Concussion – Dispelling the myths

Rehabilitation following a concussion injury can be a complicated process so it helps if you understand what you are dealing with.

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Home 9 Conditions Treated 9 Cyclic Vomiting Syndrome

Cyclic Vomiting Syndrome

About Cyclic Vomiting Syndrome

What Cyclic Vomiting Syndrome?

Cyclic vomiting syndrome (CVS) is a rare disorder characterised by recurrent episodes of severe vomiting that occur with predictable cycles or patterns. It primarily affects children but can progress into adulthood. The exact cause of CVS is not well understood, but it is believed to involve dysregulation of the brain-gut axis, leading to abnormal functioning of the digestive system.

Cyclic Vomiting Syndrome Diagnosis

How Do We Diagnose Cyclic Vomiting Syndrome?

The International Classification of Headache Disorders (ICHD) provides diagnostic criteria for cyclic vomiting syndrome, which include recurrent, severe episodes of vomiting lasting hours to days, with symptom-free intervals between episodes. Blood tests may be performed to evaluate electrolyte levels, liver function, and rule out other conditions that may cause similar symptoms.

It is important to exclude other potential causes of vomiting and establish a pattern of recurrent episodes for a diagnosis of cyclic vomiting syndrome.

Cyclic Vomiting Syndrome Symptoms

There are typically symptom-free intervals between episodes, during which the individual feels well.

Intense Nausea

Recurrent episodes of severe vomiting

Abdominal pain

Increased Sensitivity

Sensitivity to triggers such as stress, certain foods or fasting

Fatigue

Treating Cyclic Vomiting Syndrome With The Watson Headache® Approach

Cyclic Vomiting Syndrome Treatment

 

Treatment for cyclic vomiting syndrome is similar to the approach for abdominal migraine. Identifying triggers and implementing lifestyle changes can help manage this condition, similar to ‘standard migraine’.

The underlying driver of migraine (brainstem sensitivity) is the same for all migraine presentations, so abdominal migraine will respond to similar interventions such as dietary changes, sleep improvements, exercise, and upper neck treatment. The upper neck has direct connections with the control centre for nausea and vomiting which sits in the brainstem. This is why treatment of the upper neck using the Watson Headache Approach can be effective in changing abdominal migraine symptoms.

Recent research has identified that a key area in the brainstem, named the Solitary nucleus, controls nausea. CVS patients have an increased activation of the solitary nucleus which generates the sensation of nausea. Understanding the relationship between the upper neck and the brainstem’s Solitary Nucleus has enabled treatment options for patients other than medication. Children as young as 3 years old can tolerate treatment without side effects and with potential for rapid and sustained relief.

Other treatment of cyclic vomiting syndrome aims to alleviate symptoms, prevent or reduce the frequency of vomiting episodes, and improve overall quality of life. Treatment options may include medications for acute episodes such as ondansetron or promethazine. These can be prescribed to help manage nausea and vomiting during acute episodes. Preventive medications, such as tricyclic antidepressants, antiepileptic drugs, or serotonin receptor antagonists, may be prescribed to reduce the frequency and severity of vomiting episodes.

 

For further tips on managing CSV, read our blogs on Diet, Sleep Hygiene, and Neck-Migraine Connections.

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Cyclic Vomiting Syndrome (CVS) – Frequently Asked Questions

What is Cyclic Vomiting Syndrome (CVS)?

Cyclic Vomiting Syndrome (CVS) is a rare condition characterised by recurring episodes of severe nausea and vomiting, often without an identifiable cause. These episodes can last for hours or even days and are typically separated by symptom-free periods.

What are the symptoms of CVS?

The primary symptoms include intense nausea, repeated vomiting (up to several times an hour), abdominal pain, and extreme fatigue. Some individuals may also experience headaches, dizziness, or sensitivity to light and sound during episodes.

What causes Cyclic Vomiting Syndrome?

The exact cause of CVS is unknown, but it is believed to involve a combination of genetic, neurological, and environmental factors. Triggers may include stress, infections, certain foods, hormonal changes, or sleep deprivation.

Who is at risk of developing CVS?

CVS can affect both children and adults, though it is more commonly diagnosed in children. Individuals with a family history of migraine or those who experience motion sickness may have a higher risk of developing CVS.

How is CVS diagnosed?

Diagnosis is often challenging and involves ruling out other potential causes of vomiting, such as gastrointestinal disorders or infections. A detailed medical history, physical examination, and specific diagnostic criteria are used to confirm CVS.

What triggers CVS episodes?

Common triggers include emotional stress, physical exhaustion, certain foods (e.g., chocolate, cheese, or caffeine), infections, and hormonal changes. Identifying and avoiding triggers is a key part of managing CVS.

How is CVS treated?

Treatment focuses on managing symptoms and preventing episodes. This may include anti-nausea medications, hydration therapy, lifestyle changes, and in some cases, migraine medications. A tailored treatment plan is essential for effective management.

Can CVS be cured?

There is currently no cure for CVS, but with proper management, many individuals can reduce the frequency and severity of episodes. Early diagnosis and a personalised treatment plan are crucial for improving quality of life.

What is the connection between CVS and migraine?

CVS is often linked to migraine, as both conditions share similar triggers and may involve overlapping neurological pathways. In fact, individuals with CVS or a family history of migraine are more likely to experience both conditions.

When should I seek medical help for CVS?

Seek medical attention if you or your child experience recurring episodes of severe vomiting, especially if they are accompanied by dehydration, weight loss, or other concerning symptoms. Early intervention can help manage the condition effectively.