Cyclic Vomiting Syndrome | Digestive Health | Loyola Medicine

Cyclic Vomiting Syndrome

Overview and Facts about Cyclic Vomiting Syndrome

Cyclic vomiting syndrome occurs when you have episodes of severe vomiting with no apparent or identifiable cause. The vomiting can come and go, and last for hours or days.

The episodes tend to be similar, with the same symptoms and start time. Although cyclic vomiting syndrome can occur at any age, it often begins between ages three and seven. Treatments include management with medication and lifestyle changes.

Symptoms and Signs of Cyclic Vomiting Syndrome

The signs and symptoms of cyclic vomiting syndrome include:

  • Severe vomiting several times an hour that can last from a few hours up to a week
  • Three or more episodes of vomiting in a six-month period
  • Severe nausea
  • Sweating
  • Abdominal pain
  • Diarrhea
  • Fever
  • Dizziness
  • Headache
  • Retching or gagging
  • Light sensitivity​

These vomiting episodes may begin around the same time, share the same symptoms, and last a similar duration. In between episodes, you may be free of symptoms.

Causes and Risk Factors of Cyclic Vomiting Syndrome

The root cause of cyclic vomiting syndrome is unknown but may have something to do with genetics, digestive issues, problems in the nervous system, or hormonal imbalances. Vomiting episodes are often triggered by, or occur with:

  • Sinus problems, including allergies and colds
  • Stress or excitement
  • Anxiety and panic attacks
  • Certain foods, including chocolate, cheese, and caffeine
  • Overeating or fasting
  • Hot weather
  • Physical exhaustion, including overexertion
  • Menstruation
  • Motion sickness

Certain risk factors have also been identified. When cyclic vomiting syndrome develops in childhood, there’s often a family history of migraines. It’s also associated with chronic marijuana use.

When left untreated, excessive and repeated vomiting can lead to dehydration. If you experience excessive thirst, reduced urination, dry skin, or exhaustion along with vomiting, contact your doctor right away.

Tests and Diagnosis of Cyclic Vomiting Syndrome

Since there’s no specific test to confirm cyclic vomiting syndrome, it can be difficult to diagnose. Doctors must rule out other conditions and, therefore, complete a full medical history and physical exam. To help determine cyclic vomiting syndrome, your doctor may request:

  • Medical imaging, including ultrasound, endoscopy, or CT scan
  • Motility testing, which shows how food moves through your digestive system
  • Laboratory testing for metabolic and thyroid conditions

Treatment and Care for Cyclic Vomiting Syndrome

Treatment for cyclic vomiting syndrome often involves two aspects: lifestyle changes and medication. Identifying what triggers your episodes and learning to avoid them can reduce the frequency of cyclic vomiting syndrome. You should also strive to get adequate sleep, eat small meals, and downplay upcoming events to limit excitement.

When you have more than one episode a month or your episode is so severe it requires hospitalization, preventive medication may be prescribed. This can include medications to address:

  • Nausea
  • Pain
  • Stomach acid

Other types of medication may reduce the symptoms of cyclic vomiting syndrome, including antidepressants as well as antiseizure and migraine medication.