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.

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What are cyclic vomiting syndrome symptoms and signs?

Cyclic vomiting syndrome is characterized by attacks of intense nausea, vomiting, and lethargy that last anywhere from an hour to 10 days. An affected person may vomit several times per hour, potentially leading to a dangerous loss of fluids (dehydration). Cyclic vomiting syndrome attacks can be debilitating, making it difficult for an affected person to go to work or school.

In most affected people, the signs and symptoms of each attack are quite similar. The following are common CVS symptoms and signs:

These symptoms and signs listed above can occur with many other diseases. The alternating pattern of symptoms and periods of remission is the major sign of cyclic vomiting syndrome. In addition, most individuals with cyclic vomiting syndrome exhibit the same pattern of symptoms during each cycle of severe nausea and vomiting.

What tests do health-care professionals use to diagnose cyclic vomiting syndrome?

Cyclic vomiting syndrome is hard to diagnose because no tests -- such as a blood test or X-ray -- can establish a diagnosis of cyclic vomiting syndrome. A doctor must look at symptoms and medical history to rule out other common diseases or disorders that can cause nausea and vomiting. Making a diagnosis takes time because the doctor also needs to identify a pattern or cycle to the vomiting. For example, the patient who has had at least five separate episodes of vomiting or at least three separate episodes over six months for children or one year for adults, that have had attacks similar to previous episodes (for example, they started the same time of day, last same time span and have the same intensity), makes the diagnosis of CVS more likely.

However, it is not unusual to have laboratory tests such as CT, ultrasound or MRI of the abdomen, magnetic resonance enterography, endoscopy, upper GI series of X-rays, gastrointestinal motility tests, food allergy tests, and others performed to help the physician be sure that diseases with similar symptoms are not causing the problems.

Medically Reviewed by a Doctor on 3/10/2016

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