Also known as abdominal migraine, bilious attacks, periodic syndrome, and recurrent vomiting, cyclic vomiting syndrome (CVS) is a poorly understood condition that causes its victims to suffer from periodic bouts of intense nausea and vomiting. Treatment for cyclic vomiting syndrome must be geared to the needs and triggers of the individual patient. Children are the most common victims of cyclic vomiting syndrome; however, doctors are beginning to recognise cyclic vomiting syndrome in adults.
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Samuel Gee first described cyclic vomiting syndrome in his 1882 report entitled "On Fitful or Recurrent Vomiting." These patients displayed sudden-onset nausea and vomiting that would last for hours or days. Gee wrote that between episodes, patients appeared free of any disease. According to the journal "Pediatric Nursing," modern medicine only began investigating ways to treat to cyclic vomiting syndrome in the 1990s, after some researchers began to theorise that it was related to migraine.
According to Neil Gordon, author of "Recurrent Vomiting in Childhood, Especially of Neurological Origin," there is a long list of serious conditions that can cause vomiting, each of which has to be eliminated before diagnosing a patient with cyclic vomiting syndrome. During an episode, supportive care is of the highest priority. If you're staying at home, rest in a dark, quiet place. In hospital, IV fluids and sedatives might be given to help maintain hydration and limit vomiting until the episode is over.
Managing cyclic vomiting syndrome is a process of noting when a patient is entering prodome, the phase that precedes an episode of vomiting. The anti-anxiety drug lorazepam can sometimes stop an episode before it begins. In "The Indian Journal of Pediatrics," J. B. Ghosh and colleagues report that the anti-migraine medication amitriptyline has been found to be effective in lowering the frequency and severity of cyclic vomiting episodes in some patients. They note that amitriptyline is also useful in confirming a diagnosis of cyclic vomiting syndrome, since CVS is the only vomiting condition that responds to this drug.
A 2010 study in "BMC Neurology" reports that cyclic vomiting syndrome patients taking the nutritional supplement coenzyme Q10 experienced nearly the same reduction of symptoms as patients taking amitriptyline, with none of the side effects. According to "Extreme Emesis: Cyclic Vomiting Syndrome," 56 to 72 per cent of adult sufferers of CVS experience relief from an attack by taking a hot bath or shower. In children, deep sleep upon entering the prodome phase can sometimes help stop an attack before it begins.
In children, cyclic vomiting syndrome often resolves on its own by puberty. Families of children with cyclic vomiting syndrome identify stress and infections, especially sinus infections, as episode triggers. Positive events, including holidays and birthdays, are highly likely to induce an episode in children. Adults with chronic vomiting syndrome are likewise susceptible during times of negative stress or happy excitement. Adult triggers also include menstruation and exhaustion. Avoiding triggers can be a powerful weapon against cyclic vomiting syndrome.
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- "Paediatric Nursing;" Cyclic Vomiting Syndrome: A Disease in Disguise; Jan Bullard and Nancy E. Page; January / February 2005
- "Developmental Medicine & Child Neurology;" Recurrent Vomiting in Childhood, Especially of Neurological Origin; 1994
- Cyclic Vomiting Syndrome Association Online: Empiric Guidelines for Treatment of Cyclic Vomiting Syndrome
- "The Indian Journal of Pediatrics;" Cyclic Vomiting Syndrome; J. B. Ghosh et al.; 2009
- "BMC Neurology;" Treatment of Cyclic Vomiting Syndrome with Co-enzyme Q10 and Amitriptyline, a Retrospective Study; Richard G. Boles et al.; 2010