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Monday, August 20, 2018

Cyclic Vomiting Syndrome (CVS) and Gastroparesis Part 1

As someone who suffers both from Cyclic Vomiting Syndrome (CVS) and Gastroparesis (GP), it is sometimes hard to tell the difference between the two. It is so hard to get control of my vomiting once it starts because of Cyclic Vomiting Syndrome. This will be a two part article because there is a lot of information about CVS. The second part will be about living with CVS and Gastroparesis, and how one effects the other. Let me explain what CVS is, and how it can be dangerous on top of Gastroparesis.







According to the Mayo Clinic, Cyclic Vomiting Syndrome is defined as follows,


"Cyclic vomiting syndrome is characterized by episodes of severe vomiting that have no apparent cause. Episodes can last for hours or days and alternate with symptom-free periods. Episodes are similar, meaning that they tend to start at the same time of day, last the same length of time, and occur with the same symptoms and intensity.

Cyclic vomiting syndrome occurs in all age groups, though it often begins in children around 3 to 7 years old. Although more common in children, the number of cases diagnosed in adults is increasing.

The syndrome is difficult to diagnose because vomiting is a symptom of many disorders. Treatment often involves lifestyle changes to help prevent the events that can trigger vomiting episodes. Medications, including anti-nausea and migraine therapies, may help lessen symptoms.



Symptoms

The symptoms of cyclic vomiting syndrome often begin in the morning. Signs and symptoms include:

Severe vomiting that occurs several times an hour, continues for hours to days, but lasts less than one week
Three or more separate episodes of vomiting with no apparent cause in the past six months, or five or more episodes occurring at any time
Severe nausea
Intense sweating



Other signs and symptoms during a vomiting episode may include:

Abdominal pain
Diarrhea
Fever
Dizziness
Sensitivity to light
Headache
Retching or gagging
The time between vomiting episodes is usually symptom-free.


Causes
The underlying cause of cyclic vomiting syndrome is unknown. Some possible causes include genes, digestive difficulties, nervous system problems and hormone imbalances.


Specific bouts of vomiting may be triggered by:

Colds, allergies or sinus problems
Emotional stress or excitement, especially in children
Anxiety or panic attacks, especially in adults
Foods, such as caffeine, chocolate or cheese
Overeating, eating right before going to bed or fasting
Hot weather
Physical exhaustion
Exercising too much
Menstruation
Motion sickness
Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.


Risk factors
The relationship between migraines and cyclic vomiting syndrome isn't clear. But many children with cyclic vomiting syndrome have a family history of migraines or have migraines themselves when they get older. In adults, the association between cyclic vomiting syndrome and migraine may be lower.

Chronic use of marijuana (Cannabis sativa) also has been associated with cyclic vomiting syndrome because some people use marijuana to treat their symptoms.

However, cannabis can lead to a condition called cannabis hyperemesis syndrome, which typically leads to persistent vomiting without normal intervening periods. People with this syndrome often demonstrate frequent showering or bathing behavior.

Cannabis hyperemesis (hyperemesis means a lot of vomiting) syndrome can be confused with cyclic vomiting syndrome. To rule out cannabis hyperemesis syndrome, you need to stop using marijuana for at least one to two weeks to see if vomiting lessens. If it doesn't, your doctor will continue testing for cyclic vomiting syndrome.




Complications

Cyclic vomiting syndrome can cause these complications:

Dehydration. Excessive vomiting causes the body to lose water quickly. Severe cases of dehydration may need to be treated in the hospital.
Injury to the feeding tube. The stomach acid that comes up with the vomit can damage the tube that connects the mouth and stomach (esophagus). Sometimes the esophagus becomes so irritated it bleeds.
Tooth decay. The acid in vomit can corrode tooth enamel.




Prevention

Many people know what triggers their cyclic vomiting episodes. Avoiding those triggers can reduce the frequency of episodes. While you may feel well between episodes, it's very important to take medications as prescribed by your doctor.

If episodes occur more than once a month or require hospitalization, your doctor may recommend preventive medicine, such as amitriptyline, propranolol (Inderal), cyproheptadine and topiramate.



Lifestyle changes also may help, including:

Getting adequate sleep
Downplaying the importance of upcoming events because excitement can be a trigger
Avoiding trigger foods, such as caffeine, cheese and chocolate
Eating small meals and small carbohydrate-containing snacks daily at regular times




When to see a doctor

Call your doctor if you see blood in your or your child's vomit.

