Cyclic Vomiting Syndrome in Children
Children who struggle with repeated episodes of intense nausea and vomiting suffer from what's called cyclic vomiting syndrome (CVS). At RWJBarnabas Health, we recognize the unique challenges that cyclic vomiting syndrome presents to children and their families. Our pediatric gastroenterology specialists offer diagnosis, treatment and support for children with this chronic condition.
What Is Cyclic Vomiting Syndrome?
Cyclic vomiting syndrome (CVS) is a condition where children experience periods of intense, unremitting nausea and vomiting that last hours to days. These episodes occur two or more times within a 6-month period. Each episode is similar for the patient and is separated by weeks to months, with the child returning to normal health between episodes. Episodes often start overnight or in the early morning and can be preceded by belly pain. Most vomiting episodes last less than 24 hours and often resolve when the child can sleep.
Cyclic Vomiting Syndrome Causes
The exact cause of cyclic vomiting syndrome is unknown, but it has a strong association with migraines. Many children with CVS have a first-degree relative with migraines, and most CVS patients may develop classic migraine headaches in the future. Motion sickness is also commonly reported among CVS patients.
Cyclic Vomiting Syndrome Symptoms in Children
Children with cyclic vomiting syndrome experience a range of symptoms, including:
- Severe, ongoing nausea
- Vomiting episodes that last for hours or even days
- Episodes that start overnight or early in the morning
- Belly pain before vomiting starts
- Periods of feeling completely well between episodes
- Each episode is very similar for the child
Cyclic Vomiting Syndrome Diagnosis
To diagnose cyclic vomiting syndrome, doctors look for:
- Two or more episodes of severe nausea and vomiting within 6 months
- Episodes that are very similar each time for the child
- Episodes that are separated by weeks or months, with the child feeling well in between
Pediatric gastroenterologists may perform tests to rule out other diseases, such as:
- An upper GI study with barium and X-rays to check for blockages
- An abdominal ultrasound to look for gallstones or kidney blockages
- A head MRI to check for increased pressure in the brain
- Metabolism evaluation with blood and urine tests to check for enzyme issues
Cyclic Vomiting Syndrome Treatments
Treatment for cyclic vomiting syndrome depends on how often the episodes are happening and how severe they are.
- Medications like ondansetron or sumatriptan can be given at the start of symptoms to stop an episode.
- Daily medications like cyproheptadine or amitriptyline may help prevent episodes.
Help for Pediatric Cyclic Vomiting Syndrome
While there is no specific way to prevent or screen for cyclic vomiting syndrome, avoiding known triggers and managing migraines can help reduce the number of episodes.
If your child is experiencing symptoms of cyclic vomiting syndrome, contact RWJBarnabas Health for a consultation with our pediatric gastroenterology team today. We can help your child manage symptoms and improve their quality of life.