Find us on Google+ Gastroparesis: migraines

Copyright

“You agree that you will not modify, copy, reproduce, sell, or distribute any content in any manner or medium without permission."
Showing posts with label migraines. Show all posts
Showing posts with label migraines. Show all posts

Saturday, August 17, 2019

How and Why does Temperature Affect Chronic Illness?

I have wondered why temperature has affected chronic illnesses for a while.  I have a few chronic illnesses (Ehlers Danlos Syndrome, Gastroparesis, Complex Regional Pain Syndrome, Endometriosis, Poly-cystic Ovaries, etc.) and I have noticed that when I am in extreme heat or extreme cold that I become dizzy, nauseated, and feel like I am about to pass out.  Additionally, I have noticed that pressure changes and storms effect me in the same ways. I can always tell when it is going to rain before it actually does. I wanted to research why this happens and what a person with a chronic illness can do about temperature changes and how it affects their illness.


CVS Speaks,  an organization that, "We are social media outreach organization. We are all volunteer run. We seek to raise awareness of Cyclic Vomiting Syndrome. We seek to help all people of CVS find a support group that fits their needs. We also support and assist admin of a variety of groups maintain the highest quality groups on FACEBOOK," sent me an article on this topic that I found interesting and wanted to share.












According to Just Another Moment,



"Temperature – rapid changes in temperature can either trigger fibromyalgia/chronic pain flare-ups or help ease them. Cold weather is known to contract and tense up your muscles, and this undoubtedly affects your nerves, leading to more aggravation of existing chronic pain.
Wind – whether it’s a full force storm or a light wind, it’s been found to trigger both headaches and muscle pain, again associated with tense muscles and colder air.  
Pressure – barometric pressure is a measurement of the weight that’s exerted by the air around us. A drastic change in this pressure, for example, a sunny day to a sudden storm, can trigger muscle pain and cause flare-ups."
"TEMPERATURE SENSITIVITY EXPLAINED
Temperature sensitivity is thought to be caused by hormonal imbalances, that’s the short answer. 
The longer answer is that our body temperature is regulated by the hypothalamus. What’s the hypothalamus? It’s a section of your brain that’s responsible for hormone production. The hypothalamus isn’t the only thing responsible for controlling body temperature though, so is your thyroid. 
An overactive thyroid can cause you to feel too hot, and an underactive thyroid can cause you to feel too cold. Interestingly your thyroid gland is actually controlled by the pituitary gland, and I bet you can guess what I’m about to say next. Your pituitary gland is regulated by the hypothalamus, and anything that disrupts this will disrupt your thyroid function. 
It can be a bit confusing, and you might be asking why this is even connected to explaining why you struggle with temperature sensitivity. Well, it seems that most fibromyalgia symptoms are triggered by imbalances in your hormone levels, and we’ve just explained how these hormones are responsible for regulating your body temperature… 
So, the result is the inability to regulate your body temperature, meaning you’re either too hot or too cold most of the time.


TIPS FOR MANAGING TEMPERATURE SENSITIVITY  
Everyone is different when it comes to temperature sensitivity. Some people will feel too hot, others will feel too cold, and if you’re like me, then you’ll struggle with both throughout the day. Whether you struggle to warm up or struggle to cool down, here are some tips for both. 


HEAT SENSITIVITY 
Make sure you have a way to cool down your home, whether it’s through an air conditioning unit or a powerful fan. The first thing to do is to control the heat within your surroundings. 
Wear lightweight clothing fits loosely, you don’t want to wear tight clothes when you’re too hot as it will increase your body temperature. Also make sure to avoid dark colored clothing as these absorb heat! 
You can cool down your body temperature quickly by placing your wrists in a sink filled with cold water, or by running them under the cold tap. An ever quicker method is to apply an ice pack on your wrists. 
Another way to quickly cool down your body temperature is to have a cool bath or shower, make sure that it isn’t too cold for your body to cope with though as this can cause symptoms to flare. 
It’s incredibly important to stay hydrated as if you are overheating and sweating you can quickly become dehydrated.


