Cyclical vomiting syndrome

Abstract

Cyclical vomiting syndrome is an uncommon, disabling symptom complex of unknown cause, with features in common with migraine. It affects principally children and adolescents. Differential diagnosis and theories of pathogenesis are discussed. Therapy should be aimed at prophylaxis of vomiting bouts, 'switching off' episodes once they commence and preventing complications of established vomiting episodes. Families need rapid access to care to minimize morbidity and disruption to functioning.

Precipitants and aetiology of cyclic vomiting syndrome

“…The vomiting continues for a few hours or a few days''. Interest in CVS has been intermittent since then but the recent development of patient support groups and an international symposium on CVS have stimulated renewed research into this problem (2). The aetiology of CVS remains unknown, although migraine, epilepsy, irritable bowel syndrome and psychiatric factors have been proposed as causative factors or precipitants.…”

Cyclic vomiting syndrome: A common, underrecognized disorder

“…Rapid access to medical care in CVS can shorten the episode and prevent complications from prolonged vomiting. Avoidance of triggers, where they can be identified, may help in aborting an episode, and should be attempted (Forbes, ). Hospitalization with intravenous fluids and antiemetics may be necessary.…”

“…Intravenous administration of fluids to combat dehydration, and subsequent intravenous administration of agents, such as chlorpromazine (thorazine), diphenhydramine (benadryl), or lorazepam (ativan), to block the nausea may also be warranted (Forbes, ). These treatments can often be provided in clinics and emergency departments (Venkatesan et al, ); if the patient does not respond to them, however, hospital admission may be required.…”