INFORMATION ABOUT

Cyclic Vomiting Syndrome

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SHORT

Overview of CVS

CVS is an unexplained disorder of children and adults that was first described by Dr. S. Gee in 1882. The condition is characterized by recurrent, prolonged attacks of severe nausea, vomiting, and prostration with no apparent cause. In some, there is severe abdominal pain. Vomiting occurs at frequent intervals for hours or days (1-4 days, most commonly). The episodes tend to be similar to each other in symptoms and duration, and are self-limited with return of normal health between episodes.

CVS can begin at any age. It can persist for months, years, or decades. Episodes may recur several times a month or several times a year. Females are affected slightly more than males. The person may be prone to motion sickness, and there is often a family history of migraine. There is a high likelihood that children’s episodes will be replaced by migraine headaches during adolescence.

Episodes may begin at any time, but often start during the early morning hours. There is relentless nausea with repeated bouts of vomiting or retching. The person is pale, listless, and resists talking. They often drool or spit and have an extreme thirst. They may experience intense abdominal pain and less often headache, low-grade fever, and diarrhea. Prolonged vomiting may cause mild bleeding from irritation of the esophagus. One mother aptly described her child’s state during the episode as a “conscious coma.” The symptoms are frightening to the person and family, and can be life-threatening if delayed treatment leads to severe dehydration.

CVS has been difficult to diagnose because it is infrequently recognized and is often misdiagnosed as stomach flu or food poisoning. There are as yet, no blood tests, x-rays, or other specific procedures used to diagnose the disorder. The diagnosis is made by careful review of the patient’s history, physical examination, and lab studies to rule out other diseases that may cause vomiting similar to that found with CVS.

Patients may not know exactly what triggers their attacks; however, many patients identify specific circumstances that seem to bring on their episodes. Colds, flus and other infections, intense excitement (birthdays, holidays, vacations), emotional stress, and menstrual periods are the most frequently reported triggers. Specific foods or anesthetics may also play a role.

Treatment is generally supportive, with much importance placed on early intervention. A dark quiet environment is critical for sleep. Hospitalization and IV fluid replacement may be necessary. Medication trials sometimes succeed in finding something to prevent, shorten, or abort episodes. It is important to work with a physician who does his/her best to understand CVS and is supportive.

The foundation of long-term management involves a responsive collaborative doctor-patient-family relationship, sensitive to stresses caused by the illness and to triggers such as feelings and attitudes that may pre-dispose the patient to attacks. Consistent and accessible physician care by a care coordinator who understands and communicates the nature of CVS, regardless of specialty, is vital to the family’s well-being. Connections with the Cyclic Vomiting Syndrome Association, a family and professional network, can do a great deal toward healing a family that has been in doubt and despair for years.

In-Depth information on

Cyclic Vomiting Syndrome

1

What is CVS?

1

What is CVS?

Cyclic vomiting syndrome, or cyclical vomiting syndrome, (CVS) is a chronic functional condition of unknown cause characterized by recurring attacks of intense nausea, vomiting, and sometimes abdominal pain, headaches…

2

Pathophysiology and Etiology

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Pathophysiology and Etiology

Even though the etiology and pathophysiology of CVS are not known, studies have suggested several potential brain-gut mechanisms…

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Cyclic Vomiting Syndrome and Mitochondrial Dysfunction and treatment

3

Cyclic Vomiting Syndrome and Mitochondrial Dysfunction and treatment

Mitochondria are small organelles within the cell responsible for energy production and other critical functions…

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Members only

4

CVS subgroups

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CVS subgroups

Subcategories of CVS have been identified, including CVS plus, catamenial CVS, and Sato’s variant of CVS…

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Members only

5

Treatment of CVS

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Treatment of CVS

The clinical course of CVS can be divided simply into the episode phase and the well phase, during which the person returns to his or her normal or baseline state of health.

The episode phase is further divided into the prodrome …

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CVS plus

6

CVS plus

Cyclic vomiting syndrome is characterized by severe discrete episodes of nausea, vomiting, and lethargy. Approximately 25% of cases have coexisting neuromuscular disease manifestations (cyclic vomiting syndrome plus)…

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Members only

7

Adult CVS

7

Adult CVS

It has long been thought that CVS was a condition of childhood and adolescence. Now we know that adults also suffer from CVS.

 

There is CVS that begins in childhood and may extend into adulthood as well as adult onset CVS. As so many adults can attest, the condition causes untold suffering and disability, and often leads to family, school, and career upheaval.

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Members only

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Adult CVS and confusion with Cannabinoid Hyperemesis Syndrome

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Adult CVS and confusion with Cannabinoid Hyperemesis Syndrome

Coinciding with the increasing rates of cannabis abuse has been the recognition of a new clinical condition known as Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and frequent hot bathing….

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Cyclic vomiting syndrome and abdominal migraine

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Cyclic vomiting syndrome and abdominal migraine

Both cyclic vomiting syndrome and abdominal migraine are relatively unusual conditions that present with recurrent and severe paroxysmal vomiting or abdominal pain, separated by periods of weeks or months of good health….

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