Constant vomiting: understand what is cyclic vomiting syndrome | Drauzio Varella





The condition is most common among school-age children, but can also affect adults. The impact on the patient’s life is great. See what your treatment options are.

Imagine a routine that includes constant vomiting and nausea, which can last from hours to days. Uncomfortable, no? This is what people with cyclic vomiting syndrome (CVS) experience, a gastrointestinal condition that causes crises that do not always have apparent reasons, but that have a great impact on the patient’s quality of life.

According with the doctor. Eduardo Grecco, gastrosurgeon and endoscopist at the EndoVitta Institute, a member of the Brazilian Society of Digestive Endoscopy (Sobed), medicine has not yet discovered what is behind the syndrome. In other words, its cause is not known for sure, but it has already been observed that it manifests itself more frequently in school-age children – although it can also affect young adults –, and that the crises may be associated with emotional and environmental factors.

“There is no very well-established factor. Some patients, about more than 80%, develop migraine attacks. So, patients who already have migraine may also have some change in relation to it. For children in particular, the high incidence at school age may have to do with the situation of change in diet, in addition to the anxiety itself of leaving the family environment to go to school, something much more connected with the emotional than the physiological”, explains the doctor.

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Symptoms

In general, symptoms are reduced to bouts of nausea and vomiting, which can last from hours to days, and rarely have an apparent reason. The patient may also experience abdominal pain, headachesalivation and photophobia (sensitivity to light).

Crises can also be triggered by factors such as:

  • Stress;
  • Anxiety;
  • infections;
  • Physical tiredness;
  • Specific foods (eg, cheese, chocolate);
  • Menstruation;
  • Hot climate;
  • Overeating/Fasting.

It is important to note that, when not in crisis, the patient becomes completely asymptomatic.

Diagnosis

The diagnosis is entirely clinical, based on the physician’s assessment of the symptoms described by the patient. But for the diagnosis of the syndrome to be closed, some patterns need to be present, as Dr. Edward.

“The diagnosis is given to the patient who has several episodes of vomiting over a period of days, and who has had at least three attacks in a period of six months. These vomiting will be recurrent; so, if he has at least three crises in six months, that is what is recommended for us to characterize that he has cyclic vomiting syndrome.”

The doctor also works on the investigation of the condition with the patient, to exclude other possible diagnoses. At this stage, the professional may request some tests, such as endoscopy, colonoscopyblood tests, and checking for intolerances to lactose and the gluten.

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Impact on quality of life

“It is a syndrome that totally disables the individual during episodes of crisis”, highlights Dr. Decio Chinzon, specialist in Gastroenterology and Endoscopy at Alta Diagnostics. Thus, depending on the intensity of the crises, temporary absence from work and studies may be recommended, as the doctor explains.

“During this period, we advise the person to be more isolated, prioritizing being in calmer environments and with less exposure to light, which totally changes the routine and quality of life of the individual.”

In women, the syndrome can also be related to the menstrual cyclewhich leads to more intense crises during this period.

Treatment

There is no specific treatment for cyclic vomiting syndrome, or a definitive cure for the condition. To restore the patient’s quality of life, the treatment works on two fronts: the ingestion of liquids to combat dehydration provoked by constant vomiting, and the use of medications to control nausea and decrease the episodes of vomiting itself.

Depending on the level of the crisis, intravenous hydration in a hospital environment may be necessary. In the fight against nausea and vomiting, the doctor can prescribe specific medications.

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