Continued vomiting may cause severe dehydration that can be life-threatening. Call your doctor if you or your child is showing symptoms of dehydration, such as:

Excess thirst
Less urination
Dry skin
Exhaustion and listlessness




Diagnosis

Cyclic vomiting syndrome can be difficult to diagnose. There's no specific test to confirm the diagnosis, and vomiting is a sign of many conditions that must be ruled out first.

The doctor will start by asking about your child's or your medical history and conducting a physical exam. The doctor will also want to know about the pattern of symptoms that you or your child experiences.


After that, the doctor may recommend:

Imaging studies — such as endoscopy, ultrasound or a CT scan — to check for blockages in the digestive system or signs of other digestive conditions
Motility tests to monitor the movement of food through your digestive system and to check for digestive disorders
Laboratory tests to check for thyroid problems and other metabolic conditions
Treatment
There's no cure for cyclic vomiting syndrome, though many children no longer have vomiting episodes by the time they reach adulthood. For those experiencing cyclic vomiting episode, treatment focuses on controlling the signs and symptoms. You or your child may be prescribed:

Anti-nausea drugs
Pain-relieving medications
Medications that suppress stomach acid
Antidepressants
Anti-seizure medications
The same types of medications used for migraines can sometimes help stop or even prevent episodes of cyclic vomiting. These medications may be recommended for people whose episodes are frequent and long lasting, or for people with a family history of migraine.

IV fluids may need to be given to prevent dehydration. Treatment is individualized based on the severity and duration of symptoms as well as the presence of complications.






Lifestyle and home remedies

Lifestyle changes can help control the signs and symptoms of cyclic vomiting syndrome. People with cyclic vomiting syndrome generally need to get adequate sleep. Once vomiting begins, it may help to stay in bed and sleep in a dark, quiet room.

When the vomiting phase has stopped, it's very important to drink fluids, such as an oral electrolyte solution (Pedialyte) or a sports drink (Gatorade, Powerade, others) diluted with 1 ounce of water for every ounce of sports drink. Some people may feel well enough to begin eating a normal diet soon after they stop vomiting. But if you don't or your child doesn't feel like eating right away, you might start with clear liquids and then gradually add solid food.

If vomiting episodes are triggered by stress or excitement, try during a symptom-free interval to find ways to reduce stress and stay calm. Eating small meals and small carbohydrate-containing snacks daily, instead of three large meals, also may help.




Alternative medicine

Alternative and complementary treatments may help prevent vomiting episodes, although none of these treatments has been well-studied.


These treatments include:

Coenzyme Q10 (ubiquinone), a natural substance made in the body that is available as a supplement. Coenzyme Q10 assists with the basic functions of cells.
L-carnitine, a natural substance that is made in the body and is available as a supplement. L-carnitine helps your body turn fat into energy.
L-carnitine and coenzyme Q10 may work by helping your body overcome difficulty in converting food into energy (mitochondrial dysfunction). Some researchers believe mitochondrial dysfunction may be a factor causing both cyclic vomiting syndrome and migraine.

Be sure to see a doctor and have the diagnosis of cyclic vomiting syndrome confirmed before starting any supplements. Always check with your doctor before taking any supplements to be sure you or your child is taking a safe dose and that the supplement won't adversely interact with any medications you're taking. Some people may experience side effects from L-carnitine and coenzyme Q10 that are similar to the symptoms of cyclic vomiting syndrome, including nausea, diarrhea and loss of appetite.





Coping and support

Because you never know when the next episode might occur, cyclic vomiting syndrome can be difficult for the whole family. Children may be especially concerned, and may worry constantly that they'll be with other children when an episode happens.

You or your child may benefit from connecting with others who understand what it's like to live with the uncertainty of cyclic vomiting syndrome. Ask your doctor about support groups in your area.






Preparing for your appointment

You're likely to start by seeing your primary care doctor or your child's pediatrician. But you may be referred immediately to a digestive diseases specialist (gastroenterologist). If you or your child is in the middle of a severe vomiting episode, the doctor may recommend immediate medical care.

Here's some information to help you get ready for your appointment and know what to expect from the doctor.



