ANRED: Cyclic Vomiting Syndrome

Question: I'm frightened for my child. He will be just fine, and then all of a sudden he throws up and complains about bad headaches and pain in his stomach. The doctor says he has cyclic vomiting syndrome. I've never heard of this problem. Do you have information?

Yes, we do. Here's a summary of CVS:

Cyclic vomiting syndrome is usually found in children between 2 and 16, although some adults have received the diagnosis as well. CVS is not very common, and so far researchers have no definite explanations.

Symptoms include recurrent episodes of stomach pain, nausea, vomiting, and headaches. During an episode, which often appears without warning, the person can do little else but be miserable. Often s/he is bothered by bright light.

Vomiting occurs frequently, up to 10 or more times per hour. Episodes last from a few hours up to several days. People afflicted with CVS are usually well and normal between episodes.

Causes of cyclic vomiting syndrome

Researchers are not sure of the exact cause or causes. They do not even know if it is a problem primarily of the brain or of the gut. Current thinking speculates it may be caused by some sort of neurologic malfunction or flawed stress-hormone activity.

Because migraine headache sufferers report the same cluster of symptoms (nausea, vomiting, abdominal pain, and light sensitivity), the two problems may share common mechanisms.

Treatment of cyclic vomiting syndrome

CVS is currently treated with amitriptyline or cyproheptadine. Both these medications are also used to prevent migraine headaches, and so far they seem to work for CVS as well. Anecdotal reports suggest some success with Imitrex and low-dose beta blockers. Ask your physician for an opinion.

Please note

CVS is not an eating disorder in the same way that anorexia nervosa and bulimia nervosa are. CVS apparently lacks an emotional or psychological component. There is no evidence to suggest it is anything but a physiological/neurological problem, perhaps triggered by stress. We include this page on our web site because we receive many questions about CVS from concerned parents and sufferers. For more CVS information and resources, please visit the Web site of the Cyclic Vomiting Syndrome Association.

Important: There are many causes of pain and vomiting in children and young people. A medical diagnosis is essential because these symptoms can indicate serious medical problems (e.g., appendicitis, blocked kidney, infection, etc.) that demand immediate attention. Depending on what your physician discovers during a physical exam, further diagnostic procedures may include upper and lower G.I. series, ultra sound, cat scan, MRI, endoscopic exams, and thorough lab work.

Please Note: ANRED information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, talk to your physician and a mental health professional.

Page updated November 26, 2006