensitive to light and may develop:[3]

  • Headache
  • Fever
  • Dizziness
  • Diarrhea
  • Abdominal pain
Based on several recent studies of adult patients with cyclic vomiting syndrome, the most uniform feature of adult patients with cyclic vomiting syndrome was the stereotypical nature of the nausea, vomiting, and abdominal pain with intermittent symptom free periods. The abdominal pain appears to be more pronounced in the adult patients than in pediatric patients.[1] Furthermore, the events or situations that trigger episodes in adults cannot always be pinpointed as easily as they can in children.[2]  
Last updated: 11/21/2008

How might cyclic vomiting syndrome be treated?

Cyclic vomiting syndrome can not be cured nor is there a standard, evidence-based treatment regimen.[2][4] Management remains largely based on clinical experience and must be individualized and fine-tuned during the course of the patient's illness.[1][4] In general, the treatment approach to a patient with cyclic vomiting syndrome should include consideration of lifestyle changes including avoidance of potential triggering factors, drug therapy to prevent subsequent episodes, supportive care treatment during acute episodes, and support of the family.[1]

Treatment varies, but people with cyclic vomiting syndrome are generally advised to get plenty of rest; sleep; and take medications that prevent a vomiting episode, stop or alleviate one that has already started, or relieve other symptoms. Once a vomiting episode begins, treatment is supportive. It helps to stay in bed and sleep in a dark, quiet room. Severe nausea and vomiting may require hospitalization and intravenous fluids to prevent dehydration. Sedatives may help if the nausea continues. Sometimes, during the prodrome phase, it is possible to stop an episode from happening altogether. For example, people who feel abdominal pain before an episode can ask their doctor about taking ibuprofen (Advil, Motrin) to try to stop it. Other medications that may be helpful are ranitidine (Zantac) or omeprazole (Prilosec), which help calm the stomach by lowering the amount of acid it makes.[2]

People whose episodes are frequent (occur more than once a month) and long-lasting may be treated during the symptom-free intervals in an effort to prevent or ease future episodes. Medications that help people with migraine headaches—propranolol, cyproheptadine, and amitriptyline—are sometimes used during this phase, but they do not work for everyone.[2][3] Other medications which may be helpful include nortriptylinesumatriptan (Imitrex) and zolmitriptan (Zomig).[3]  Taking the medicine daily for 1 to 2 months may be necessary to see if it helps.[2]

To learn more about new treatments which are being studied, visit ClinicalTrials.gov, a service of the U.S. National Institutes of Health and the National Library of Medicine. ClinicalTrials.gov provides patients, family members, and members of the public with current information on clinical research studies.
 

Last updated: 11/21/2008

What is the prognosis for patients with cyclic vomiting syndrome?

Important advances are being made in the clinical understanding of cyclic vomiting syndrome which may open the way for new treatments.  Long-term outcomes and the natural history of cyclic vomiting syndrome in adults, however, will require more studies.[1]
Last updated: 11/21/2008

Where can we connect with other adult patients with cyclic vomiting syndrome and others who have had difficulty managing their symptoms?

You can connect with other patients with cyclic vomiting syndrome by contacting the Cyclic Vomiting Syndrome Association.

Cyclic Vomiting Syndrome Association
3585 Cedar Hill Road, NW.
Canal Winchester, OH 43110
Phone: 614–837–2586
Fax: 614–837–2586
Email: waitesd@cvsaonline.org
Web: www.cvsaonline.org
Web page for adult patients: http://www.cvsaonline.org/CVSAAdults.htm
Last updated: 11/21/2008

References
Other Names for this Disease
  • CVS
  • Familial cyclic vomiting syndrome (subtype)
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.