Cyclical Vomiting Syndrome (CVS) is a condition causing recurrent attacks of intense nausea, vomiting, abdominal pain and sometimes headaches or migraines. Attacks can last from a few hours to several days at a time. The condition is more prevalent among children, and seems to occur less frequently in adults. Many children will grow out of the condition once they reach adulthood. CVS is debilitating, and can be dangerous if dehydration occurs.
A person suffering from CVS typically has pale skin, abdominal pain, nausea, and vomiting, but some patients will also experience diarrhoea, headaches, migraines and light sensitivity.
The cause of CVS is largely a mystery, but there do seem to be some common themes amongst those who suffer with CVS. While the cause is elusive, common triggers for CVS episodes include overexertion, fatigue, hormonal changes around a woman’s menstrual cycle, infections, lack of sleep, temperature extremes, alcohol consumption, allergies, extended periods without eating, and certain foods. Some of the food triggers associated with migraines such as chocolate, cheese and monosodium glutamate, are also considered triggers for CVS.
There are no tests to specifically confirm CVS, rather the diagnosis is based on ruling out other possible causes of the vomiting or abdominal symptoms. Cyclical Vomiting Syndrome is believed to be a class of migraine.
Similar to migraines CVS has four stages.
Symptom free phase – no symptoms appear to be present between episodes.
Prodromal phase – nausea appears with or without abdominal pain. This phase can last a few minutes to several hours.
Vomiting phase – nausea and vomiting can be violent. There is an inability to eat, drink or take medicines without vomiting. Drowsiness, exhaustion, and dehydration may occur.
Recovery phase – after the vomiting stops and skin colour, vitality and appetite returns.
What can be done?
The medical management of CVS often involves avoidance of triggers, symptomatic relief such as the use of medications to reduce nausea, stop vomiting and maintain hydration. Pharmaceuticals may be used also to prevent future episodes if attacks occur greater than once per month. Medications may include tricyclic antidepressants, beta blockers, antihistamines, anticonvulsants and sometimes antibiotics. These medications can be helpful in some cases in the short term, but often come with side effects such as fatigue, drowsiness and are not ideal for the quality of life or long-term use.
Naturopathic care acknowledges that CVS has many and varied potential causes, that no two people are alike, and as such, there is not a one size fits all medicine. In saying that, there is some good evidence for certain nutrients and herbs for this condition and these may be considered where relevant. For example, the cell’s ability to generate energy is considered to be a mechanism which may be affected in CVS. This is similar to what can happen with migraines and there is some evidence that coenzyme Q10 and L-Carnitine may be useful in addressing this cause and alleviating symptoms. Your naturopath may consider these as part of your treatment if indicated as part of the whole picture of your health. Naturopathic support options may also include stress management, emotional wellness practices and the use of herbal and nutritional formulas suited to your needs.
CVS is a challenging condition to live with and a potentially complex condition to treat, however, naturopathy offers the opportunity to manage the symptoms, treat potential underlying causes holistically, and reduce the need for medication which may have detrimental side effects with long-term use.