Cyclic Vomiting Syndrome

Patients with cyclic vomiting syndrome suffer from recurring seizures that make them vomit several times an hour. The causes have not been finally clarified. Therapy is difficult and mostly supportive.

What is Cyclic Vomiting Syndrome?

Many diseases are characterized by cyclical symptoms. One such disease is cyclic vomiting syndrome, also known as Cyclical Vomiting Syndrome ( CVS ). Most patients with the disease are children. The syndrome occurs particularly between the ages of three and seven. For what is horner syndrome, please visit gradinmath.com.

The clinical picture is characterized by recurrent and paroxysmal symptoms of the gastrointestinal tract. In addition to nausea and vomiting, disorders of the general condition occur. The seizures are similar in course, severity, and duration. A seizure lasts from a few hours to several days. The person affected usually has no symptoms between the individual attacks.

Since the symptoms of CVS can also occur in the context of other diseases, the diagnosis of the syndrome is relatively difficult, especially in adults. The exact prevalence is not known. The number of unreported cases is likely to be relatively high because of the difficulty of the diagnosis. The median age of onset for cyclic vomiting syndrome is 35 years.

Causes

The exact cause of the syndrome of cyclical vomiting is not yet known. However, there are a number of speculations. A family background is up for discussion. In up to 83 percent of all cases, migraines were discovered in the family history. Nonetheless, for many patients, there is no identifiable trigger for the seizures.

In addition to migraines, physical stress, milder viral diseases such as the flu, inflammation of the chest or throat and painful injuries have been associated with the syndrome. Also, prolonged fasting or insomnia have been documented in some cases of the syndrome. In addition, some patients with cyclic vomiting syndrome have reported exposure to anesthetics that they had received in the recent past.

Cold and food sensitivity, anxiety, and family problems may also play a role in the etiology of CVS. For a smaller subset of CVS sufferers, mitochondrial DNA mutations appear to be causative.

Symptoms, Ailments & Marking

Patients with cyclic vomiting syndrome vomit at short intervals. The peak of an attack is characterized by vomiting at frequencies of six to twelve times an hour. A seizure can last a few hours. However, the attack can also last up to ten days. The average duration is one to four days.

The end of seizures occurs spontaneously and is difficult to predict. Individual seizures of the patients are extremely similar in course and duration. Between attacks, the sufferer stabilizes in good general condition. In addition to nausea and abdominal pain, the most important symptoms in the acute phase include headaches, sensitivity to movement, sensitivity to light and fever.

General paleness, diarrhea and water loss can also occur. Accompanying symptoms are often excessive salivation or social withdrawal. Adult patients in particular almost always suffer from more or less severe abdominal pain or stomach cramps during an attack. Typically, adults with the syndrome have at least three time-separated seizures per year.

Diagnosis & course of disease

The diagnosis of cyclic vomiting syndrome is difficult. Vomiting can occur with many diseases. For this reason, the diagnosis of CVS is usually made exclusively using exclusion criteria. Diagnostic test methods to confirm the diagnosis are not available. It often takes several years before a patient can be diagnosed. Misdiagnoses are common.

For adults, at least three different criteria must be met for the diagnosis to be made. The cyclical vomiting must have occurred in repeated and severe bouts, such as at least three bouts in six months. There must be an interval of at least one week between attacks. In an acute attack, vomit at least four times an hour and for at least one hour.

Between attacks the patient must have been well and all other causes of vomiting must be ruled out. In order to rule out other causes, imaging of the intestines and stomach, for example, is required as part of the diagnosis. Children with CVS have a better prognosis than adults. In most cases, the relapses resolve themselves as soon as they reach adulthood.

Complications

The syndrome of cyclical vomiting represents a considerable physical burden for the patient. During the course of the attacks, there is usually a massive loss of fluids and nutrients. If this is not adequately counteracted, it can lead to serious failures and even dehydration. The lives of children, the elderly and the sick may be at risk.

Due to the constant vomiting, the tooth enamel also erodes, which promotes tooth decay and other diseases of the teeth and gums. In addition, injuries to the esophagus can occur. Bleeding in the pharynx in turn promotes inflammation and can subsequently cause further complications. In general, the syndrome of cyclical vomiting has a negative effect on the well-being and severely limits the quality of life of the person affected.

