Do you also have severe vomiting that starts suddenly and lasts for days? (Cyclic Vomiting Syndrome)

Has your child been playing well and suddenly started vomiting violently? Maybe for hours, or even two or three days, they vomit continuously. Then they start playing again as if nothing had happened. A few months later, they start doing the same thing again. This can happen not only to you, but also to an adult. Today we are talking about this kind of severe vomiting that comes and goes without any apparent cause.

What is Cyclic Vomiting Syndrome (CVS)?

Simply put, Cyclic Vomiting Syndrome (CVS) is a condition in which you experience severe nausea and vomiting for no apparent reason. The unique thing about it is that during these episodes, you are completely healthy and symptom-free.

Think of it like a switch in our body. Suddenly, this switch is 'on' and vomiting begins. It can last for hours, maybe even days. During this time, it can be so difficult that you can't even get out of bed. You may even have to go to the hospital and be given saline (IV fluids) to prevent dehydration. Then, as if the switch is 'off', all of a sudden all the symptoms disappear and you are back to normal.

This condition can last for months or even years. But symptoms are not always present. Usually, it can happen a few times a year. For some, it can even happen once or twice a month. The type of symptoms, time of day, severity, and duration of symptoms are often the same for the same person each time.

How common is this condition?

CVS is most common in children. According to statistics, about 3 out of 100,000 children may have this condition. Most often, children start it between the ages of 3 and 7. However, it is important to remember that it can start at any age.

What are the symptoms of CVS?

We can identify that CVS occurs in four main stages, like scenes in a play.

In addition to these main stages, several other symptoms may be seen:

• Severe stomach ache
• Diarrhea (stomach ache)
• Dizziness or vertigo
• Drooling or drooling
• Intense thirst
• Appetite
• Pale skin
• Severe headache and extreme fatigue
• Sensitivity to light or sound (blue eyes, difficulty hearing sounds)
• Fever (up to 101°F or 38.33°C)
• Retching (dry-heaving) - This means that you feel like vomiting, but nothing comes out because there is nothing in your stomach.

Why does this happen? What are the reasons?

It's not known for sure if this is the only cause of CVS, but there are a few things that are thought to be contributing to it.

• Issues with your brain-gut axis: Simply put, there is a communication between our brain and the nerves in our gut. When something goes wrong with this 'communication', uncontrollable vomiting can occur. Some scientists call this a brain-gut disorder.
• Changes in your autonomic nervous system: This system controls things in our body that we don't control, such as heart rate, blood pressure, and vomiting. If something goes wrong with this system, vomiting can occur.
• Migraine headaches: About 80% of children with CVS and 25% of adults also have migraines. A migraine is not just a severe headache. Like CVS, a migraine can be a strange feeling when it starts. Many people with CVS have a family history of migraines.
• Abnormal mitochondrial DNA: Mitochondria are the powerhouses of every cell in our body. The instructions (DNA) that tell them how to work can be altered by a disease, genetic condition, or medication/toxin. The nerve cells in our intestines need a lot of energy to function properly. When there is a problem with this energy source (the mitochondria), uncontrollable vomiting can occur.

What are the triggers for CVS?

Certain events, foods, and mental states can trigger vomiting. We call these 'triggers'.

• Changes in weather (especially common in autumn and winter)
• Foods like chocolate, cheese, coffee, and MSG
• Children's excessive joy (for example, a birthday party, a picnic)
• Severe stress and anxiety in adults
• Allergies, sinus infections, or colds
• Physical overexertion
• Going for a long time without eating
• Long-term cannabis use
• Women's monthly menstruation
• Motion sickness

What are the complications that can arise from this?

Continuous, severe vomiting can harm our body.

How does a doctor figure out this is CVS?

Diagnosing CVS is a bit tricky because there is no single test that specifically diagnoses it. Your doctor will want to make sure you don't have other conditions that cause similar symptoms.

Your doctor will ask you a lot about your medical history, family medical history, and your vomiting pattern. He or she will then perform a physical exam and probably order several tests.

Tests that can be done

• Blood and urine tests (Lab tests): These tests help to see if there are any metabolic diseases, mitochondrial diseases, or problems with other organs in the body.
• Imaging tests: These can look for problems with the organs in your digestive system and nervous system. For example, you may be asked to do an abdominal ultrasound, an MRI or CT scan of your brain, or an upper GI series. A gastric emptying test may also be needed to check how quickly food moves through your intestines.
• Upper endoscopy: A test in which a small camera is inserted through the mouth to look for problems in the esophagus, stomach, and small intestine.

What are the treatments for CVS?

Treatment depends on what stage you are in. That is, whether you are vomiting or trying to prevent a vomiting episode.

• Prodrome phase: As soon as symptoms begin, medications to reduce nausea, reduce stomach acid, and treat migraines can be given.
• Vomiting phase: During this time, you will also be given medication to treat migraines, reduce stomach acid, and reduce anxiety. You may need to be hospitalized and given IV fluids to prevent dehydration. Resting in a dark, quiet place during this time can help relieve symptoms.
• During the recovery phase: If necessary, continue to give saline, gradually moving on to liquids and then solid foods.
• In the Well Phase: The doctor may prescribe preventative medications to prevent future episodes of vomiting.

Anti-migraine medicines, anti-nausea medicines, and sometimes even anti-seizure medicines are used for treatment.

Can this situation be prevented?

Although it cannot be completely prevented, the risk of recurrent vomiting can be reduced.

• Identify your triggers (foods, events) and stay away from them as much as possible.
• Use the medicine exactly as prescribed by the doctor.
• If you have allergies and sinus problems, get them treated quickly.
• Stay active, but don't overexert yourself.
• Sleep well.
• Manage stress and anxiety.

Questions to ask the doctor

When you see your doctor, it may be important to ask these questions.

• What tests should I have to know for sure if I have CVS?
• What medicine should I take to stop vomiting and prevent it from coming back?
• What lifestyle changes should I make to avoid my triggers?
• What other things can I do to reduce symptoms?
• What symptoms should I see you for, or should I go straight to the hospital's ETU (Emergency Treatment Unit)?

CVS is often a frustrating and frustrating condition. There is no one-size-fits-all solution to this problem, and no one-size-fits-all lifestyle change is perfect for everyone. You and your doctor will need to work with you to find the right treatment and triggers for you. Over time, many people become better at avoiding things and situations that make them uncomfortable.