Cyclic vomiting syndrome (CVS) is a rare disorder characterized by recurrent, stereotypic episodes of vomiting, often accompanied by abdominal pain, nausea, and other symptoms such as dizziness, headache, and sensitivity to light and sound. These episodes typically occur in a cyclic pattern, with symptom-free intervals between attacks. The condition is most commonly seen in children, but can also affect adults. In this article, we will discuss CVS based upon pre-hospital attendance and UK information.
Symptoms: The symptoms of CVS can be severe and debilitating. During an episode, patients may experience several rounds of vomiting, each lasting hours to days. The vomiting is usually intense and forceful, and may be so severe that it causes dehydration, electrolyte imbalances, and weight loss. Patients may also experience abdominal pain, diarrhea, and fever during an episode. In some cases, the symptoms may be preceded by an aura, which is a warning sign that an attack is imminent.
Causes: The exact cause of CVS is not yet known. However, research has suggested that there may be a genetic component to the disorder, as it tends to run in families. Other factors that may trigger an episode include stress, infections, certain foods, and motion sickness. In some cases, CVS may be associated with other conditions such as migraine, anxiety disorders, and autonomic dysfunction.
Diagnosis: Diagnosing CVS can be challenging, as there is no specific test or marker for the disorder. Instead, doctors typically rely on a combination of symptoms and medical history to make a diagnosis. Tests may be performed to rule out other conditions that may cause similar symptoms, such as gastroesophageal reflux disease (GERD), peptic ulcer disease, and inflammatory bowel disease.
Treatment: Treatment for CVS is aimed at relieving symptoms and preventing future episodes. During an acute attack, patients may be treated with intravenous fluids to restore hydration and electrolyte balance. Anti-emetic medications such as ondansetron or metoclopramide may also be given to alleviate nausea and vomiting. In some cases, hospitalization may be necessary for more aggressive treatment.
Prevention of future episodes can be achieved through various lifestyle changes and medications. Patients may be advised to avoid triggers such as stress, certain foods, and motion sickness. Medications such as amitriptyline, cyproheptadine, and topiramate may also be prescribed to prevent future episodes.
Conclusion: Cyclic vomiting syndrome is a rare disorder characterized by recurrent episodes of vomiting and other symptoms. Although the exact cause of CVS is not yet known, there are several triggers that may contribute to the development of the disorder. Diagnosis can be challenging, but treatment is available to relieve symptoms and prevent future episodes. If you or a loved one is experiencing recurrent episodes of vomiting, seek medical attention promptly for proper evaluation and management.
References:
- Venkatesan T, Tarbell S, Adams K, et al. A survey of emergency department use in patients with cyclic vomiting syndrome. BMC Emerg Med. 2010;10:4.
- Boles RG. High degree of efficacy in the treatment of cyclic vomiting syndrome with combined co-enzyme Q10, L-carnitine and amitriptyline, a case series. BMC Neurol. 2011;11:102.
- Bhandari S, Venkatesan T. Cyclic Vomiting Syndrome: A Review, with Emphasis on Management. Med Sci (Basel). 2018;6(4):100. Published 2018 Nov 6
Article written by : S Hutchinson.