What you can do

Keep a record of any symptoms, including how often vomiting occurs and any typical triggers you may have noticed, such as food or activity.
Write down key medical information, including other diagnosed conditions.
Write down key personal information, including dietary habits and any major stresses or recent changes — both positive and negative — in your child's life or yours.
Bring a list of all medications, vitamins or supplements that you or your child takes.
Write down questions to ask the doctor.
Questions to ask the doctor




Some basic questions to ask the doctor include:

What's the most likely cause of these symptoms?
Are any tests needed?
Do you think this condition is temporary or long lasting?
What treatments do you recommend?
Is there a medication that can help?
Are there any dietary restrictions that can help?
Don't hesitate to ask other questions that occur to you during your appointment.






What to expect from the doctor

Be ready to answer questions your doctor may ask:

When did you or your child begin experiencing symptoms?
How often does an episode of severe vomiting occur, and how many times do you or does your child typically vomit?
How long do the episodes typically last?
Do you or does your child experience abdominal pain?
Have you noticed any warning signs that an episode is coming, such as loss of appetite or feeling unusually tired, or any common triggers, such as intense emotions, illness or menstruation?
Have you or has your child been diagnosed with any other medical problems, including mental health conditions?
What treatments, including over-the-counter medications and home remedies, are you or your child taking for other conditions?
Does anything seem to improve the symptoms or shorten the duration of an episode?
Do you or does your child have any history of severe headaches?
Does anyone in your family have a history of cyclic vomiting syndrome or of migraines?
Do you or your child use cannabis in any form? If so, how often?
What you can do in the meantime
The doctor will likely want to see you or your child immediately if an episode of severe vomiting is underway. But if the vomiting has passed, get plenty of rest, drink extra fluids and follow an easy-to-digest diet. It's also a good idea to avoid caffeinated beverages or foods containing caffeine, as these may trigger symptoms."






The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting. Source: https://www.niddk.nih.gov/health-information/digestive-diseases/cyclic-vomiting-syndrome/symptoms-causes






According to the National Institute of Diabetes and Digestive and Kidney Diseases,

"Definitions & Facts for Cyclic Vomiting Syndrome

What is cyclic vomiting syndrome?

Cyclic vomiting syndrome, or CVS, is a functional gastrointestinal (GI) disorder that causes sudden, repeated attacks—called episodes—of severe nausea and vomiting. Episodes can last from a few hours to several days. The episodes are separated by periods without nausea or vomiting. The time between episodes can be a few weeks to several months. Episodes can happen regularly or at random. Episodes can be so severe that you may have to stay in bed for days, unable to go to school or work. You may need treatment at an emergency room or a hospital during episodes. Cyclic vomiting syndrome can affect you for years or decades.

CVS is not chronic vomiting that lasts weeks without stopping. CVS is not a condition that has a definite cause, such as chemotherapy.



How common is cyclic vomiting syndrome?

Experts don’t know how common cyclic vomiting syndrome is in adults. However, experts believe that cyclic vomiting syndrome may be just as common in adults as in children. Doctors diagnose about 3 out of 100,000 children with cyclic vomiting syndrome every year.



You may be more likely to get cyclic vomiting syndrome if you have:

migraines or a family history of migraines
a history of long-term marijuana use
a tendency to get motion sickness
Among adults with cyclic vomiting syndrome, about 6 out of 10 are Caucasian.


People with cyclic vomiting syndrome may have other health problems, including:

migraines
anxiety and depression
gastroparesis
autonomic nervous system disorders
high blood pressure
gastroesophageal reflux disease
irritable bowel syndrome




What are the complications of cyclic vomiting syndrome?

The severe vomiting and retching that happen during cyclic vomiting episodes may cause the following complications:

dehydration
esophagitis
Mallory-Weiss tears
tooth decay or damage to tooth enamel
References
[1] Drumm BR, Bourke B, Drummond J, et al. Cyclical vomiting syndrome in children: a prospective study. Neurogastroenterology and Motility. 2012;24(10):922–927.

[2] Bhandari S, Venkatesan T. Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Digestive Diseases and Sciences. 2017;62(8):2035–2044.

December 2017




Symptoms & Causes of Cyclic Vomiting Syndrome


What are the main symptoms of cyclic vomiting syndrome?

The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting. You may vomit several times an hour. Episodes can last from a few hours to several days. Episodes may make you feel very tired and drowsy.

