Cyclic Vomiting Syndrome

19 March 2021

Cyclic vomiting syndrome is on the rise in adults – and it may be Migraine related.

A review recently published in Headache: The Journal of Head and Face Pain discusses treatment of cyclic vomiting syndrome, as well as a surprising rise in adult cases.

The connection between migraine and vomiting and nausea is not news. Cyclic vomiting syndrome (CVS) has also long been connected to migraine – in fact, some have suggested that it may be a subtype of migraine.

But there’s still a lot we don’t know about CVS. In fact, as the Mayo Clinic puts it, “Cyclic vomiting syndrome is characterized by episodes of severe vomiting that have no apparent cause.”

Which is why doctors first need to rule out other conditions when (usually children) develop CVS. For example, a part of the intestine may not be developing in the right position (intestinal malrotation). A swelling of the kidneys (hydronephrosis) might also be a cause. So some tests will be required when someone is diagnosed. Anxiety or panic attacks may also bring on problems, in both adults and children.

CVS in adults may also come from certain diseases related to the gallbladder or liver.

Though the nausea/vomiting connection is the most obvious link to migraine, there are other symptoms that some patients get that make the link even stronger. For example, abdominal pain (abdominal migraine is more common in children, but adults get it as well), dizziness, photophobia (sensitivity to light), and, of course, headache.

Why is CVS on the rise in adults? Increased anxiety? Environmental factors? Dietary problems?

What’s the connection to migraine? Is it a gut-brain issue? Are there genetic factors? Lifestyle commonalities? Once more, we’re not sure.

However, the study recommends that we further our research into the CVS-migraine link, and try to diagnose CVS as early as possible. Early treatment, as with migraine, can lead to better results. And in the case of children, we often have the opportunity to catch both early, and so can avoid many problems later in life.

But doctors and patients need to look carefully for migraine-type symptoms, because migraine treatments may be able to conquer both issues.

Report abstract (and link to full report): Cyclic vomiting syndrome: A narrative review and guide to management

28 October 2013

6 Key Stomach/Gut Terms related to Migraine

James Information 1

Abdominal Migraine Common in children, but also seen in adults. A type of migraine that could include stomach pain and nausea, and may not include headache.
Cyclic Vomiting Syndrome (CVS) Particularly in children, this could be related to migraine or could actually be a type of migraine.
Gastric Stasis A common condition in migraine patients – a delayed emptying of the stomach – which can keep medications from working properly.
Gut-Brain Connection The enteric nervous system or “second brain” in the gut may explain why diet and treatment of stomach issues are closely connected to migraine.
Irritable Bowel Syndrome (IBS) A common disorder comorbid with migraine.
Nausea One of the most common symptoms of migraine (including vomiting).

15 June 2010

Cyclic Vomiting Syndrome, Migraine, and CoQ10

James Discoveries & Stats, Treatments 0

Cyclic Vomiting Syndrome (CVS) in children has been closely related to migraine. In fact, the symptoms are common in migraine, and recent studies suggest that CVS may actually be a type of migraine. Abdominal migraine is common in children, and stomach pain and vomiting are common (more on abdominal migraine symptoms).

Various treatments have been used for abdominal migraine and CVS – many familiar to migraineurs in general, such as biofeedback, beta-blockers, and triptans. Another common treatment is amitriptyline, a tricyclic antidepressant with brand names such as Endep and Elavil.

Coenzyme Q10 is increasingly popular as a migraine preventative, in part because of its few side effects. So, a study published in January (2010) set out to compare amitriptyline with co-enzyme Q10 (CoQ10) as a treatment for CVS. 162 patients took amitriptyline, and 22 took CoQ10.

Patients were watched for common aspects of a CVS attack – frequency, duration, number of times child throws up, nausea severity. 72% of the patients taking amitriptyline saw at least a 50% reduction in one of these things. 68% of patients taking coenzyme Q10 experienced at least a 50% reduction in one of these things.

So, amitriptyline is "better", right? Not so fast.

50% of patients reported side effects with the amitriptyline, and in fact 21% had to discontinue treatment!

Side effects with the coQ10? 0% of patients. None.

Not only is this an encouraging result for those thinking of trying CoQ10 for CVS, it’s also encouraging for (other) migraine patients who are thinking about it. CoQ10 continues to be a good option with very few side effects. It’s an up-and-coming preventative for children as well as adults.

For a more in-depth discussion of coenzyme Q10 and migraine, read this article.