Cyclic vomiting syndrome in children and adults

Cyclic vomiting syndrome in children occurs significantly more often than adults, because the first time it was described – and it happened in the nineteenth century, and in France the description of him was given by the pediatrician. For a long time it was believed that cyclic vomiting syndrome exclusively a childhood disease, but over time, the medicine has established that it is found in adults.

Diagnosis it is very difficult and requires a physician of great knowledge. In the medical literature, the syndrome is described rarely and sparingly. It occurs in about one child out of hundreds of thousands.

What is cyclic vomiting syndrome and under what conditions it appears

The reasons for developing cyclic vomiting syndrome, medicine remains largely a mystery. There are only assumptions and hypotheses about the link with:

• migraine. The communication mechanism is not understood, but it is noted that many patients with the syndrome suffer from migraine, and that the families of many children with the syndrome of migraine sick older relatives;
• metabolic disorders. It is believed that the syndrome may arise from rare genetic mutations that disrupt metabolism;
• hormonal disturbances. The process of gastric emptying is disturbed sometimes due to the fact that in the blood increases the proportion of certain hormones, the production of which provokes stress. As syndrome cyclic vomiting often occurs after stress, it is believed that it can cause pathologically increased production or increased digestibility of certain hormones.

Cyclic vomiting syndrome symptoms are very similar to the cannabinoid syndrome uncontrollable vomiting that occurs due to the long Smoking of marijuana.

Despite the fact that the causes of the syndrome are still under question, factors which can be the trigger for the next attack, studied and described well. Among them:

• stress in children cyclic vomiting syndrome often begins as a response to the anxiety over exams, problems within the family or the expectations of the coming holiday;
• infectious and inflammatory processes that impair the body from the common cold and flu to relapse of chronic diseases.
• eating certain foods – commonly called cheese, chocolate, drinks containing caffeine, products that have monosodium glutamate;
• the influence of specific weather – often cyclic vomiting syndrome becomes a response to heat or temperature changes;
• the influence of certain States of pregnancy and menstruation in women;
• a wrong relationship with food – may provoke an attack as overeating, especially before bedtime and fasting;
• a wrong relationship with physical activity may provoke an attack as the lack of activity, and severe fatigue and exhaustion;
• sleep problems – the attack may be a response to lack of sleep;
• pitching – attack may be the answer as the sickness in transport, and sea-sickness.

Patients, as a rule, better than the doctor know what triggers an attack specifically at them and learn to avoid dangerous situations.

Interestingly, although the symptoms and supposed causes are the same, cyclic vomiting syndrome develops more often in women than in men.

Symptoms

Cyclic vomiting syndrome is characterized by the presence of steps, which are very easy to follow:

1. The occurrence of vomiting – the patient feels nausea and a slight pain in the stomach.
2. Directly vomiting – sick sick he has no appetite, is weak.
3. Recovery period – the patient has a good appetite, it ceases to tear out the weakness, he gradually attains its own kind.
4. Remission – the patient no longer remembers vomiting at all.

The ratio of time under uneven: the active phase lasts from a few hours to two weeks, while the period of remission can last several months. The attack is characterized primarily:

• constant nausea and lack of appetite;
• vomiting while trying to eat something.

Often the attack is accompanied with other unpleasant symptoms, including:

• light sensitivity the patient begin to tear and hurt your eyes;
• sensitivity to smell and sound – the patient complains that the world around is too loud and too strong smell;
• the increase in pressure is accompanied by headache, weakness, paleness;
• fever accompanied by weakness, pain in muscles and joints, fatigue;
• pain localization is very individual and depends on the patient, can concentrate in the stomach, at the base of the spine, hands and feet;
• vomiting of bile is accompanied by an unpleasant odor.

Vomiting in the peak intensity of the attack may occur up to twelve times per hour. The main danger in this case is dehydration, but it can be fear and other complications.

Possible complications

Cyclic vomiting syndrome, including complications, rarely fatal, usually because patients or relatives time to get to the doctor sooner. Among the possible unpleasant consequences are:

• Dehydration. Not too dangerous for an adult person, but poses a great threat to the child, the elderly or person with reduced immunity. On the approach of a dangerous condition indicate drynessthe mouth, lack of tears when you try to cry, sunken eyes and cheeks, fever, constant fatigue. The child may become whiny and cranky, the old man to sleep.

If almost no urge to urinate, little urine and it has an unpleasant dark color, and there is dizziness and darkening of the eyes – hence, the dehydration got to the point that life-threatening. You should immediately call an ambulance.

• Caries. Vomit will contain bile, which in itself is a strong acid. It is the most detrimental effect on the teeth, eroding tooth enamel, resulting in tooth decay. Without proper treatment it can go into the pulpit, and provoke constant bad breath.
• Lesions of the esophagus and gastric walls. Vomiting stomach acid up the esophagus from the stomach, corroding the delicate mucus membrane. As a result, the patient can develop gastritis, or esophagitis. The fact that it happened will point appeared to vomit blood.