COLD SENSITIVITY 
Keeping your home warm will obviously be at the top of the list for cold sensitivity. This isn’t always as easy as it sounds though, whether it’s because you can’t financially afford to keep your heating on or whether it’s because your house doesn’t heat well because of age or size. Choosing one room to spend most of your time in can help with this, choose one with a fireplace in or turn up the radiator in just that room, as well as keeping the door closed to keep in the heat you build up. 
Make sure you dress warmer, especially when it’s colder weather. Wearing thicker clothes and knitted jumpers are an easy way to keep warm. Make sure you also keep your feet warm as it’s known that if you have cold feet your body is usually cold too! 
Using a blanket to keep your body covered will keep in your body heat, and using a heatpad can provide even more warmth. 
Drink warm liquids, like tea or coffee throughout the day. Having hot meals are also a great way to warm up your body. 
Finally, taking a hot bath is an incredibly good way to warm up, as well as relaxing!"
If you would like to read more regarding winter and how temperature affects chronic pain, please check out her other articles below:

https://justanothermoment.co.uk/how-to-survive-winter-when-youre-chronically-ill/






































According to Synapse



"Temperature Control and Dysautonomia - Fact Sheet


Cold-blooded creatures take on the temperature of their surroundings. They are hot when their environment is hot and cold when their environment is cold. Cold-blooded animals are much more active in warm environments and are very sluggish in cold environments. These animals are very dependent on their environment when compared to warm blooded animals like ourselves.
Warm-blooded creatures, like mammals and birds, try to keep the inside of their bodies at a constant temperature. They do this by generating their own heat when they are in a cooler environment, and by cooling themselves when they are in a hotter environment. This independence from our environment allows warm blooded animals to live in a much broader variety of climates.




Homeostasis

It takes a lot of fuel to generate body heat and indeed a lot of fuel is needed to keep cool. Most of the food we eat is used to keep our bodies at a stable temperature with a stable amount of fluid of a stable composition.
Our bodies actually put a lot of effort into staying the same. The medical term for this process is homeostasis.
In human beings, the homeostatic regulation of body temperature involves such mechanisms as sweating when the internal temperature becomes excessive and shivering to produce heat, as well as the generation of heat through metabolic processes when the internal temperature falls too low.


          The Autonomic Nervous System (ANS)

These aspects of homeostasis are regulated through the autonomic nervous system.


The autonomic nervous system manages most of our bodily systems, including the cardiovascular system, gastrointestinal, urinary and bowel functions, temperature regulation, reproduction and our metabolic and endocrine systems. Additionally, this system is responsible for our reaction to stress - the flight or fight response.


          Sympathetic and Parasympathetic


The autonomic nervous system consists of two parts: the sympathetic system and the parasympathetic system. The sympathetic system can best be thought of as controlling the 'fight or flight' reactions of the body; producing the rapid heart rates, increased breathing and increased blood flow to the muscles that are necessary when an individual is in danger or under stress. The parasympathetic system controls the 'quiet' body functions, for instance the digestive system. In short, the sympathetic system gets the body ready for action, while the parasympathetic system gets the body ready for rest. And in most individuals the parasympathetic and sympathetic components of the autonomic nervous systems are in perfect balance, from moment to moment, depending on the body's instantaneous needs.


Dysautonomia

Brain disorders such as traumatic brain injury can affect the autonomic nerve system and result in Dysautonomia: The autonomic nervous system loses that balance and at various times the parasympathetic or sympathetic systems inappropriately predominate.


Symptoms

Symptoms can include frequent, vague but disturbing aches and pains, faintness (or even actual fainting spells), fatigue and inertia, severe anxiety attacks, tachycardia, hypotension, poor exercise tolerance, gastrointestinal symptoms such as irritable bowel syndrome, sweating, dizziness, blurred vision, numbness and tingling, anxiety and (quite understandably), depression.


A person suffering from Dysautonomia may exhibit all these symptoms and more or only one or two. It can be an acute, short lived problem or a chronic problem that will last a lifetime. There is no cure for Dysautonomia but some medications and strategies can help alleviate the symptoms.



          Management Strategies



The homeostatic regulation of body temperature may be severely impaired in a person suffering from dysautonomia and they may develop excessively high body temperatures and consequent irritability, confusion and disorientation. The treatment for a high temperature as a result of a damaged autonomic nervous system is entirely symptomatic and supportive. That is: the fever is treated but not the cause. Remember the cause is unfortunately incurable.
Essentially the treatment is to cool the person down
A wet towel across the neck can be of help as most of our body heat is lost through the head and the external carotid arteries carry large amounts of blood to the brain. Cooling this area will effectively cool the whole body from the inside out.


Drink plenty of fluids, preferably water. Other fluids, particularly alcohol or caffeine, can reduce the fluid levels in the body by increasing fluid loss through sweating or urination.


