Cyclic vomiting syndrome (CVS) is characterized by periodic bouts of nausea and vomiting that happens at cyclical intervals. It affects all ages, but is more common in children. The condition is quite stereotypical in that there are paroxysms or bouts of vomiting that is recurrent and follows days of normal health.
Causes: There is no definite reason identified, but it is said to have a strong hereditary correlation. Studies have shown mitochondrial heteroplasmic (abnormal growth of mitochondria, which is a cellular component) to be one of the factors that can lead to CVS. The genetic correlation, however, is very difficult to establish, specifically because vomiting and nausea are common symptoms that occur with most conditions in children. And CVS is most commonly noted with conditions like infections and emotional excitement. Infection could be either tooth decay or sinusitis or anything else. Lack of sleep, anxiety, holidays, allergies, overeating, certain foods, menstruation - a host of factors have been shown to induce CVS. There is also a strong association with migraine and conditions that lead to excessive production of stress hormones.
Symptoms: The syndrome (a group of symptoms) usually has 4 phases:
1. Symptom-free interval phase: The child is completely normal in this phase, which happens in between bouts.
2. Prodromal phase: Prodrome is an indication that a disease or a condition is about to happen. In CVS, this is usually nausea and abdominal pain that can last from a few minutes to a few hours. Treatment in this phase can curb the disease. However, there could be some children in whom this may not manifest and the child may directly start with vomiting.
4. Recovery phase: As the nausea and vomiting begin to subside, which may take a couple of days, the child returns back to normal slowly. However, the lethargy and energy levels will take a couple of days to return to normal.
Treatment: Treatment again depends on the severity and the phase at which it is being recognized. If a child has repetitive bouts, then the parent and the doctor would have identified a pattern to it.
1. If the causative agent has been identified, for instance, infection or migraine, then managing that takes care of the CVS also.
2. If identified during the prodromal phase, again it can be managed with suitable anti-emetic medications.
3. If identified after full onset, rest and sleep and medications to control nausea and vomiting are required. Adequate hydration with electrolyte replenishment and sedatives can provide additional support.
However, in most cases of childhood CSV, the pattern will be identified and that helps in better management, both the child/parent and the podiatrist.
While pregnancy is not a pathological condition, it is a happy time that can be marred by various conditions. Debilitating morning or all day sickness, which is usually characterised by nausea, reflux in the gastro esophageal band, heartburn and acidity. This can also turn into vomiting and lead to complications if it does not stop.
Persistent, almost daily vomiting can be termed as excessive vomiting in pregnancy, and this is known as Hyperemesis Gravidarum in medical terms. Let us find out more about this condition.
Routine: Hyperemesis Gravidarum usually strikes as a matter of routine at a set time everyday where the patient will either be in unappetising company of acute and painful acidity and nausea, or will also be vomiting.
Severity: The severity of the condition usually decreases as the patient's pregnancy progresses. Usually, this condition strikes around the fourth or fifth week of pregnancy, before becoming better towards the middle of the second trimester. There are cases, though, where it continues to be just as severe till the very end of the pregnancy.
When to take Action: The patient may have to be hospitalised in case too much vomiting takes place, so as to prevent excess loss of water and salt from the body, and resultant weakness which may affect the growth of the foetus. Also, it is best to call the doctor when you have experienced fainting and dizzy spells.
Causes: Hyperemesis Gravidarum or excessive vomiting during pregnancy cannot be attributed to any specific or single cause. Usually, it is known to be a genetic condition passed down by mothers to their daughters. But in most cases, doctors believe that the condition is due to hormonal changes where an increase in the HCG hormone, or Human Chronic Gonadotropin hormone level during pregnancy may lead to a variety of symptoms such as morning sickness or excessive vomiting. This hormone is known to be at its peak during pregnancy.
Risk Factors: It has mostly been seen that women who are carrying twins are at risk of suffering from this condition. Also, women who have suffered from chronic motion sickness in the past report excessive vomiting during pregnancy.
Treatment: The best way to treat this issue is to prevent too much of nausea and vomiting with the help of a bland diet that does not have heavy to digest ingredients. Also, it is best to take small and frequent meals.
Working your way around excessive vomiting during pregnancy is a matter of ensuring that you take rest, fluids and other precautions.