Abstract

Cyclic vomiting syndrome is defined by recurrent stereotypical episodes of severe nausea and vomiting lasting from hours to days, followed by asymptomatic periods. The prevalence ranges between 1.9-2.3% and is slightly more predominant in females. The etiology is still unknown, but it is thought to be associated with comorbidities such as migraines, anxiety and panic disorder. The syndrome mostly occurs among children, but can affect people of all ages. Associated symptoms are non-specific and may cause diagnostic difficulties, which leads to diagnostic delay and dissatisfaction among patients. Cyclic vomiting syndrome has four phases: interictal, prodromal, emetic and recovery. During the interictal phase, the therapeutic goal is to prevent episodes
by avoidance of identified triggers, maintenance of good sleep hygiene, hydration and regular exercise. Reassurance and guidance, as well as cognitive-behavioral therapy, may help reduce the frequency of attacks. In the prodromal and emetic phase, abortive therapy with antimigraines, antiemetics and sedatives may be necessary. If non-pharmacologic interventions are not effective in preventing episodes, the use of pharmacologic prophylactic therapy is recommended. Children can outgrow their symptoms but most of them develop migraine headaches in adulthood.