Each episode of cyclic vomiting syndrome tends to start at the same time of day, last the same length of time, and happen with the same symptoms and intensity as previous episodes. Episodes may begin at any time but often start during the early morning hours.

The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting.





What are some other symptoms of cyclic vomiting syndrome?


Other symptoms of cyclic vomiting syndrome may include one or more of the following:

retching—trying to vomit but having nothing come out of your mouth, also called dry vomiting
pain in the abdomen
abnormal drowsiness
pale skin
headaches
lack of appetite
not wanting to talk
drooling or spitting
extreme thirst
sensitivity to light or sound
dizziness
diarrhea
fever



What are the phases of cyclic vomiting syndrome?

Cyclic vomiting syndrome has four phases:

prodrome phase
vomiting phase
recovery phase
well phase






Source: https://www.researchgate.net/figure/Schematic-representation-of-the-four-phases-of-Cyclic-Vomiting-Syndrome-and-their_fig2_7402882





How do the symptoms vary in the phases of cyclic vomiting syndrome?

The symptoms will vary as you go through the four phases of cyclic vomiting syndrome:

Prodrome phase. During the prodrome phase, you feel an episode coming on. Often marked by intense sweating and nausea—with or without pain in your abdomen—this phase can last from a few minutes to several hours. Your skin may look unusually pale.
Vomiting phase. The main symptoms of this phase are severe nausea, vomiting, and retching. At the peak of this phase, you may vomit several times an hour. You may be quiet and able to respond to people around you and unable to move and unable to respond to people around you. You may have twisting and moaning with intense pain in your abdomen. The nausea and vomiting can last from a few hours to several days.

Recovery phase. Recovery begins when you stop vomiting and retching and you feel less nauseated. You may feel better gradually or quickly. The recovery phase ends when your nausea stops and your healthy skin color, appetite, and energy return.

Well phase. The well phase happens between episodes. You have no symptoms during this phase.



When should I seek medical help?


You should seek medical help if:

the medicines your doctor recommended or prescribed for the prodrome phase don’t relieve your symptoms
your episode is severe and lasts more than several hours
you are not able to take in foods or liquids for several hours
You should seek medical help right away if you have any signs or symptoms of dehydration during the vomiting phase.


These signs and symptoms may include:

extreme thirst and dry mouth
urinating less than usual
dark-colored urine
dry mouth
decreased skin turgor, meaning that when your skin is pinched and released, the skin does not flatten back to normal right away
sunken eyes or cheeks
light-headedness or fainting


If you are a parent or caregiver of an infant or child, you should seek medical care for them right away if they have any signs and symptoms of dehydration during the vomiting phase.


These signs and symptoms may include:

thirst
urinating less than usual, or no wet diapers for 3 hours or more
lack of energy
dry mouth
no tears when crying
decreased skin turgor
sunken eyes or cheeks
unusually cranky or drowsy behavior




Source: On Image.







What causes cyclic vomiting syndrome?

Experts aren’t sure what causes cyclic vomiting syndrome.


However, some experts believe the following conditions may play a role:

problems with nerve signals between the brain and digestive tract
problems with the way the brain and endocrine system react to stress
mutations in certain genes that are associated with an increased chance of getting CVS



What may trigger an episode of cyclic vomiting?

Triggers for an episode of cyclic vomiting may include:

emotional stress
anxiety or panic attacks , especially in adults
infections, such as colds, flu, or chronic sinusitis
intense excitement before events such as birthdays, holidays, vacations, and school outings, especially in children
lack of sleep
physical exhaustion
allergies
temperature extremes of hot or cold
drinking alcohol
menstrual periods
motion sickness
periods without eating (fasting)
Eating certain foods, such as chocolate, cheese, and foods with monosodium glutamate (MSG) may play a role in triggering episodes.




Diagnosis of Cyclic Vomiting Syndrome


How do doctors diagnose cyclic vomiting syndrome?

Doctors diagnose cyclic vomiting syndrome based on family and medical history, a physical exam, pattern of symptoms, and medical tests. Your doctor may perform medical tests to rule out other diseases and conditions that may cause nausea and vomiting.



Family and medical history

Your doctor will ask about your family and medical history. He or she may ask for details about your history of health problems such as migraines , irritable bowel syndrome, and gastroparesis. Your doctor may also ask about your history of mental health problems, use of substances such as marijuana, and cigarette smoking.



