Vomiting in children is usually preceded or followed by other symptoms. The most common cause of vomiting in children is stomach virus. For some children, deep coughing can trigger vomiting. Vomiting that occurs without other symptoms for more than 24 hours can indicate serious disease or injury. If vomiting continues without the development of other symptoms, a rare condition called cyclic vomiting cycle could be the cause. Cyclic vomiting cycle affects people of all ages, but children who have the disease first exhibit signs between 3 and 7 years of age.
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Cyclic Vomiting Cycle
Cyclic vomiting cycle, or CVS, causes cycles of severe vomiting that can last for hours or days. Vomiting episodes usually occur with the same characteristics as earlier episodes, including the time of day episodes occur, how long episodes last and the type and severity of the symptoms. Children with CVS are often pale, non-verbal and listless during episodes. They might drool and be extremely thirsty. The triggers for CVS episodes include illnesses, some foods, overeating, motion sickness, menstruation and hot weather. Excitement and stress are common triggers for children. Children may be misdiagnosed before the CVS diagnosis is made. For some children, CVS episodes prevent normal activities.
The four phases of CVS define the periods before, during and after vomiting episodes. During the prodrome phase of CVS, nausea or stomach pain might warn of the onset of vomiting. The prodrome phase can last for a few minutes or hours, although some people with CVS begin vomiting with no warning signs. The vomiting phase of CVS includes nausea, vomiting and fatigue. Vomiting stops during the recovery phase and energy and appetite return. During the interval phase, which occurs between vomiting episodes, patients do not have nausea, vomiting or stomach pains.
Researchers report a connection between CVS, migraine headaches and abdominal migraines. The three conditions cause severe episodic symptoms that begin and subside quickly. The conditions share the same types of symptoms and episode triggers. Children who have CVS usually have a family history of migraines. Some children with the disease develop migraines as they age or migraines replace CVS altogether. The connections between CVS and migraines, although not fully understood, influence the treatment of CVS.
Diagnosis and Treatment
Doctors diagnose CVS by reviewing family history, eliminating other conditions and identifying a pattern to vomiting episodes. Doctors treat CVS with the same medications used to treat migraines. However, some migraine medications have not been tested for use in children. The medications can prevent or reduce the frequency of vomiting episodes and decrease the severity of vomiting and other symptoms. Treatment includes bed rest in darkened rooms during episodes. Some children require sedatives and other medications to treat nausea. Children with CVS can develop severe, life-threatening dehydration and require hospitalization to correct electrolyte imbalances. Treatment of CVS can prevent complications, including tooth decay and damage to the esophagus.