Cyclic vomiting syndrome

What is the long-term outlook for people with cyclic vomiting syndrome?

The long-term outlook for people with cyclic vomiting syndrome varies from person to person. Many children with CVS "outgrow" the condition by late childhood or early adolescence, but some continue to have symptoms through adulthood. It has been reported that many children with CVS go on to develop migraine headaches by late childhood. Some of these children experience a phase of abdominal migraines in between.

In adults with CVS, the course of the condition and how long it lasts have not been well-studied. There is substantial morbidity associated with CVS in adults, possibly due to lack of awareness and long delays in diagnosis.

Although people with CVS are symptom-free about 90% of the time, the condition can be quite disabling. Children with CVS may miss many days of school and may need home tutoring or home schooling. Because of increased likelihood of episodes during times of stress or excitement, CVS may interfere with birthdays, holidays, and vacations.

Last updated on 05-01-20

How might cyclic vomiting syndrome be treated?

Treatment of cyclic vomiting syndrome (CVS) aims to prevent episodes (prophylactic therapy), stop episodes (abortive therapy), and provide supportive care while symptoms are present (supportive therapy). There is no specific treatment that has been proven effective in controlled trials, but several therapies based on observation and experience (empiric therapies) have been effective in case series. Treatment options for each person may depend on the person's age, whether there is a family history of migraines, the severity of episodes, and how often episodes occur. People with CVS should consult with their doctor about a personalized treatment plan.

Prophylactic therapy options include:

  • Avoiding triggers of episodes (e.g. certain foods, physical exhaustion, sleep deprivation, or psychological stress).
  • Various medications (usually for patients with more than one episode per month). Examples include cyproheptadine, amitriptyline (a tricyclic antidepressant), various anti-convulsants, propranolol, and erythromycin. There is consensus among experts that amitriptyline should be used as the first treatment for children over 5 years old, and cyproheptadine for children under 5 years old. Approximately 80% of those with a family history of migraines respond well to anti-migraine medications.
  • Supplements called coenzyme Q-10 and L-carnitine. Retrospective studies have shown these to be very effective.

Abortive therapy options include various anti-migraine and anti-nausea medications such as ondansetron, promethazine, prochlorperazine, and a group of drugs used for migraines called triptans (e.g. sumatriptan).

Supportive therapy is needed when both prophylactic and abortive therapies are unsuccessful. Supportive care is an extremely important aspect of treatment while a person is having symptoms. This may involve:

  • Oral fluids if possible.
  • IV fluids if needed.
  • Sedatives or pain medications to allow for sleep and a break from severe nausea.

Last updated on 05-01-20

Where To Start

International Foundation for Functional Gastrointestinal Disorders

International Foundation for Functional Gastrointestinal Disorders has an overview of Cyclic vomiting syndrome as well as more information for patients and their families.

Last updated on 04-27-20

Mayo Foundation for Education and Research

The Mayo Foundation for Education and Research provides information about cyclic vomiting syndrome. Click on the above link to access information about this condition.

Last updated on 04-27-20

Name: International Foundation for Functional Gastrointestinal Disorders IFFGD PO Box 170864
Milwaukee, WI, 53217, United States
Phone: +1-414-964-1799 Toll Free: 1-888-964-2001 Fax : +1-414-964-7176 Email: Url:
Name: Cyclic Vomiting Syndrome Association P.O. Box 270341
Milwaukee, WI, 53227, United States
Phone: 414-342-7880 Fax : 414-342-8980 Email: Url:
Name: National Headache Foundation 820 N Orleans, Suite 201
Chicago, IL, 60610-3132, United States
Phone: +1-312-274-2650 Toll Free: 1-888-643-5552 Email: Url:
Cyclic vomiting syndrome April 19, 2013; Reference Link Venkatesan T, Li BUK. Cyclic Vomiting Syndrome Medscape Reference. November 30, 2012; Reference Link Boles RG. Cyclic Vomiting Syndrome National Organization for Rare Disorders (NORD). 2012; Reference Link What is CVS? Cyclic Vomiting Syndrome Association. Reference Link Cyclic Vomiting Syndrome in Adults International Foundation for Functional Gastrointestinal Disorders (IFFGD). June 3, 2016; Reference Link Cyclic Vomiting Syndrome National Digestive Diseases Information Clearinghouse (NDDIC). March 2014; Reference Link

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