Cyclic Vomiting Syndrome (CVS)

Cyclic vomiting syndrome (CVS) is episodes of nausea, gagging and vomiting. The episodes can last for hours or days. There are periods in between episodes that are symptom-free.

The cause is unknown but can be related to migraine headaches. CVS has an increased incidence in children who have had migraines or have family members with a history of migraines.

CVS can occur more commonly in children ages 3 to 7 years old but can occur at any age, including adulthood.

There may or may not be a warning sign or trigger prior to the start of the cyclic vomiting episode. If there is a trigger or warning sign, it may occur within minutes to hours before the episode starts. Sometimes, an episode starts without any trigger or warning.

Some examples of triggers or warning signs:
  • Feeling tired
  • Foods like chocolate and cheese
  • Eating too much or right before bed
  • Allergies
  • Heat
  • Increased physical exertion
  • Lack of sleep
  • Motion sickness
  • Hormonal changes
  • Stress (good and bad)
  • Sinus problems
  • Illness
During the vomiting episode, other symptoms may include:
  • Headache
  • Nausea
  • Fever
  • Dizziness
  • Abdominal pain
  • Unable to eat, drink, or take medications
  • Light or sound sensitivity
  • Dehydration

Members of your child’s healthcare team might ask if your child has had:

  • Three or more episodes a year with severe vomiting and nausea
  • Two episodes that have lasted for hours to days but less than a week
  • Periods of being symptom-free with no nausea or vomiting

There is no one specific test to diagnose cyclic vomiting. Your child’s healthcare team will rule out other causes of the symptoms such as:

  • Inner ear problems
  • Metabolic problems
  • Intestinal problems like a rotation in the intestines or blockage
  • Kidney problems
  • Central nervous system problems
  • Eating disorders
  • Pregnancy

There is no cure for CVS, but there are treatments. Children can respond differently to the same treatment. Treatment options can include:

  • Dietary and lifestyle changes (avoiding dietary triggers, getting enough sleep)
  • Medications (to prevent episodes or stop an episode)
  • IV fluids
  • Other supportive measures (counseling, family support)

Over time, most children do grow out of CVS.

  • Signs of possible dehydration – dizziness, weakness, dark urine, eyes sunken, eyes unable to make tears, loss of sweat in armpits and groin, heart palpitations.
  • Unusual behavioral or motor / balance changes
  • Vomiting violently with no relief with prescribed medications
  • Severe abdominal pain
  • Severe headache
  • High fever
  • Coughing up blood from vomiting

Last Updated 12/2013