Cyclic vomiting syndrome (CVS) is a health condition that causes sudden attacks of severe nausea and vomiting. Doctors believe it is a result of the brain and the digestive system sending mixed signals to each other. This miscommunication sets off repeated cycles of vomiting and nausea.
Cyclic vomiting syndrome episodes can last for hours or even days. The attacks tend to follow a pattern: they often begin at the same time of day, last approximately the same amount of time, and occur with the same level of intensity. After an episode, people typically experience long periods without symptoms, which can last for weeks or months.
Cyclic vomiting syndrome can affect people of all ages. However, it most often begins in children between the ages of three and seven. Even though children are more likely to have it, more and more adults are being diagnosed with CVS. In fact, research from the American Gastroenterological Association shows that about 2% of adults in the U.S. live with this condition. Unfortunately, doctors sometimes overlook CVS in adults or mistake it for another illness, which can delay proper treatment.
Right now, there is no single known cause of cyclic vomiting syndrome. Diagnosis can be tricky because vomiting is a common symptom of many different conditions. Treatment usually focuses on lifestyle changes that help prevent attacks. In some cases, doctors prescribe medicines such as anti-nausea drugs or migraine treatments to help reduce symptoms.
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Currently, the underlying cause of cyclic vomiting syndrome is unknown. Some possible causes include genetic factors, digestive issues, nervous system conditions, and hormonal imbalances.
Episodes may be triggered by:
Colds, allergies, or sinus conditions
Strong emotions, such as stress or excitement, especially in children
Anxiety or panic attacks
Certain foods and drinks, such as alcohol, chocolate, cheese, or caffeinated foods and beverages
Overeating, fasting, or eating immediately before going to bed
Lack of sleep
Temperature extremes, either hot or cold
Physical exhaustion
Overexercising
Menstruation
Motion sickness
Working with your doctor to identify triggers for your vomiting episodes may help with managing cyclic vomiting syndrome.
PEOPLE AT RISK
Common in children ages three to seven
Increasingly recognized in adults, but it can often be misdiagnosed
About 2% of U.S. adults are affected, according to the American Gastroenterological Association
RISK FACTORS
Family & Medical History
A history of migraines in yourself or in your family
Kids with CVS can later develop migraines
Substance Use
Long-term marijuana use may trigger a condition called cannabis hyperemesis syndrome (CHS)
CHS causes nonstop vomiting, with frequent hot showers/baths needed for relief
CHS may be ruled out by stopping marijuana for a few months. If vomiting continues, CVS may be the cause.
SIGNS & SYMPTOMS
Pattern of Episodes
Sudden, repeated bouts of severe nausea and vomiting
Often start in the early morning
Episodes repeat similarly each time
Symptom-free periods in between
Phases of an Episode
Prodrome Phase: Nausea, sweating before vomiting starts
Vomiting Phase: Frequent vomiting (sometimes projectile in kids), may last hours to days
A thin tube with a camera is inserted into the esophagus, stomach, and small intestine to identify potential causes of vomiting.
TREATMENT
Currently, there is no cure for cyclic vomiting syndrome, though many children who suffer from CVS no longer experience vomiting episodes by the time they reach adulthood. For those experiencing a cyclic vomiting episode, treatment focuses on managing the symptoms.
Your doctor may recommend any of the following treatments:
Medicines
Anti-nausea drugs: reduce nausea and vomiting
Pain relievers: ease stomach or headache pain
Stomach acid reducers: lower irritation from vomiting
Antidepressants: help regulate brain chemicals that may trigger episodes
Antiseizure medicines: effective for preventing attacks in some cases
Migraine medicines: may stop or prevent episodes, especially for those with migraine history
Other Care
IV fluids: used to replace lost fluids and prevent dehydration during severe vomiting
PREVENTION
Many people are aware of what triggers their cyclic vomiting episodes, and avoiding those triggers can help reduce the frequency of episodes. While you may feel better between episodes, it's essential to take your medications as prescribed by your doctor to prevent episodes.
