The Cyclic Vomiting Program evaluates and treats children with unexplained episodic vomiting. This program is the only one in Northeast Ohio and one of the only three in the country. The consultation includes an evaluation by a neurometabolic specialist and metabolic gastroenterologist. Experts in pediatric headache, psychology and psychiatry are an integral part of the team.
Overview
CVS is an unexplained disorder of children and adults that was first described by Dr. S. Gee in 1882. The condition is characterized by recurrent, prolonged attacks of severe nausea, and vomiting with no apparent cause. in some there is severe abdominal pain. Vomiting occurs at frequent intervals for hours or days (1-4 commonly). The episodes tend to be similar to each other in symptoms and duration and are self-limited with return of normal health between episodes.
Symptoms
Episodes may begin at any time but often start during the early morning hours. There is relentless nausea with repeated bouts of vomiting or retching. The person is pale, listless, and resists talking. They often drool or spit and have extreme thirst. They may experience intense abdominal pain and less often headaches, low-grade fever, and diarrhea. Prolonged vomiting may cause mild bleeding from irritation of the esophagus. They symptoms are frightening to the person and family and can be life-threatening if delayed treatment leads to dehydration.
Treatment
Treatment is generally supportive with much importance placed on early intervention. A dark quiet environment is critical for sleep. Hospitalizations and IV fluid replacement may be necessary. Medication trials sometimes succeed in preventing, shortening, or aborting episodes. A nutritional consult can be arranged to help identify and avoid food related triggers. The foundation of long-term management involved a responsive collaborative doctor-patient-family relationship, sensitive to stresses caused by the illness and to triggers such as feelings and attitudes that may pre-dispose to attacks.
Specialty Care Providers Who Treat This Condition: