Medically Reviewed by Dr. K on 3 March 2021
Table of contents
Cyclic Vomiting Syndrome & Abdominal Migraines
Cyclic vomiting syndrome (CVS) and abdominal migraines (AM) are separate diseases causing abdominal discomfort. They each have overlapping symptoms, however are treated differently.
Both CVS and AM are related to a condition known as migraine headaches. Migraine headaches cause throbbing pain, leading to nausea and sensitivities to light and sound. CVS and AM happen most frequently in children, and they often outgrow these conditions when they’re teenagers. Patients with CVS and AM are healthy with no pain between episodes of attacks.
Abdominal migraines attack in episodes lasting 3 days. Symptoms include stomach discomfort and pain, nausea or vomiting. Some patients can appear pale and tired during these episodes.
Cyclic vomiting syndrome attacks with episodes of intense nausea, vomiting, and occasional stomach discomfort. On occasion, these episodes are so bad that patients are required to be admitted to the hospital for treatment.
Who Gets CVS and AM?
Abdominal migraines affect 1% to 4% of children, affecting girls more than boys.
AM is more common than CVS. CVS affects boys more than girls, and affects Caucasian children more than other races.
CVS and AM have no clear causes, however there are a list of triggers that increase the likelihood of developing an episode.
- travel sickness
- Stress – physical or emotional
- Sinus infections
- Chest infections
- Hot weather
- Anxiety or nervousness
- flashing lights
- Foods like chocolate, processed meats, monosodium glutamate (MSG)
- Irregular sleeping times
- Irregular meal times
Associations between AM and CVS?
Both CVS and AM are associated with migraine headaches. Children with migraines are more predisposed to also getting cyclic vomiting syndrome.
Children with abdominal migraines are predisposed to developing migraine headaches with age. There will also be a family history of migraines associated with AM.
CVS is a diagnosis of exclusion. It is generally diagnosed after excluding other potential causes like food poisoning, other digestive issues or the flu. A full history will be taken, to also include medical history and family history. A complete physical exam will also be carried out. A full blood test profile, urine test panel, and X-rays will also be required to rule out any underlying conditions. Once all the tests have been completed, a gastroenterology review may be then required to further investigate with specialist testing.
AM is also a diagnosis of exclusion, in which other underlying causes must be first excluded to reach this diagnosis. If recurring symptoms like stomach discomfort, nausea, vomiting or loss of appetite persists; abdominal migraine will then be considered as the reason for the symptoms experienced.
There are no specific treatments used for AM, however medication used for migraine headaches will help.
For CVS, anti-nausea medication, antacids for abdominal discomfort and anti-anxiolytics for anxiety may offer some relief.
Patients who are constantly nauseas and actively vomiting, will become dehydrated with time. In these cases, it is advised that these patients go to hospital for treatment to replace fluids and minerals.
Managing AM and CVS
Knowing what triggers set off your AM or CVS attacks will greatly help you plan your life around your illness. A symptom diary is one very affective way of identifying what potential triggers set off your symptoms.
There is no known cure currently for AM or CVS, however there are clear steps your doctor can use to help guide you to manage your symptoms. There are also clinical trials underway that are testing new medications that could potential be used in the management of AM or CVS.
Referenced on 2.3.2021:
- International Headache Society, International Classification of Headache Disorders, third edition (Beta version).
- American Migraine Foundation: “Abdominal Migraine."
- University of Chicago Pediatrics Clerkship: “Abdominal Migraine and Cyclic Vomiting Syndrome."
- National Institute of Diabetes and Digestive and Kidney Diseases: “Cyclic Vomiting Syndrome."
- Cephalalgia: “Abdominal migraine."
- Cyclic Vomiting Syndrome Association.
- Gastroenterology: “Childhood Functional Gastrointestinal Disorders: Child/Adolescent."
- American Journal of Clinical Nutrition: “Food sources of nitrates and nitrites."
- Clinical and Translational Allergy: “Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence."
- Headache: “Abdominal Migraine: An Under-Diagnosed Cause of Recurrent Abdominal Pain in Children."