Your Health: Understanding Cycling Vomiting Syndrome

Most of us have experienced bouts of the flu or other illnesses that have made us sick to our stomachs. In most cases, the nausea and vomiting makes us feel miserable for a day or two but, after that, we start to feel better. People with Cyclic Vomiting Syndrome (CVS) are forced to endure recurring bouts of severe nausea, excessive vomiting and even prostration - all without any apparent cause. People who suffer from this condition may be subject to recurring bouts of vomiting which can last for months at a time or longer. Needless to say, Cyclic Vomiting Syndrome can be a horrible and frightening condition to live with.

What is Cyclic Vomiting Syndrome?

Cyclic Vomiting Syndrome, also known as bilious attacks, periodic syndrome or abdominal migraines, is an unexplained disorder, first diagnosed by Dr. S. Gee back in 1882. While the condition sometimes involved severe abdominal pains, this was not always the case. The similarity lay in the fact that the duration seemed to last anywhere from 1-4 days, happened at frequent intervals, and was both preceded and followed by periods of normal health. While the condition was often misdiagnosed as food poisoning or other kinds of illness, the patient showed no signs of being sick and would continue to suffer this fluctuating condition, sometimes for months or even years at a time.

Originally, CVS was believed to be a pediatric disorder, as it was commonly found to start to affect children between the ages of 3 and 7. As more studies were done, however, it was soon learned that Cyclic Vomiting can begin at any age and it can occur in any age group, from the very young to the elderly. Many medical researchers have come to the conclusion that there is a link between CVS and migraine headaches, though migraines are not always present when an attack occurs.

Interesting to note is that there is usually a distinct similarity from one bout of CVS to the next. Episodes of Cyclic Vomiting Syndrome usually occur at the same time every day, usually last the same length of time and occur with the same level of intensity. Needless to say, this is one way of differentiating CVS from a stomach bug or food poisoning.

The Symptoms of Cyclic Vomiting Syndrome

It's very tricky, determining if someone has CVS, due to the fact that there are a wide variety of diseases and disorders which can cause nausea and vomiting. There are a few clues, however, which may suggest you might have Cyclic Vomiting Syndrome. They include (but are not limited to) periods of wellness between frequent and severe vomiting bouts, three or more separate vomiting issues throughout the year, possible abdominal pain, diarrhea, fever, lightheadedness, headache, and drooling or excessive salivation.

In addition to the usual symptoms, there are also four main stages of CVS. While it may take months or even years to properly uncover the pattern of Cycling Vomiting, the four distinct phases will make themselves known over time:

Phase one: Symptom-free intervals. The first phase of CVS is the period of time during which the patient suffers no sign of illness or discomfort.

Phase two: Prodrome. This is the period just before an onset of CVS, at which time the patient begins to feel nauseated and may or may not begin to experience abdominal pains. This phase differs, depending on the patient and can last a few minutes or can last several hours. Many report that they can take medication when this phase starts and may be able to avoid an episode of CVS though this is not always the case. Also interesting to note is that not all patients who suffer from CVS will notice this phase. In some cases, it seems like they just suddenly launch into the next stage.

Phase three: Vomiting. This is the period of time where the patient suffers severe bouts of nausea and vomiting. They are unable to eat, drink or take any kind of medication without vomiting and some may lapse into a state where they are barely aware of their surroundings. It's not uncommon for the patient to become very pale and to quickly tire, slipping into a state of exhaustion after this retching and vomiting phase.

Phase four: Recovering. This is the stage after vomiting, where the patient begins to recover and will regain their appetite, their color will return and they will begin to regain their lost energy. After this stage, the patient will begin again at phase one and begin to cycle through the stages once again.

Causes of Cycling Vomiting Syndrome

Sadly, there is no known cause for CVS though research has determined that there seems to be a link between CVS and migraine headaches (this is why they are often referred to as abdominal migraines). Patients have reported a wide variety of triggers that can set off the condition, including infections, stress, excitement, anxiety, over-eating, eating before going to bed, physical exertion, hot weather, eating certain foods or even menstruation. Fortunately, the condition has been gaining more recognition and further study is underway, with doctors hoping to find better medications to treat this condition, as well as tests to diagnose it and what causes it.

CVS: Diagnosis and Treatment

Sadly, it's very difficult to diagnose Cycling Vomiting Syndrome. To date, there are no tests that aid in the diagnosis, such as blood tests or imaging scans. The only way to diagnose a case of CVS is to check the patient's past history, compare it to other case studies and simply observe the patient over time. In some cases, this may take months or even years to properly diagnose.

Treatment for this condition varies, depending on the individual and what phase they are attempting to treat. Many patients express that they are able to stop an onset of CVS if they catch it during the second, or prodrome phase, and take medication at this time. Others simply have little option than to retreat to a dark room and get an adequate amount of bed rest until the episode passes. Severe cases of nausea and vomiting may require hospitalization to prevent dehydration or further damage to the esophageal lining of the throat.

One of the most important ways of preventing and treating cycling vomiting syndrome is to keep a journal and record the onset of any episodes, listing moods and events, sleep patterns and what was eaten. Over time, this journal may help you to discover triggers that might lead to a bout of CVS, thereby helping you to avoid triggering the condition in the future.

Sources:

http://digestive.niddk.nih.gov/ddiseases/pubs/cvs/ - Informative article that discusses the stages of CVS

http://www.cvsaonline.org/ - Support and information about ongoing research