Cyclic vomiting syndrome: phases, symptoms, causes, and treatment.

This syndrome affects mostly boys and girls, and its causes are not well known.

Do you know about cyclic vomiting syndrome (CVS)? It is a disease that usually appears more in children than in adults, and consists in the appearance of repeated episodes or cycles of nausea and/or vomiting of severe intensity.

In this article we will know more details about this syndrome, general characteristics and prevalence, as well as symptoms, causes and treatments of the same one.

Cyclic vomiting syndrome: what is it?

The cyclic vomiting syndrome (SVC, or CVS in English), is a condition in which severe, repeated nausea and vomiting occur at regular intervals.. These may occur in episodic form or in the form of cycles (i.e., even more frequently).

Between cycles of nausea and/or vomiting, but the person is in good general health. Cyclic vomiting syndrome usually appears in children, although there are adults who also manifest it.

Vomiting cycles

In cycles of vomiting and/or nausea, the child may vomit several times in an hour.. The cycles vary in duration, i.e., they can last for hours or even days.

On the other hand, vomiting cycles are usually similar in duration and frequency for each child, i.e., they usually last for hours or even days.i.e. they usually start at the same time of day (e.g. in the evening), last the same length of time (which is usually quite a long time) and have a similar intensity.

A child suffering from cyclic vomiting syndrome has, on average, about 12 episodes or cycles of vomiting per year, although this depends on each child, of course.

Prevalence and population

The exact prevalence of cyclic vomiting syndrome is unknown, although an estimate has been made.In the United States, for example, the syndrome is estimated to affect 3 out of every 100,000 children. In terms of gender distribution, the syndrome is slightly more common in girls than in boys.

At what age is cyclic vomiting syndrome most likely to manifest? At pre-school age or at the beginning of school the risk is higher. Specifically, the average age of onset of the syndrome is around 5 years of age.. As we have seen, its onset is more frequent in boys and girls, but it can also affect the adult population.

Symptoms

The symptoms of cyclic vomiting syndrome can appear at any time of the day, although they often appear either in the afternoon/evening or in the early morning.

The two main symptoms of the syndrome are nausea and vomiting. Both are of severe intensity, and are repeated in time in episodes or cycles.

In addition to these two main symptoms, other associated symptoms appear, such as: pallor, abdominal pain, excessive tiredness, migraines or headaches, diarrhea, low-grade fever, sensitivity (especially to sounds/noises and light), and babesia.sensitivity (especially to sounds/noises and light) and drooling, among others.

Phases

Cyclic vomiting syndrome is characterized by four distinct phases, as follows.

Phase 1: prodrome

In the first phase there is a kind of warning or signal announcing the arrival of an attack of vomiting and/or nausea. In this phase, the typical symptoms are: stomach pain, headache, anxiety and nausea..

These symptoms (or some of them) appear in 60% of people with cyclic vomiting syndrome.

Phase 2: vomiting

In the second phase of the syndrome, attacks of vomiting or nausea (which may be retching) occur. The symptoms of this phase can last for hours or even a whole day.

3. Phase 3: recovery

In this third phase, vomiting and nausea have stopped. This is the recovery phase, where the child feels a little better. At this stage some children can eat solid foods immediately; others need a little more time and must start with liquids.and must start with liquids.

During this phase, abdominal pain and fatigue or exhaustion may also appear as a consequence of vomiting.

4. Phase 4: no symptoms

This fourth phase of the cyclic vomiting syndrome is the one that appears between cycles of vomiting, where there are no remarkable symptoms and the person is well, in good health..

Causes

The cause of cyclic vomiting syndrome is unknown. However, some facts are known; for example, it has been shown that children who suffer from the syndrome, also frequently manifest symptoms such as migraine headaches or abdominal migraines.. In this sense, it has also been seen how most patients have a family history of migraines, especially in the family on the mother's side.

Thus, although the cause is unknown, certain factors have been related to cyclic vomiting syndrome, which could even be its cause (or part of it). These factors or situations are:

• Situations where there is overexertion.
• Situations that provoke great excitement
• Food: certain types of food, such as cheese and chocolate, for example.
• Lack of sleep
• Dizziness
• Not eating for a long time
• Stress
• Infections (e.g. flu, sinusitis...)
• Allergies
• Menstruation

Treatment

In most cases of cyclic vomiting syndrome, symptoms subside without treatment.. Moreover, there is no "cure" for it, so its treatment is aimed at managing or relieving the symptoms as much as possible.

What to do when an episode of vomiting starts? If it happens to your child, try to keep him/her calm. Try to get him/her to relax. When vomiting has not yet started, it is ideal for the child to be somewhere calm and quiet (e.g. his or her room). (e.g. his room). Sleeping also helps a lot.

In some cases, certain drugs are also taken for nausea, as well as sedatives to help the child relax and sleep. In severe cases, the child should be taken to the hospital to avoid severe dehydration. In the hospital, intravenous fluids are usually given to prevent dehydration.

Drug treatment

In relation to the drugs that are usually administered in cyclic vomiting syndrome, the treatment can be of two types:

1.1. Abortive treatment.

This type of treatment is aimed at preventing or slowing down the onset of the symptoms of the attack.It includes anti-nausea drugs, sedatives and drugs for anxiety (anxiolytics).

Preventive treatment

In the case of preventive treatment its aim is to reduce or eliminate attacks. It usually includes mainly two types of drugs: amitriptyline (tricyclic Antidepressant and analgesic) and cyproheptadine (antihistamine).

Bibliographic references:

• Buk, L. (2018). Managing cyclic vomiting syndrome in children: beyond the guidelines. Eur J Pediatr, 177: 1435-1442.
• Fleisher, D.R & Matar, M. (1993). The cyclic vomiting syndrome: a report of 71 cases and literature review. J Pediatr Gastroenterol Nutr, 17: 361. Cyclic Vomiting Syndrome Association. Cyclic vomiting syndrome.
• National Digestive Diseases Information Clearinghouse. (2014). Cyclic vomiting syndrome.