Cyclical vomiting syndrome

Check if it's cyclical vomiting syndrome

The main symptoms of cyclical vomiting syndrome are severe episodes of feeling sick (nausea) and being sick (vomiting), followed by periods of feeling well.

Each episode can last anything from a few hours up to a few days.

They begin with sweating, feeling sick and looking paler than usual, followed by retching (trying to be sick) and vomiting.

Other symptoms of cyclical vomiting syndrome may include:

• being very tired (exhaustion)
• loss of appetite
• tummy pain
• diarrhoea
• dizziness
• headaches
• eye pain when looking at bright lights

Episodes usually start at the same time of day or night and last for the same length of time. Once these symptoms improve, most people with cyclical vomiting syndrome feel better for a few weeks or months until a new episode begins.

Cyclical vomiting syndrome often starts in children around 5 years old and improves as they get older. But it can also affect adults and is often more severe in adults who did not have the condition as a child.

How cyclical vomiting syndrome is diagnosed

If you or your child have episodes of severe nausea (feeling sick) and vomiting (being sick), a doctor will check if your symptoms could be caused by cyclical vomiting syndrome.

The doctor may ask you about:

• how many episodes you've have and how long they last
• how often you vomit during each episode
• if you feel well between the episodes and how long you feel well for

You may need tests to rule out other conditions.

Treatment for cyclical vomiting syndrome

Medicines may be able to help with cyclical vomiting syndrome if you have more than 1 episode a month.

The medicines you're prescribed will depend on your symptoms and age, but may include:

• medicines that can be used to treat and prevent migraines
• anti-sickness medicines
• painkillers

A doctor can also offer support if your child is struggling to cope with the symptoms of cyclical vomiting syndrome.

If an episode is very severe, you may need to be treated in hospital with medicine and fluids given directly into a vein (intravenously). This will help to prevent dehydration and treat the symptoms.

How to manage the symptoms of cyclical vomiting syndrome

There are things you can do to help prevent episodes of cyclical vomiting syndrome, or manage the symptoms.

To help prevent episodes:

• keep a diary to see if certain things trigger your symptoms – for example, some people find certain foods, large meals, stress or lack of sleep can be triggers and it can help to avoid them
• remember to take any medicine you've been prescribed

During an episode:

• stay in bed and sleep in a dark, quiet room
• keep taking small sips of fluid, such as water or diluted squash, to prevent dehydration during and after an episode of vomiting – a pharmacist can recommend oral rehydration solutions that you mix with water and drink

Causes of cyclical vomiting syndrome

The exact cause of cyclical vomiting syndrome is not known, but you're more likely to have it if you or anyone in your family gets migraines.

You may find the episodes of vomiting are triggered by something. Common examples include:

• stress, anxiety or excitement
• not getting enough sleep or doing too much exercise:
• colds, allergies and infections
• certain foods and drinks, such as alcohol, caffeine, cheese or chocolate
• going without food or fluid for a long time