If the dehydration was not detected in time, it can lead to death, and if time has not been discovered gastritis or esophagitis, they can ruin patient life. To prevent this, you need to start treatment in time.

Diagnosis

In order that the treatment has borne fruit, we must first make the correct diagnosis, which in the case of cyclic vomiting syndrome is somewhat complicated.

There's no test that could reliably confirm the presence of this disease. Say that the patient has it, on the basis of three criteria:

• the presence of vomiting – they should be stereotyped to begin to last about the same time and place not less frequently than three times per year;
• the presence of periods of remission – they should take between a week to several months and be completely free of any symptoms characteristic of a seizure;
• the absence of any reasons which could induce vomiting.

The main diagnostics consists of a medical history, which should ideally include:

• the time and number of bouts of vomiting throughout the active phase;
• characteristic signs heralding the attack, and the accompanying additional symptoms;
• any existing diagnoses – allergies, chronic illness;
• take any drugs – not only drugs, but also vitamins and food supplements;
• personal information – use the products and any changes in them, any great excitement, both positive and negative.

And tests needed to rule out other probable diagnoses. Use:

• tests on blood and urine – to rule out the presence of hormonal disorders;
• laboratory studies of the gastrointestinal tract to exclude the presence of diseases like gastritis or duodenitis;
• laboratory studies of the brain to exclude the presence of benign or malignant tumors.

If all the tests revealed nothing, can be considered as a diagnosis and begin treatment.

A doctor who treats cyclic vomiting syndrome – a gastroenterologist. Although doing this may be enough qualified therapist.

Treatment

Cyclic vomiting syndrome in adults as in children, treated in four main phases, which makes sense, given how it develops.

• The occurrence of vomiting. At this stage it is preferable to get away from all the triggers that may exacerbate the condition. Get off the bus, if the attack was provoked by motion, to try to calm down, if the attack caused by stress. You can take anti-nausea medication prescribed by a doctor – but only if directly vomiting hasn't started yet.
• Directly vomiting. At this stage it is preferable to give yourself a complete rest. To hide in a dark room, go to bed. Reduce activity to a minimum, try to sleep more and drink warm water. If vomiting lasting more than twelve hours, you should call an ambulance and go to hospital to further attack could take place under medical supervision.

It is very important to a sick child during an attack of cyclic vomiting syndrome was carried out constant supervision. Not only will this allow us to react when the deterioration, but will greatly reduce a child experiencing stress.

• The period of recovery. At this stage you need to drink a lot of water or unsweetened weak tea – juices, and soft drinks should be avoided. Also need more rest, try not to fall under the influence of stress and stick to a simple sparing diet: boiled, steamed, or anything that could cause flatulence, no caffeine, and food additives. The bread is slightly dried, porridge is well cooked, the meat is white. Less salt and spices.

In remission you can do the main treatment, which is reduced actually to the change of lifestyle to more healthy. You will need:

• To change the sleep mode. The day should sleep about eight hours to go until midnight, at the same time, and at the same time to get up.
• To change the habit to physical exercise. Suffering from cyclic vomiting syndrome is often recommended activity, which affects not only the body but on the mind. Yoga is well-suited, smooththerapeutic exercises, Jogging in the morning in the Park. Thus it is necessary to do not too intense, not to exhaustion – or you can start a new attack. You can also just walk.
• To change the habit of eating. People suffering from cyclic vomiting syndrome, suggest there are not three times a day in large quantities, and six times in small portions. Not worth it to skip Breakfast and have dinner later than two hours before bedtime. More boiled, steamed, less fried and salty. However, if the products are not trigger specific diet is not required. Enough to improve nutrition in General.
• To reduce the level of stress. The doctor may refer the patient to a psychologist or prescribe sedatives. Sometimes the patient to cope themselves – do yoga, start to meditate, drink soothing herbs instead of tea. Sometimes in the course of diagnostics it is detected by the depression and then the treatment begins with the therapist.

It is very important to provide support to children suffering from cyclic vomiting syndrome, because if the attack will begin in front of other children, it is likely to cause ridicule and rejection. It is useful to talk to the child to take him to a psychologist or to meet with other children who have the same problem.

In addition to lifestyle changes, your doctor may prescribe drugs against migraine. It may help, may not help, but usually the prescription is issued anyway, on trial.

May also be assigned primary support and vitamins.

The details of treatment

To treat cyclic vomiting syndrome is difficult and you need to take into account the individual features:

• Despite the fact that the syndrome is considered to be mainly children, it occurs in adults. And if you have children, the disease may eventually pass itself, then adults need to be careful to avoid triggers and make changes in your lifestyle to improve the condition.
• Diagnosis is possible only by eliminating all other options. This examination should be as complete and partial surveys may have to pay.
• The disease is curable. You may need a long time to find drugs or to use them in combinations to achieve a result, but the cyclic vomiting syndrome is not a sentence.

To cope with the disease, it is not enough just to follow the doctor's instructions. You need to persevere and act with optimism, and to seek support from people who have already faced this problem. To do this, in big cities there are support groups for people suffering from the syndrome is to sign up and not act alone, but with others to be a great solution and a great help on the way.