It is essential to seek medical assistance if any fever is severe or prolonged as the fever itself may damage organs including the brain, heart and kidneys.
A host of medications have been tried in patients with dysautonomia. Those most commonly felt to be useful include:
  • Tricyclic antidepressants
  • Anti-anxiety medications
  • Medications affecting high or low blood pressure and
  • Non steroidal anti-inflammatory medications.  The most effective medications will vary from person to person depending on the particular symptoms that Dysautonomia produce in them.

As with any long-term health condition, it is highly recommended that a relationship be maintained with a GP or other suitable medical professional.
References and further information
Biology Online: http://www.biology-online.org/4/1_physiological_homeostasis.htm•Dysautonomia Network: http://www.dinet.org/•The Children's Hospital at Westmead: http://www.dinet.org/"









Image Source: On Image





How and Why Does Temperature Affect Chronic Illness? 

I found some wonderful information on The Autoimmune Mom's website regarding temperature changes and chronic illnesses.  I did not realize how tough of a subject this would be to research.  It has been a real challenge. However, this website offers some wonderful information.

"Cold Weather’s Impact on Autoimmune Disease Flares + Tips For Being Outside in Fall and Winter
By: Gary Rothbard, MD, MS in Environment 


Changes in or extreme climates can often have an effect on disease conditions.  In some cases, there are certain types of weather that can be helpful in controlling or improving a condition; other times, climate can impact disorders negatively in terms of symptoms and disease progression.  Here we consider the effects of cold weather and temperatures on autoimmune disease.
Why does cold air (dry or wet) affect pain and flares in autoimmune disease?
The first thing to mention here is that autoimmune conditions come in all shapes and sizes, and as such are affected by many factors.  Some conditions, such as rheumatoid arthritis, are greatly impacted by the weather (especially cold and/or rainy), while others are minimally affected, if at all.  In contrast, other disorders show an improvement in symptoms with cooler weather and may flare on warmer days.  There is no hard and fast rule as to how weather will affect individual patients.  Having said this, the short answer is we’re not entirely sure why autoimmune flares tend to worsen in cold weather, but we do know a few things regarding this phenomenon. 
In general, weather extremes of any kind will place additional stress upon the body, which is usually not helpful for those suffering from a host of conditions, autoimmune and otherwise.  Thus, generalized stress can increase the incidence and severity of autoimmune conditions in a non-specific way, simply by adding to the heightened physiological demands of the body during such periods.  For instance, in very cold weather, bodily heat escapes quickly, leaving less energy and fewer resources available to deal with basic and enhanced requirements.  Other conditions such as cold agglutinin disease, which is a variant of autoimmune hemolytic anemia, only occur during periods of lowered body temperature.  
This emotional and/or physical stress can leave an autoimmune sufferer more susceptible to flares, which might be better controlled in more temperate weather (though sometimes the opposite is true; it is a very individualized presentation). 
More specifically, it seems that one likely cause of cold-induced pain in many cases is the fact that smaller blood vessels tend to spasm in low temperatures, which leads to a restriction of blood flow to the associated areas.  This is known as Raynaud’s phenomenon when it is secondary to an established autoimmune disease (or Raynaud’s disease when it appears on its own) and it is something that many autoimmune patients know all too well, as it often occurs in conjunction with various autoimmune conditions.  The spasms can cause extreme pain, swelling, numbness and discoloration, and they occur most prominently in the fingers, toes, ears and nose (because these are all areas with very small vessels and therefore less blood flow and adaptive ability).  It is possible, though not certain, that similar problems in larger joints (and therefore vessels) are related in terms of pathology.
Another potential but controversial explanation for joint inflammation during certain types of weather involves the postulation that lower barometric pressure leads to increased swelling in the joint spaces.
Are there any studies done on brief breaks from cold weather, e.g., beach vacation in winter, and helping to reduce joint pain and other symptoms from the cold? 
Unfortunately, the literature is fairly sparse in this area, and it appears that there hasn’t been a great deal of research or investigation into the causes of or remedies for such flares.  There is one unofficial site, written by a doctor, that does a decent job of collecting most of the available research on the topic and providing brief summaries. 
  Another brief response from a different physician (not a study, just clinical advice) advises that in most cases the best weather for autoimmune patients is warm and dry, such as in the Southwest.  But again, this will vary from patient to patient, and what works for one may be detrimental to another.  Otherwise, not much else was found upon literature review. 
What is the best way to combat cold weather effects on pain and inflammation?
There is unfortunately no secret weapon used to combat such effects in those diagnosed with autoimmune disease.  That is, there is really nothing special one can do in cases of autoimmune conditions, other than the normal measures anyone would take in extreme cold to prevent complications.  Still, there are several effective ways to prevent or at least mitigate the negative impact cold weather has on some autoimmune sufferers. 
Just as is the case in people without autoimmune conditions, extreme cold requires some contemplation and preparation.  On particularly cold days, one should dress in layers, being sure to wear gloves and a hat; this serves the dual purposes of keeping joints warm and more flexible, and reducing overall cold stress.  If it is absolutely necessary to remain outside for long periods, it is crucial that one plans to take breaks and go inside occasionally, preferably before symptoms can begin to flare. 
And while patients should consider exercising indoors during these temperature extremes, it is important, when doing so outdoors, to remain active for the duration, in order to keep joints and muscles warm and more flexible, making them less prone to pain and inflammation.  Finally, in extreme autoimmune cases, some people have found that changing climates (by moving) is quite helpful, though clinicians and researchers are divided on the issue, and it is, once again, very personalized as to the benefits. 
Questions for your doctor: 
  • What is the best climate, if there is one, for my condition(s)?  Is it worth considering moving?
  • What are the recommended protective/preventive measures I should take when out in extreme cold temperatures?
  • Can you provide me with any resources or information regarding the effects of cold weather on autoimmune disease, or disease in general?
  • What is your opinion of the barometric pressure theory of joint pain and swelling?
  • Are there other causes of cold weather complications in autoimmune disease, besides vessel spasms and those mentioned above?

