Cpt

Cyclic vomiting syndrome
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Recurrent episodes of severe nausea and vomiting
Complications	Dehydration, esophagitis, Mallory-Weiss tear
Onset	Childhood
Duration	Hours to days
Types	N/A
Causes	Unknown
Risks	Migraine, anxiety, depression
Diagnosis	Clinical evaluation
Differential diagnosis	Gastroenteritis, appendicitis, pancreatitis
Prevention	N/A
Treatment	Hydration, antiemetics, triptans
Medication	Ondansetron, sumatriptan
Prognosis	Variable
Frequency	Rare
Deaths	N/A

Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent, severe episodes of nausea and vomiting. These episodes can last from hours to days and are interspersed with symptom-free periods. CVS is often associated with migraine headaches and can significantly impact the quality of life of affected individuals.

Signs and Symptoms

The primary symptom of cyclic vomiting syndrome is recurrent episodes of severe nausea and vomiting. These episodes are often predictable and may occur at regular intervals. Other symptoms may include:

• Abdominal pain
• Diarrhea
• Dizziness
• Sensitivity to light and sound
• Headache

Complications

Complications of CVS can arise from the frequent vomiting and include:

• Dehydration
• Electrolyte imbalance
• Esophagitis
• Mallory-Weiss tear
• Tooth decay

Causes

The exact cause of cyclic vomiting syndrome is unknown. However, it is believed to be related to migraine headaches, as many patients with CVS have a family history of migraines. Other potential triggers include:

• Infections
• Stress
• Anxiety
• Certain foods
• Sleep deprivation

Diagnosis

Diagnosis of cyclic vomiting syndrome is primarily clinical, based on the patient's history and symptoms. There are no specific tests for CVS, but other conditions must be ruled out. The following criteria are often used:

• At least five episodes of vomiting in any interval or at least three episodes over six months
• Episodes of vomiting lasting from one hour to ten days
• Symptom-free intervals between episodes
• No other identifiable cause of vomiting

Differential Diagnosis

Conditions that may mimic cyclic vomiting syndrome include:

• Gastroenteritis
• Appendicitis
• Pancreatitis
• Intestinal obstruction
• Peptic ulcer disease

Treatment

Treatment of cyclic vomiting syndrome focuses on managing symptoms and preventing episodes. Strategies include:

• Hydration with oral or intravenous fluids
• Antiemetics such as ondansetron
• Triptans for migraine-associated CVS
• Prophylactic medications such as amitriptyline
• Lifestyle modifications including stress management and dietary changes

Prognosis

The prognosis for cyclic vomiting syndrome varies. Some children outgrow the condition, while others continue to experience episodes into adulthood. With appropriate management, the frequency and severity of episodes can often be reduced.

Epidemiology

Cyclic vomiting syndrome is considered a rare disorder, with an estimated prevalence of 1-2% in children. It is less common in adults. The condition is often underdiagnosed due to its episodic nature and similarity to other gastrointestinal disorders.

See Also

• Migraine
• Gastroenterology
• Nausea
• Vomiting