Cyclic Vomiting Syndrome - Background

Background

Sufferers may vomit or retch six to twelve times an hour, and an episode may last from a few hours to well over three weeks and in some cases into months, with a median episode duration of 41 hours. Acid, bile, and (if the vomiting is severe) blood may be vomited. Some sufferers will ingest water to reduce the irritation of bile and acid on the esophagus during emeses. Between episodes the sufferer is usually otherwise normal and healthy but can be in a weak state of fatigue or have muscle pain. In approximately half of sufferers the attacks, or episodes, occur in a time related manner. Each attack is stereotypical: that is, in any given individual the timing, frequency and severity of attacks is similar.

Episodes may happen every few days or every few months. For some there is not a pattern in time that can be recognized. Some sufferers have a warning of an attack: they may experience a prodrome, usually intense nausea and pallor sometimes heightened sensitivity to especially light but also smell, sound, pressure, and temperature with sometimes oncoming muscle pain and fatigue is reported by some patients. The majority of sufferers, but not all, can identify "triggers" that may precipitate an attack. The most common are various foods, infections (such as colds), menstruation, extreme physical exertion, lack of sleep, and psychological stresses both positive and negative.

During an attack a sufferer may be light sensitive (photophobic), sound sensitive (phonophobic), and, less frequently, temperature or pressure sensitive. Some sufferers also have a strong urge to bathe in warm or cold water. Some sufferers reports that they experience a restless sensation or stinging pain along the spine, hands, and feet followed by weakness in both legs. Some of these symptoms may be caused by dehydration rather than any underlying cause for the CVS.