Symptoms:

Cyclic vomiting syndrome causes severe vomiting, nausea and gagging — sometimes as often as 12 times an hour. Episodes in children generally last only a day or two, but adults can have symptoms for almost a week. Adults tend to have about four episodes a year, while children have about 12. Episodes typically begin late at night or first thing in the morning.

Other common signs and symptoms include pallor and exhaustion. Some people are also sensitive to light during cyclic vomiting episodes and may develop:

• Headache.
• Fever.
• Dizziness.
• Diarrhea.
• Abdominal pain.

Causes:

The cause of cyclic vomiting syndrome is unknown, but the bouts of vomiting that characterize the condition can be triggered by:

• Colds, allergies or sinus problems.
• Emotional stress or excitement.
• Foods such as chocolate or cheese.
• Overeating, or eating right before going to bed.
• Hot weather or physical exhaustion.
• Menstruation.
• Motion sickness.

Risk factors:

Many children who have cyclic vomiting syndrome have a family history of migraine or begin having migraines themselves when they get older. Abdominal migraine — a type of migraine more common in children — causes abdominal pain but not the severe vomiting associated with cyclic vomiting syndrome.

Complications:

• Cyclic vomiting syndrome can cause the following complications:
• Dehydration. Excessive vomiting causes the body to lose water quickly. This can also lead to an imbalance in electrolytes, the important salts needed to keep the body working properly. In severe cases, hospital treatment is required.
• Injury to the esophagus. The stomach acid that comes up with the vomit can damage the tube that connects the mouth and stomach (esophagus). Sometimes the esophagus becomes so irritated, it bleeds.
• Tooth decay. The acid in the vomit can corrode tooth enamel.

Treatments and drugs:

There's no cure for cyclic vomiting syndrome. Severe bouts may require hospitalization for administration of intravenous fluids. Anti-nausea drugs and sedatives also may be delivered intravenously.
In many cases, the same types of medications used for migraines often help stop or even prevent episodes of cyclic vomiting. These medications include:

• Tricyclic antidepressants, such as amitriptyline and nortriptyline.
• Triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig).
• Analgesics, such as ibuprofen (Advil, Motrin, others).