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Cyclic vomiting syndrome (CVS) is a disorder, causing recurring episodes of vomiting, lethargy and nausea. It is a functional gastrointestinal disorder and the attacks are sudden and repeat constantly. The attacks or the episodes can last from a few hours  to several days. Cyclic vomiting syndrome affects all age groups, although children between ages 3 to 7 are the most affected ones. It is commonly found in children, but the current statistics reveal a hike in the number of adults with cyclic vomiting syndrome.
Cyclic vomiting syndrome is difficult to diagnose because of vomiting being a common symptom of various disorders. The symptoms  of cyclic vomiting syndrome can become too severe that it restricts your day to day activities such as going to work or school. Episodes of vomiting, lethargy, and nausea can occur at random or regular intervals. Cyclic vomiting syndrome is considered as a different version of a migraine and abdominal migraine, due to the similarities in its symptoms such as nausea, vomiting, severe headaches associated with pain, and extreme sensitivity to sound  and light.
The disorder and its frequency are not widely known to the public due to the lack of medical attention. By the 2000s, researchers believed that it was due to the commonality of the symptoms that cyclic vomiting syndrome goes undiagnosed.
Symptoms Of Cyclic Vomiting Syndrome
The attacks of intense nausea, lethargy and vomiting are the major signs of cyclic vomiting syndrome. The symptoms can last for a period  of one hour to 10 days, which can result in massive loss of fluids from your body resulting in dehydration, pallor, abdominal pain etc. The symptoms of cyclic vomiting syndrome are mostly similar.
An individual affected by the rare disorder may show one or more of the following signs.
Phases Of Cyclic Vomiting Syndrome
An episode of the cyclic vomiting syndrome disorder has four  distinct stages.
1. Prodrome phase
This phase acts as the indicator or the warning, where an individual understands that an episode of vomiting and nausea is about  to begin. The prodrome phase may cause abdominal pain, and can last for just a few minutes to several hours. It will also cause your skin to appear pale. In adults, the prodrome phase can result in panic attacks  or anxiety.
2. Vomiting or episode phase
Consisting of nausea, vomiting and  retching, this phase causes the individual to be unresponsive. During the vomiting phase, you will not be able to drink, eat or even take medicines without instantly vomiting it out. It causes you to feel drowsy, exhausted or dizzy. The vomiting can occur 5 to 6 times in an hour and can last up to a period of 10 days.
3. Recovery phase
During this phase, the vomiting and the retching will stop. The skin begins to regain its colour and you regain the appetite and energy. The recovery can be gradual or immediate.
4. Symptom-free interval or well phase
In this phase, there will be no symptoms. It is actually the period between the episodes.
Causes Of Cyclic Vomiting Syndrome
Researchers have proposed various factors to be the contributing factors causing cyclic vomiting syndrome. The main causes of cyclic vomiting syndrome  are linked to the symptoms of a migraine. It can be triggered by various factors, with the most common and possible causes being digestion difficulties, hormone imbalances, nervous system issues, infections etc.
- Anxiety or panic attacks, especially in adults
- Emotional stress or excitement, especially in children
- Overeating, eating right before going to bed or fasting
- Hot weather
- Physical exhaustion or too much exercising
- Motion sickness 
- Foods, such as caffeine, chocolate, cheese, and food containing monosodium glutamate (MSG)
- Colds, allergies or sinus problems
- Sleep deprivation.
Diagnosis Of Cyclic Vomiting Syndrome
The identification of the problem is deemed to be a bit arduous, due to the very common symptoms the disorder encompass.
To conduct the diagnosis, your doctor will ask about your medical history and a physical exam will follow. The doctor will also  ask about the pattern of the symptoms experienced. Then, the doctor may recommend the following methods.
1. Motility tests
This test will be done to monitor the movement of food through your digestive system. Motility tests will find out if there are any digestion-related disorders.
2. Imaging studies
Procedures such as endoscopy, ultrasound  or a CT scan will be conducted to check for any form of blockages in your digestive system. It will also check for other related digestive conditions as well.
3. Laboratory tests
This will be done to check the possibility of any thyroid problem or any metabolic conditions.
Treatment Of Cyclic Vomiting Syndrome
Various studies have been conducted to find a proper method of treatment for the condition of cyclic vomiting syndrome. The treatment for cyclic vomiting syndrome focuses on controlling the signs and symptoms. And varies from one individual to the other. Studies  have revealed the effectiveness of using migraine medications in some cases of cyclic vomiting syndrome. The treatment involves
- anti-nausea drugs such as ondansetron
- anti-seizure medications
- pain-relieving medications such as ibuprofen
- medications that suppress stomach acids such as ranitidine, lansoprazole or omeprazole
- migraine treatments such as sumatriptan and propranolol.
In some severe cases with dehydration, IV fluids will be used to balance the body fluids.
Cyclic vomiting syndrome can cause various complications within your body.
1. Tooth decay
The constant and continuous vomiting caused by cyclic vomiting syndrome can result in developing tooth decay, as the acid in the vomit may corrode the tooth  enamel.
2. Injury to oesophagus
The stomach acid that develops  with the vomit can cause internal irritations. It can damage the oesophagus, causing it to bleed.
Excessive and continuous vomiting can cause your body to release fluids, even the necessary ones. The loss of water can result in dehydration and sometimes it can  be severe.
- Chronic use of Cannabis sativa or marijuana is linked to cyclic vomiting syndrome. It is often used by individuals to treat the symptoms. The constant  use can lead to a condition called cannabis hyperemesis syndrome, that causes continuous vomiting.
- Migraines and cyclic vomiting syndrome have been associated with each other. However, there is a bit of ambiguity in the connection. Individuals who suffer from cyclic vomiting syndrome have been found out to have a family history of migraines.
Diet To Follow
It is best that you follow a diet that is well-balanced and nutritious. Skipping meals should not even be an option and incorporate liquids that contain electrolytes and glucose such as, broths, caffeine-free soft drinks, fruit juices, sports drinks, and oral rehydration solutions, such as Pedialyte. Gluten-free diets, a paleo diet based on foods such as fish, meat, vegetables, and fruit without dairy or green products are advised.
Avoid consuming foods such as chocolate, cheese, and foods with monosodium glutamate (MSG) and alcohol.
An individual suffering from cyclic vomiting syndrome will be aware of the triggers that cause it. The best method to prevent the onset of the vomiting and nausea is by avoiding the triggering elements.
- Getting enough  sleep.
- Treating any persisting allergies or sinus problems.
- Taking steps to manage anxiety and stress.
- During the symptom-free interval or well phase, eat a balanced diet with regular meals.
- Utilize the medications prescribed by a physician.
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