Cyclic vomiting syndrome is an idiopathic disorder characterized by recurring episodes of forceful vomiting followed by an absence of vomiting between cycles. Onset is acute. Episodes may last 24-48 hours in children or 3-6 days in adults; they follow a pattern unique to the patient. The average age of diagnosis is 9.6 years of age. Symptom-free intervals vary by individual but average 3 months.
Prodromal or concurrent signs and symptoms of cyclic vomiting syndrome include nausea, pallor, abdominal or epigastric pain, lethargy, headache, anorexia, diarrhea, photophobia, and fever. Studies show a link between cyclic vomiting syndrome and migraine headaches. Other associations include metabolic (food allergy), mitochondrial, catamenial, and endocrine disorders.
Cyclic vomiting syndrome
Alerts and Notices
Synopsis
Codes
ICD10CM:
G43.A0 – Cyclical vomiting, not intractable
SNOMEDCT:
18773000 – Cyclic Vomiting Syndrome
G43.A0 – Cyclical vomiting, not intractable
SNOMEDCT:
18773000 – Cyclic Vomiting Syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Gastric outlet obstruction
- Volvulus
- Gastroesophageal reflux disease – vomiting is less severe in nature and not cyclic
- Gastroparesis
- Migraine
- Seizure disorder
- Demyelinating disorder
- Psychiatric illness (eg, rumination disorder)
- Irritable bowel syndrome
- Gastrointestinal malignancy (see gastric cancer)
- Drug use (eg, marijuana [see cannabinoid hyperemesis syndrome], narcotics [see sympathomimetic toxicity])
- Obstruction of the third or fourth ventricle of the brain (see hydrocephalus)
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Management Pearls
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Therapy
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References
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Last Reviewed:05/31/2018
Last Updated:01/12/2022
Last Updated:01/12/2022