Cyclical Vomiting Syndrome Treatment

What is Cyclical Vomiting Syndrome?

Cyclical Vomiting Syndrome (CVS) is characterised by periods of severe vomiting, followed by periods symptom-free periods, or periods of remission. While the symptoms may completely disappear throughout remission, its is possible that they may linger as more mild symptoms. CVS sufferers will vomit at least 4 times in one hour during an attack, with attacks lasting anywhere from 1 hour up to 10 days ^{[1, 2]}. Due to the length of time and intensity of these attacks, it can leave sufferers experiencing dehydration ^[2]. While CVS is most commonly experienced in children aged 3-7, it is also reported in adults.

CVS is considered a migraine-like condition, as it has been associated with sensitivities in the central nervous system.

Symptoms

The most common signs and symptoms of CVS are ^{[1, 2]}:

Recurrent vomiting, lasting up to 1 week
Severe nausea
Intense sweating

These associated features may also be present:

Abdominal pain
Diarrhoea
Fever
Dizziness

As the symptoms of CVS are similar to several other conditions, it is often mid-diagnosed.

While CVS is considered to be a “migraine disorder”, it is rarely associated with headaches. This is due to attacks including headaches being classified as “classic” or “common” migraine.

Abdominal Migraine vs Cyclic Vomiting Syndrome

Due to the similarities in symptoms between CVS and abdominal migraines, they are often considered the same condition ^[2]. However, there are some key differences.

CVS relates to intense bouts of nausea, vomiting and other stomach related symptoms, lasting up to 10 days. Comparatively, abdominal migraines last for 3 days. Also, while it is possible for people experiencing abdominal migraines to experience nausea and vomiting, it is most commonly just experienced as abdominal pain. Both VCVS and abdominal migraine sufferers experience a loss of appetite and pale skin during an attack.

In both cases, sufferers can experience loss of appetite and pale skin during an attack.

What is the cause of Cyclical Vomiting Syndrome?

There are many different theories about the cause of CVS. Some suggest that chemicals such as, histamines and serotonin are involved. Other theories include genetic differences or hormone imbalances. There seems to be a strong link in children who suffer from CVS, to developing Migraines later in life. Because of this there it is proposed that CVS is a form of migraine. One of the reasons it can be hard to establish a cause, is that children have a hard time differentiating between CVS, abdominal migraines and stomach flu. As such, it is important to rule out these differentials, as well as Irritable Bowel Syndrome, gastroenteritis and appendicitis.

It is common for sufferers of CVS to present with no identifiable pathology. In these cases, a sensitised brainstem may be the true cause.

Modern research suggests that dysfunction in the cervical spine, resulting in a sensitised brainstem can lead to a wide variety of symptoms. In the case of CVS, this over sensitive brainstem would determine low-level inputs, such as eating certain food, as a threat and trigger a reaction of aggressive vomiting and pain. It is this vicious relaying of information that CVS sufferers experience.

I’ve tried it all, is there anything else that I can try?

Most of our patients who suffer from CVS have tried a wide range of different treatments. Many have gone through a spectrum of medications, including; over-the-counter painkillers, triptans or even anti-depressants. It isn’t uncommon for sufferers of CVS to have seen multiple doctors and specialists. Sometimes these methods can alleviate the symptoms, but in many cases, nothing seems to work.

This is where The Headache and Migraine Clinic comes in, we are specially trained to assess both the cervical spine and the brainstem in order to establish if they are in fact, the true cause of your symptoms. If this is the case, then we can start treatment right away. We work to correct the dysfunction in your neck and desensitise the brainstem using our modern, world leading techniques. The best thing is that the treatment is safe, gentle, medication free and non-invasive!