About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians.  After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time.  He may be reached at grothbard@hotmail.com."






Image Source: HERE








Does Temperature Affect Your Digestion?

According to Everyday Health,


"Your Digestion Could Be A Matter of Degree

By  
Medically Reviewed by Last Updated:  8/7/2013 
Your tongue may crave the icy temperature of an ice pop on a steamy summer day, but your digestion may rebel. 
'Some people perspire after drinking cold liquids,' says Mark Mattar MD, a clinician and assistant professor of medicine at MedStar Georgetown University Hospital, Washington, D.C. 
The body likes to keep its core temperature steady at about 100° F., which is when the best digestion occurs. If cold temperatures — such as ice water or cold food in the diet — enter the stomach, the body works quickly to warm it.

          A Centuries-Old Science

Temperature — of the body, weather, or the foods you eat — and its effects on digestion has intrigued physicians and scientists for at least 100 years. A well-regarded professor of several New York hospitals at the turn of the last century, the late William Gilman Thompson MD, included a chapter on the topic in his 1905 book, Practical Dietetics With Special Reference to Diet in Disease.
In it, he writes: 'One may begin a dinner with iced raw oysters, then take hot soup, and later conclude the meal with ice cream, followed by hot coffee,' he said of a proposed diet. 'And yet throughout, the temperature of the stomach contents does not vary so much as half a degree.' 
Dr. Thompson came to his conclusions based on the outcomes of 'many experiments which I have made upon patients…to whom I have given fluids at different temperatures, which were immediately siphoned out of the stomach and tested for heat loss or gain.'

Warm Is Better 
Even on a hot day, warm liquids generally soothe the system, Mattar said. Colonoscopy patients find warm liquids infused in the colon help alleviate pain or spasms. And anecdotally, he said, the wisdom from our grandmothers was to drink warm liquids — the belief being that warmth caused the muscles to relax — even the minuscule muscles that support the blood vessels. 
It’s also likely that the body’s preference for warmth has to do with the latest frontier in biology, the microbiome — those trillions of microscopic bugs that live in the gut, he said.
In the lab, these microorganisms thrive in incubation. Although these bugs like a warm host, even they have their limit. While hot cocoa on a hot day probably would be fine, Mattar said, 'if it’s hotter than 100 degrees, your body will try to cool it down.'
Air Temperature 
In warm climates, the blood vessels open and more hormones circulate to aid in all systems, including digestion, Mattar said. In cold climates, everything slows down, but not too much. 
In fact, the change is so subtle, the effects of air temperature on digestion usually goes unnoticed — except in extreme cases when the core temperature drops and hypothermia sets in. Treatment generally includes blankets and possibly intravenous fluids that are a little warmer than room temperature. 'You don’t want to shock the system,' he said.

