Dr. Gott: Medication can treat cyclic vomiting dehydration

Posted: Monday, November 03, 2008

Dear Dr. Gott: My grandson is 29 years old. He has been suffering with cyclic vomiting syndrome since his early college years. He is in and out of the hospital because of these episodes and is so thin I am afraid for him.

The doctors say there is no cure for this condition, but I am holding out hope that someone in the medical profession knows something that can help him.

Dear Reader: Cyclic Vomiting Syndrome (CVS) is a little-known ailment. There is no known cause, and it is not known how many people actually have the disorder. One study suggests that as many as one in 50 children may suffer from CVS. Because there are several disorders that can cause cyclic vomiting, many people are initially misdiagnosed until other disorders have been ruled out.

CVS can occur at any age but most commonly starts in children ages 3 to 7. Adults with the condition tend to have less frequent but longer-lasting episodes. Triggers, such as infection, emotional stress or excitement, colds, allergies, the flu and sinus problems are common. Some people may experience an episode after eating certain foods, too much or just before bed. Motion sickness, physical exhaustion, menstruation and hot weather can also trigger CVS.

Cyclic vomiting syndrome has four phases. The prodrome phase is the signaling indicator. It is often marked by abdominal pain, but some people may not have warning. Sometimes an episode can be stopped by taking medication as soon as signal symptoms begin. The episode phase is the actual nausea and vomiting. It is usually accompanied by exhaustion, paleness, inability to eat, drink or take medication, and drowsiness.

The recovery phase occurs once vomiting and nausea have stopped. Energy, appetite and a healthy color return.

The last phase is the period between episodes when there are no symptoms.

Symptoms include nausea, vomiting and retching/gagging. Episodes generally start at night or during the early morning and can last from a few hours to 10 days. There is no test for the diagnosis of cyclic vomiting syndrome. It is diagnosed by exclusion, symptoms and medical history.

Your grandson's doctor was correct that there is no cure, but CVS can be treated. Getting adequate amounts of sleep and rest are important. Medication to prevent vomiting, stop an episode already in progress or relieve other symptoms may be necessary. Complications from this disorder can be serious. Dehydration is the most common.

Your grandson should be under the care of a gastroenterologist and monitored closely during an episode.

I also urge you and your grandson to learn more about the condition and perhaps join a support group. You can find helpful resources, including up-to-date information, from the Cyclic Vomiting Syndrome Association. Contact them online at www.cvsaonline.org or by phone at 414-342-7880.
