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Cyclic Vomiting Syndrome in Children

Medically reviewed by Last updated on Oct 3, 2022.

What is cyclic vomiting syndrome?

Cyclic vomiting syndrome is a condition that causes your child to vomit many times in a row for no known reason. Your child first has a sense that an episode is about to start. This is followed by nausea, and vomiting that can continue for hours to days. This may happen over and over for several days. Then your child has no nausea or vomiting for weeks or months before the cycle starts again.

What other signs and symptoms may my child have?

  • Retching or heaving (vomiting but nothing comes out), or gagging
  • Feeling dizzy or tired
  • Sensitivity to light or sound
  • Abdominal pain, loss of appetite, or diarrhea
  • A fever

What causes or increases my child's risk for cyclic vomiting syndrome?

  • Migraine headaches, or his or her mother had migraines
  • An anxiety disorder
  • A problem with his or her digestive system or nervous system
  • A hormone imbalance
  • Using large amounts of marijuana

How is cyclic vomiting syndrome diagnosed and treated?

  • No test is available to diagnose cyclic vomiting syndrome. Your child's healthcare provider will examine your child and ask about his or her symptoms. Tell the provider if your child vomited at least 4 times each hour. The provider will ask if your child has had 3 or more episodes in the past year, or 2 within the past 6 months. Tell him or her if your child had nausea between episodes. He or she will ask if your child or anyone in his or her family has cyclic vomiting syndrome or migraines. Tests may be used to rule out medical conditions that can cause vomiting. An endoscopy is a test that uses a scope to see your child's stomach and intestines. CT or MRI scans may be used to check for blockages or other problems. A motility test checks how well food moves through your child's digestive system.
  • Your child's symptoms may be controlled with medicines. Medicines may be used to prevent or stop migraine headaches. This may be given if your child has migraines or is at risk because of a family history of migraines. Your child may also be given medicine to reduce nausea.

How can episodes be prevented or managed?

  • Help your child avoid triggers. Certain foods can trigger episodes, such as chocolate, cheese, and monosodium glutamate (MSG). Caffeine can also trigger an episode. Your child's healthcare provider or dietitian can help your child identify foods that trigger an episode. This will help your child avoid those triggers. Other triggers include too much exercise, motion sickness, or being in hot weather too long.
  • Talk to school officials about what to expect. Your child may have an episode at school or daycare. it may help to talk to teachers, coaches, or other school officials. Explain your child's triggers and what happens during an episode. Depending on your child's age, you may be able to give information about how to handle an episode. Teachers or others who work with your child may be able to help him or her prevent an episode.
  • Have your child eat smaller meals, more often. Your child should eat small amounts of food every 2 to 3 hours, even if he or she is not hungry. Food in your child's stomach may decrease his or her nausea.
  • Encourage your child to drink more liquids as directed. Vomiting can lead to dehydration. It is important to drink more liquids to help replace lost body fluids. Ask your healthcare provider how much liquid your child needs to drink each day and which liquids are best. Your provider may recommend that your child drink an oral rehydration solution (ORS). ORS contains water, salts, and sugar that are needed to replace the lost body fluids. Ask what kind of ORS to use, how much your child should drink, and where to get it.
  • Help your child control stress. Stress or anxiety can trigger an episode. Help your child find ways to relax and manage stress. Create a sleep schedule for your child. Have him or her go to sleep and wake up at the same times every day. Talk to your child's healthcare provider if your child has trouble sleeping.
  • Talk to your adolescent about not using marijuana (cannabis). Repeated use of marijuana over a long period of time (chronic use) can cause episodes. This is called cannabis hyperemesis syndrome. If your adolescent has an episode caused by marijuana use, a hot shower may relieve his or her symptoms. Ask your adolescent's healthcare provider for information he or she wants to quit using marijuana and needs help quitting.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

When should I seek immediate care?

  • You see blood in your child's vomit or bowel movements.
  • Your child has sudden, severe pain in his or her chest and upper abdomen after hard vomiting or retching.
  • Your child has swelling in his or her neck and chest.
  • Your child is dizzy, cold, and thirsty, and his or her eyes and mouth are dry.
  • Your child is urinating very little or not at all.
  • Your child has muscle weakness, leg cramps, and trouble breathing.
  • Your child's heart is beating much faster than normal.
  • Your child continues to vomit for more than 48 hours.

When should I contact my child's healthcare provider?

  • Your child has frequent dry heaves (vomiting but nothing comes out).
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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