Medication is one option for prevention. Other helpful prevention methods include:
Lifestyle Changes
Getting adequate sleep every night
Eating small, low-fat meals and snacks on a regular schedule
Avoiding trigger foods and drinks, such as alcohol, caffeine, chocolate, and cheese
For children, lowering excitement around big events since it can trigger episodes
Managing Episodes
Resting in a dark, quiet room when vomiting begins
Rehydrating with fluids after vomiting stops:
Oral electrolyte solutions like Pedialyte
Diluted sports drinks. Mix equal parts sports drink and water.
Starting with clear liquids, then slowly adding solid foods when ready.
Stress & Emotional Triggers
Reducing stress and anxiety during symptom-free times
Practicing calming activities to help prevent stress-triggered episodes
Cyclic vomiting syndrome is not a fatal condition and does not impact life expectancy. While it isn't deadly, cyclic vomiting syndrome can significantly impact quality of life and lead to life-threatening complications in severe cases that are left untreated.
How common is cyclic vomiting syndrome?
Cyclic vomiting syndrome is more common in children than in adults, with about three out of every 100,000 children having CVS. In most cases, episodes in children begin between the ages of three and seven; however, the disorder can also start at any age.
Recent research by the American Gastroenterological Association (AGA) shows that about 2% of adults in the U.S. suffer from cyclic vomiting syndrome. Although it was once believed to be mainly a childhood condition, this statistic suggests that CVS is relatively common among adults. Cyclic vomiting syndrome in adults is often overlooked or misdiagnosed as other conditions, which can lead to delays in receiving the correct treatment.
What are the complications of cyclic vomiting syndrome?
Complications of cyclic vomiting syndrome can include:
Dehydration: Excessive vomiting causes the body to lose fluids quickly. Severe dehydration may require hospital treatment.
Injury to the esophagus: The stomach acid that comes up with vomit can harm the esophagus. In some cases, the esophagus becomes so irritated that it bleeds.
Tooth decay: The excessive amount of stomach acid caused by vomiting can break down tooth enamel.
What condition is often mistaken for cyclic vomiting syndrome?
Conditions that may be mistaken for CVS can include:
Acid reflux
Stomach ulcers
Infections
Inflammation: gastritis, pancreatitis, or appendicitis
Twisting of the intestine (volvulus or malrotation)
Ureteropelvic (UPJ) obstruction (A blockage where your kidney attaches to your bladder)
Metabolic disorders
Your doctor will need to rule out these conditions before making a diagnosis of cyclic vomiting syndrome.
What are some triggers for cyclic vomiting syndrome to avoid?
Cyclic vomiting syndrome triggers vary from person to person, but certain conditions, events, and emotional states may trigger an episode, such as:
Seasonal changes
Reactions to foods like chocolate, cheese, caffeine, or MSG
Heightened positive emotions, like excitement (more common in children)
Panic attacks, stress, and anxiety
Allergies, sinus infections, or the flu virus
Physical exhaustion
Fasting
Prolonged marijuana use
Menstruation
Motion sickness
How is cyclic vomiting syndrome (CVS) diagnosed?
Diagnosing CVS involves ruling out other common conditions that result in similar symptoms. Your doctor will likely perform a physical exam and a variety of tests, as well as ask questions about your personal medical history, your family medical history, and your pattern of nausea and vomiting.
What is cyclic vomiting syndrome in adults?
Cyclic vomiting syndrome is a condition where an individual experiences a cycle of severe nausea, vomiting, and exhaustion. Episodes can last from a few hours to a few days. Initially, CVS was thought to be a pediatric condition, but it is becoming increasingly common in adults. Although most don’t suffer from this condition daily, it can be chronic.
How can you stop cyclical vomiting in adults?
If you’re experiencing symptoms of cyclic vomiting syndrome, talk to your doctor. Working with your healthcare team and seeking proper treatment will help you manage the condition in everyday life.
CVS treatment for adults may include:
Prescription medicines
Treating health problems that may trigger the disorder
Avoiding your triggers
Managing your triggers
Explore more on the topic of Cyclic Vomiting Syndrome:
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