Cyclic Vomiting Syndrome (CVS)

What is Cyclic Vomiting Syndrome?

Cyclic vomiting syndrome (CVS) is a disorder that causes a person to experience frequent prolonged periods of fatigue, vomiting, and nausea. Episodes happen in regular intervals for a few hours or days, and they tend to stay relatively similar in nature until the patient begins to feel healthy again. The condition can affect anyone of any age, and it can last for years or even decades.

First identified in 1882, CVS currently has no explainable cause, although there may be a connection with a family history of migraines. Women tend to be affected more often than men, and individuals with this condition could be more prone to motion sickness. Children with CVS will often see their sickness being replaced with migraines as they reach their adolescent years.

What are the Symptoms of Cyclic Vomiting Syndrome?

Many patients say that their symptoms begin in the early morning hours, although they can hit at any time of the day or night.

Symptoms include

  • Vomiting
  • Fatigue
  • Nausea
  • Drooling
  • Extreme thirst
  • Headache
  • Abdominal pain
  • Fever
  • Diarrhea
  • Mild bleeding from esophagus
  • Dehydration
  • Pale skin
  • Lethargy
  • Gagging
  • Reduced appetite
  • Weight loss
  • Light or sound sensitivity
  • Vertigo

Some who experience CVS are unaware of what triggers their symptoms. Others can pinpoint specific conditions and circumstances that appear to be directly related. Flus, colds, intense excitement, infections, menstrual periods, and emotional stress are frequently reported as catalysts for CVS episodes.

Cyclic Vomiting Syndrome Causes

Experts aren’t sure what causes CVS, but they suspect that there are a range of factors involved. Firstly, it seems that the way food is moved through the stomach and intestines, known as gastrointestinal motility, is different in those with CVS, although the reason for this isn’t clear.

The central nervous system also seems to be involved in CVS. This includes the brain, spinal cord and all the peripheral nerves that control bodily functions. The autonomic nervous system function, which controls the automatic functioning of the internal organs, also appears to operate incorrectly with CVS.

Hormone imbalances could also play a role in CVS. Hormones are produced to regulate a wide range of bodily functions, so if they are incorrectly balanced, the body’s normal digestive processes could be affected.

Although all of these things might come together to create the root cause of CVS, episodes of the condition are usually triggered by environmental factors.

The following are well-known triggers:

  • Emotional stress or anxiety
  • Physical exhaustion
  • Overeating
  • Fasting
  • Eating too close to bedtime
  • Certain types of food
  • Motion sickness
  • Menstruation
  • Hot weather
  • Infections, like a cold or the flu

How is Cyclic Vomiting Syndrome Treated?

When CVS hits, treatment is focused on managing, shortening, or preventing episode occurrence.

Each case will require unique therapy based on the symptoms reported by the patient. Anti-migraine medication is often beneficial to those with a history of migraines. Doctors may recommend lifestyle changes, including a quiet, dark environment to promote sleep, while various medications can help with other symptoms. Severe cases may require a hospital stay and IV fluids.

Cyclic Vomiting Syndrome Prevention

Since the cause of CVS isn’t fully understood, it’s not possible to completely prevent the condition. However, it may be possible to prevent episodes or reduce the frequency or severity of episodes by avoiding known triggers.

Eating small meals at regular intervals tends to be most effective for people with CVS. It can also help to keep a food diary in order to help you spot foods which appear to trigger episodes. Chocolate, cheese, caffeine, nitrates and monosodium glutamate (MSG) are particularly common triggers.

Adopting a good sleep hygiene routine may also be helpful, since physical exhaustion can trigger CVS episodes. Getting regular sleep might also reduce the risk of emotional stress which is another common trigger.