About Cyclic Vomiting Syndrome
The disease related causes of cyclic vomiting syndrome (CVS) are not fully understood, but researchers have proposed several factors that may contribute to the disorder. These include:
- Changes in brain function: CVS is believed to be a migraine-like condition, suggesting that it is related to changes in signaling between nerve cells in certain areas of the brain.
- Hormonal abnormalities: Imbalances in hormones may play a role in CVS, although the exact mechanisms are not yet clear.
- Gastrointestinal problems: Some individuals with CVS have abnormalities in their digestive system, which may contribute to the development of symptoms.
- Dysautonomia: Many affected individuals have abnormalities in the autonomic nervous system, which controls involuntary body functions like heart rate and digestion.
- Mitochondrial DNA changes: In some cases, especially those that start in childhood, CVS may be related to changes in mitochondrial DNA.
Risk factors for CVS include:
- Gender: CVS is more common in females.
- Age: It often starts in childhood between 3 and 7 years old but can also develop in adults.
If you have concerns about your risk for CVS or any other health condition, it is best to consult with your healthcare professional for personalized advice and guidance.
The most common symptoms of CVS are sudden and severe episodes of nausea and vomiting. These episodes can occur multiple times an hour and last from a few hours to several days. Other common symptoms that may occur with later stages, progression, or higher severity of CVS include:
- Feeling very tired and drowsy
- Abdominal pain
- Diarrhea
- Headache
- Fever
- Increased sensitivity to light (photophobia) or sound (phonophobia)
- Dehydration
It's important to note that the signs and symptoms of each attack are often similar in most affected individuals, but the frequency and severity can vary. If you experience any of these symptoms, it is advisable to speak with a healthcare provider for an accurate diagnosis and appropriate management.
To diagnose CVS, healthcare providers typically use a combination of medical history, physical examination, and various tests. Here are the commonly performed examinations, tests, and procedures for diagnosing CVS:
- Medical history: Your healthcare provider will gather information about your symptoms, their frequency, duration, and any triggers or patterns you may have noticed.
- Physical examination: During the exam, your healthcare provider will look for signs of other medical problems that could be causing your symptoms.
- Lab tests: Blood tests can help identify signs of anemia, dehydration, inflammation, infection, liver problems, and mitochondrial diseases. Urine tests can show signs of dehydration, infection, and kidney problems.
- Upper GI endoscopy: This procedure allows the healthcare provider to examine the upper digestive tract for any abnormalities that may contribute to nausea and vomiting.
- Imaging tests: Ultrasound of the abdomen and gastric emptying test (gastric emptying scintigraphy) are commonly used imaging tests to assess stomach emptying time after a meal.
To determine the stage or severity of CVS, additional examinations and tests may be recommended depending on your specific symptoms and body system being evaluated. These may include:
- Magnetic resonance imaging (MRI) scan or computed tomography (CT) scan of the brain: These imaging studies can help identify any structural abnormalities or brain-related causes of CVS.
- Clinical procedures: Depending on your symptoms and evaluation needs, your healthcare provider may recommend clinical procedures such as X-rays, hearing tests, or other specialized tests to gather more information about your condition.
Remember to speak with your healthcare provider about which examinations, tests, and procedures are appropriate for your individual situation.
The goals of treatment for CVS are to manage and reduce the frequency and severity of episodes, as well as to prevent complications. Here are some treatments and how they work to achieve these goals:
- Medication:
- Antiemetics: These drugs help prevent vomiting and can be taken before or during an episode to manage symptoms.
- Pain relievers: Over-the-counter pain relievers like ibuprofen and acetaminophen can help ease abdominal pain associated with CVS.
- Gastric acid suppressants: These medications reduce the acidity of stomach contents, protecting the esophagus and teeth from damage.
- Antimigraine medications: If there is a family history of migraines, these medications may help manage CVS episodes.
- Anticonvulsant medications: In some cases, antiseizure drugs can prevent CVS episodes.
- Therapies and therapeutic procedures:
- Psychotherapy: For children with comorbid anxiety or other psychological conditions, psychotherapy may be recommended.
- IV fluids: In severe cases, intravenous fluids with glucose and electrolytes can help prevent dehydration caused by vomiting.
- Health behavior changes:
- Avoiding triggers: Identifying and avoiding triggers that may initiate episodes is an important part of managing CVS.
- Getting enough sleep and rest: Prioritizing adequate sleep and rest can help reduce the occurrence of episodes.
It's important to note that treatment plans should be personalized based on individual needs. Speaking with a healthcare provider is crucial for proper evaluation and guidance. Medication dosing (how and when medication is taken) may be affected by many factors, so it's essential to speak your healthcare provider for specific dosing instructions. Other side effects can occur, so it's important to consult your healthcare provider or read the information provided with your medication for additional side effect information.