Cyclic Vomiting Syndrome (CVS)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

woman with abdominal pain

Causes of Vomiting

There are numerous causes of nausea and vomiting. These symptoms may be due to the following:

  • Acute gastritis (direct irritation of the stomach lining)
  • Central causes in which signals from the brain cause nausea and vomiting
  • Other illnesses not due to stomach problems
  • Medications and medical treatments
  • Mechanical obstruction of the bowel

Cyclic vomiting syndrome (CVS) facts

  • Cyclic vomiting syndrome is a disorder that causes recurrent episodes of nausea, vomiting, and tiredness (lethargy) most often in children but may occur in all age groups.
  • Symptoms and signs of cyclic vomiting syndrome are repeated attacks of intense nausea, vomiting, and lethargy that last anywhere from an hour to 10 days. Other CVS symptoms and signs may include
  • The most common causes of cyclic vomiting syndrome are emotional excitement and infections. Other triggers can include periods without eating, temperature extremes, lack of sleep, overexertion, allergies, ingesting certain foods or alcohol, and menstruation.
  • Cyclic vomiting syndrome has four phases: symptom-free, prodrome, vomiting, and recovery.
  • Cyclic vomiting syndrome is diagnosed by the patient's history and symptoms; there is no definitive test for cyclic vomiting syndrome.
  • Treatment is done by the patient learning to avoid the causes or triggers of the disorder. During the prodrome, vomiting, and recovery phases, medications are often used to treat the symptoms (for example, antinausea medications, NSAIDs, anti-migraine medications, fluid replenishment, and others).
  • Complications may include pain, reflux, fainting, depression, panic disorder, irritable bowel syndrome, and injury to the esophagus.
  • Cyclic vomiting syndrome is generally considered to be a variant of migraines by researchers.
  • "Cyclic vomiting syndrome plus" is considered a diagnosis when a patients also exhibit symptoms of developmental delay or intellectual disability, muscle weakness (myopathy), and/or seizures.
  • The disorder has a wide range of reported prevalence, about four to 2,000 per 100,000 children, but seems to occur less frequently in adults although the data is not clear.
  • Researchers suggest several factors may contribute to the disorder: brain function disorder, hormonal abnormalities, GI problems, migraine-like conditions, and changes in mitochondrial DNA.
  • Some people may inherit the changes in mitochondrial DNA that may cause or contribute to the development of the disorder.
Medically Reviewed by a Doctor on 3/10/2016

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