Chronic illnesses accordingly harbor the risk of mental illnesses such as depression or anxiety. When treating the disease intravenously, there is a risk of bacteria settling at the puncture site and causing sepsis. The formation of abscesses, blood clots or hematomas is also possible. If the drug gets into the surrounding tissue, it can cause tissue necrosis.

When should you go to the doctor?

If vomiting occurs once after eating, in most cases no doctor is required. It could be an intolerance or stress that caused the vomiting. If the patient is subsequently free of symptoms, there is no need for further treatment.

If the person concerned suffers from repeated vomiting, a doctor should always be consulted. Irrespective of whether the vomiting occurs weekly or daily, it is necessary to determine the cause. There is an acute need for action if the vomiting occurs several times in one hour. A doctor should be consulted immediately, as there is a risk of subsequent symptoms and complications.

Inner weakness, diffuse deficiency symptoms, irritability and a general feeling of illness should be examined and treated. Fever, abdominal pain, disorders of the autonomic nervous system and cramps must be presented to a doctor. Sensitivity to light stimuli, restricted mobility, or headaches are signs of health problems. The affected person needs medical care so that an improvement can take place.

Nausea, withdrawal from social life, and emotional and psychological problems should also be discussed with a doctor. Since dehydration can occur in severe cases, an ambulance is needed if you feel dry inside. There is a life-threatening condition that requires immediate action.

Treatment & Therapy

There is no standardized therapy for patients with cyclic vomiting syndrome. Since the cause of CVS has not been finally clarified, no causal therapy can be given. This is contrary to healing. The treatment is extremely difficult and is more or less supportive. For example, during an acute attack, patients are advised to stay in a dark, quiet environment.

They are given fluids intravenously to prevent dehydration. Ideally, those affected seek treatment early for each seizure so that their general constitution can be monitored extensively. Anti-emetic and other medications are available for drug therapy. Which drug helps which patient better has to be tested. Therefore, the administration of medication for the first attack is rather tentative.

Ideally, prophylactic measures should be taken between individual attacks. Prophylaxis must also be tried out, since the effectiveness differs from patient to patient. Prophylaxis aims to reduce the number, duration, and severity of individual episodes. One possibility in this context is the regular administration of Namin.

Prevention

A complete etiology for the syndrome of cyclical vomiting does not yet exist. As long as the causes have not been finally clarified, the syndrome cannot be prevented.

Aftercare

Cyclic vomiting syndrome is accompanied by nausea, vomiting, and general weakness and malaise. Aftercare is intended to alleviate the symptoms in the long term. Complete elimination of the disease, on the other hand, is exceptional. The patient’s general health needs to be stabilized to improve their quality of life.

There is no one-size-fits-all treatment for cyclic vomiting. The specialist has to find out for himself which therapy is most favorable for the respective patient. With repeated vomiting, the affected person loses nutrients and electrolytes. In severe cases, he can become dehydrated. In such a situation, medical assistance must be provided as soon as possible.

Fluid intake, if necessary through an IV drip, counteracts the loss. If symptoms persist or if symptoms worsen, further investigations are advisable. Follow-up treatment should be continued until the exact cause can be determined. Physical and psychological reasons are possible for the recurring vomiting.

(Chronic) pain or migraines are among the possible risk factors. Pain-relieving medicine can sometimes prevent a seizure. If stress is the trigger, external stress in everyday life and at work must be reduced in the future. The doctor can give the sick person sick leave for this time.

You can do that yourself

In the area of ​​self-help in everyday life, those affected can do something against cyclic vomiting, especially if they know the triggers. Some sufferers know that eating certain foods leads to bouts of severe vomiting. Avoiding the trigger as much as possible therefore makes sense in everyday life when the level of suffering is great.

Cyclic vomiting is often related to stress. Those who suffer from cyclical vomiting can therefore try out the individual effects of relaxation techniques such as yoga or progressive muscle relaxation. Success rates vary. In many of those affected, no trigger can be identified for the vomiting. This makes it difficult to do something to prevent seizures in the area of ​​self-help. Some sufferers report that the vomiting occurs in connection with untreated headaches. It can therefore make sense to start taking pain medication early on when pain sets in, so as not to trigger vomiting.

If a seizure occurs, staying in a quiet, dark room away from outside stimuli can help. Homeopathic remedies for vomiting relieve seizures in some people.