Physical exam


During a physical exam, your doctor will:

examine your body
check your abdomen for unusual sounds, tenderness, or pain
check your nerves, muscle strength, reflexes, and balance
Pattern or cycle of symptoms in children




A doctor will often suspect cyclic vomiting syndrome in a child when all of the following are present[3]:

at least five episodes over any time period, or a minimum of three episodes over a 6-month period
episodes lasting 1 hour to 10 days and happening at least 1 week apart
episodes similar to previous ones, tending to start at the same time of day, lasting the same length of time, and happening with the same symptoms and intensity
vomiting during episodes happening at least four times an hour for at least 1 hour
episodes are separated by weeks to months, usually with no symptoms between episodes
after appropriate medical evaluation, symptoms cannot be attributed to another medical condition
Pattern or cycle of symptoms in adults





A doctor will often suspect cyclic vomiting syndrome in adults when all of the following are present[4]:

three or more separate episodes in the past year and two episodes in the past 6 months, happening at least 1 week apart
episodes that are usually similar to previous ones, meaning that episodes tend to start at the same time of day and last the same length of time—less than 1 week
no nausea or vomiting between episodes, but other, milder symptoms can be present between episodes
no metabolic , gastrointestinal , central nervous system , structural, or biochemical disorders
A personal or family history of migraines supports the doctor’s diagnosis of cyclic vomiting syndrome.

Your doctor may diagnose cyclic vomiting syndrome even if your pattern of symptoms or your child’s pattern of symptoms do not fit the patterns described here. Talk to your doctor if your symptoms or your child’s symptoms are like the symptoms of cyclic vomiting syndrome.





Source on Image.






What medical tests do doctors use to diagnose cyclic vomiting syndrome?

Doctors use lab tests, upper GI endoscopy, and imaging tests to rule out other diseases and conditions that cause nausea and vomiting. Once other diseases and conditions have been ruled out, a doctor will diagnose cyclic vomiting syndrome based on the pattern or cycle of symptoms.





Lab tests

Your doctor may use the following lab tests:

Blood tests can show signs of anemia, dehydration, inflammation, infection, and liver problems.
Urine tests can show signs of dehydration, infection, and kidney problems.
Blood and urine tests can also show signs of mitochondrial diseases .


Upper GI endoscopy

Your doctor may perform an upper GI endoscopy to look for problems in your upper digestive tract that may be causing nausea and vomiting.


Imaging tests

A doctor may perform one of more of the following imaging tests:

Ultrasound of the abdomen.
Gastric emptying test, also called gastric emptying scintigraphy. This test involves eating a bland meal, such as eggs or an egg substitute, that contains a small amount of radioactive material. An external camera scans the abdomen to show where the radioactive material is located. A radiologist can then measure how quickly the stomach empties after the meal. Health care professionals perform gastric emptying tests only between episodes.
Upper GI series.
MRI scan or CT scan of the brain.
References
[3] Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. Journal of Pediatric Gastroenterology and Nutrition. 2008;47(3):379–393.

[4] Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380–1392.



Treatment of Cyclic Vomiting Syndrome


How do doctors treat cyclic vomiting syndrome?


How doctors treat cyclic vomiting syndrome depends on the phase. Your doctor may:

prescribe medicines
treat health problems that may trigger the disorder
recommend
staying away from triggers
ways to manage triggers
getting plenty of sleep and rest
Prodrome phase
Taking medicines early in this phase can sometimes help stop an episode from happening.



Your doctor may recommend over-the-counter medicines or prescribe medicines such as:

ondansetron (Zofran) or promethazine (Phenergan) for nausea
sumatriptan (Imitrex) for migraines
lorazepam (Ativan) for anxiety
ibuprofen for pain




Your doctor may recommend over-the-counter medicines to reduce the amount of acid your stomach makes, such as:

famotidine (Pepcid)
ranitidine (Zantac)
omeprazole (Prilosec)
esomeprazole (Nexium)






Source (and to read this study): https://www.researchgate.net/publication/263779154_Resistant_Cyclic_Vomiting_Syndrome_Successfully_Responding_to_Chlorpromazine






Vomiting phase
During this phase, you should stay in bed and sleep in a dark, quiet room. You may have to go to a hospital if your nausea and vomiting are severe or if you become severely dehydrated.




Your doctor may recommend or prescribe medication for the following for children and adults:

nausea
migraines
anxiety
pain
medicines that reduce the amount of acid your stomach makes
During the vomiting phase, you should stay in bed and sleep in a dark, quiet room.



If you go to a hospital, your doctor may treat you with:

intravenous (IV) fluids for dehydration
medicines for symptoms
IV nutrition if an episode continues for several days


Recovery phase
During the recovery phase, you may need IV fluids for a while.



Your doctor may recommend that you drink plenty of water and liquids that contain glucose and electrolytes, such as:

broths
caffeine-free soft drinks
fruit juices
sports drinks
oral rehydration solutions, such as Pedialyte
If you’ve lost your appetite, start drinking clear liquids and then move slowly to other liquids and solid foods. Your doctor may prescribe medicines to help prevent future episodes.


Well phase
During the well phase, your doctor may prescribe medicines to help prevent episodes and how often and how severe they are, such as:

amitriptyline (Elavil)
cyproheptadine (Periactin)
propranolol (Inderal)
topiramate (Topamax)
zonisamide (Zonegran)
Your doctor may also recommend coenzyme Q10 , levocarnitine (L-carnitine), or riboflavin as dietary supplements to help prevent episodes.



How can I prevent cyclic vomiting syndrome?

Knowing and managing your triggers can help prevent cyclic vomiting syndrome, especially during the well phase.

You should also:

get enough sleep and rest
treat infections and allergies
learn how to reduce or manage stress and anxiety
avoid foods and food additives that trigger episodes



How do doctors treat the complications of cyclic vomiting syndrome?

Doctors treat the complications of cyclic vomiting syndrome as follows:

dehydration — plenty of liquids with glucose and electrolytes; or IV fluids and hospitalization for severe dehydration
esophagitis — medicines to reduce the amount of acid your stomach makes
Mallory-Weiss tears — medicines or medical procedures to stop bleeding if the tears don’t heal on their own, which they generally do
tooth decay - or damage to tooth enamel—dental fillings , fluoride toothpaste, or mouth rinses





Source: https://www.google.com/url?sa=i&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwi137Kl6vvcAhVI3FMKHYMFBewQjRx6BAgBEAU&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DxnC1M1mIPIE&psig=AOvVaw2TfxZE740rfSQwa0jNtRSk&ust=1534860908500786





Eating, Diet, & Nutrition for Cyclic Vomiting Syndrome

How can my diet help prevent or relieve cyclic vomiting syndrome?

Your diet will not help prevent or relieve episodes but will help you recover and keep you healthy.

Your doctor may recommend coenzyme Q10 , levocarnitine, (L-carnitine), or riboflavin as dietary supplements to help prevent episodes.



What should I eat and drink if I have cyclic vomiting syndrome?

When your nausea and vomiting stop, you can generally go back to your regular diet right away. In some cases, you may want to start with clear liquids and go slowly back to your regular diet. You should eat well-balanced and nutritious meals between your episodes. Your doctors will recommend that you not skip meals in between episodes.



If you are dehydrated, drink plenty of liquids that contain glucose and electrolytes, such as:

broths
caffeine-free soft drinks
fruit juices
sports drinks
oral rehydration solutions, such as Pedialyte
Family eating nutritious foods.
You should eat well-balanced and nutritious meals between your cyclic vomiting episodes.
What should I avoid eating if I have cyclic vomiting syndrome?
In between episodes, you should avoid eating foods that may have triggered past episodes. Eating certain foods such as chocolate, cheese, and foods with monosodium glutamate (MSG), may trigger an episode in some people. Adults should avoid drinking alcohol.


Clinical Trials for Cyclic Vomiting Syndrome

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.



What are clinical trials and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.


What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov."



My friend Jenny has CVS and Gastroparesis. She made this image and shared it with me, so I thought I would share it with you to share her story (she is updating her story and when I receive it, I will update it here, too:





During my research into CVS, I read that it can cause abdominal migraines. There are many different types of migraines but if you would like more information on abdominal migraines, please read my blog article here: http://www.emilysstomach.com/2018/06/abdominal-migraines.html






I found this online and the source should be located in the document, but it goes into detail about Cyclic Vomiting Syndrome (CVS) with diagrams and a bit more information than Mayo provides:






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