Illness and Diseases 
In the opposite extreme, when hotter becomes the new normal, there is no real consensus on treatment, Mattar said. Some people recommend blankets and warm drinks, despite the discomfort, while others report the body should be kept cool to let the fever take its course. 
Thompson added that while 'cooling drinks have long been used [to treat] fevers…to this day one occasionally meets with opposition from mothers to giving a child with high fever anything really cold.' 
Ice also can be effective in relieving nausea, and hot liquids aid in 'cleansing the mucous membrane,' Thompson said. Likewise 'hot-air baths…are of undoubted service' in treating kidney disease. 
And despite the body’s quick response to cold drinks, the cold still can irritate the bowel, possibly causing diarrhea, constipation or abdominal pain, Mattar said, but that’s not true for everyone. 
'I myself love freezing cold water,' he said. 'But if my wife drinks it, her stomach will hurt.'"







From what I have read, stomach acid plays an essential role in the immune system by killing harmful bacteria and parasites that are ingested with food, so temperature would play a part in that.  Stomach acid activates the enzyme pepsin needed for protein digestion. The stomach acid will send signals to the pancreas to produce digestive juices and enzymes to further break down food.   I put the link above so that you can read more about the enzyme pepsin, and what it does in the digestive system. 

According to Women's Health Magazine, the weather can affect the body in so many different ways, in addition to what has already been discussed in the sources I have found.  It can cause headaches and migraines, dry skin, low energy and changes in mood, vitamin D deficiencies, breathing problems, colds, joint pain, and weakened hair and nails.  The weather can even affect your blood pressure.  According to The Mayo Clinic, your blood pressure is higher in the winter and lower in the summer. 
Image Source: On Image



Monday, August 20, 2018

Cyclic Vomiting Syndrome (CVS) and Gastroparesis Part 1

As someone who suffers both from Cyclic Vomiting Syndrome (CVS) and Gastroparesis (GP), it is sometimes hard to tell the difference between the two. It is so hard to get control of my vomiting once it starts because of Cyclic Vomiting Syndrome. This will be a two part article because there is a lot of information about CVS. The second part will be about living with CVS and Gastroparesis, and how one effects the other. Let me explain what CVS is, and how it can be dangerous on top of Gastroparesis.







According to the Mayo Clinic, Cyclic Vomiting Syndrome is defined as follows,


"Cyclic vomiting syndrome is characterized by episodes of severe vomiting that have no apparent cause. Episodes can last for hours or days and alternate with symptom-free periods. Episodes are similar, meaning that they tend to start at the same time of day, last the same length of time, and occur with the same symptoms and intensity.

Cyclic vomiting syndrome occurs in all age groups, though it often begins in children around 3 to 7 years old. Although more common in children, the number of cases diagnosed in adults is increasing.

The syndrome is difficult to diagnose because vomiting is a symptom of many disorders. Treatment often involves lifestyle changes to help prevent the events that can trigger vomiting episodes. Medications, including anti-nausea and migraine therapies, may help lessen symptoms.



Symptoms

The symptoms of cyclic vomiting syndrome often begin in the morning. Signs and symptoms include:

Severe vomiting that occurs several times an hour, continues for hours to days, but lasts less than one week
Three or more separate episodes of vomiting with no apparent cause in the past six months, or five or more episodes occurring at any time
Severe nausea
Intense sweating



Other signs and symptoms during a vomiting episode may include:

Abdominal pain
Diarrhea
Fever
Dizziness
Sensitivity to light
Headache
Retching or gagging
The time between vomiting episodes is usually symptom-free.


Causes
The underlying cause of cyclic vomiting syndrome is unknown. Some possible causes include genes, digestive difficulties, nervous system problems and hormone imbalances.


Specific bouts of vomiting may be triggered by:

Colds, allergies or sinus problems
Emotional stress or excitement, especially in children
Anxiety or panic attacks, especially in adults
Foods, such as caffeine, chocolate or cheese
Overeating, eating right before going to bed or fasting
Hot weather
Physical exhaustion
Exercising too much
Menstruation
Motion sickness
Identifying the triggers for vomiting episodes may help with managing cyclic vomiting syndrome.


Risk factors
The relationship between migraines and cyclic vomiting syndrome isn't clear. But many children with cyclic vomiting syndrome have a family history of migraines or have migraines themselves when they get older. In adults, the association between cyclic vomiting syndrome and migraine may be lower.

Chronic use of marijuana (Cannabis sativa) also has been associated with cyclic vomiting syndrome because some people use marijuana to treat their symptoms.

However, cannabis can lead to a condition called cannabis hyperemesis syndrome, which typically leads to persistent vomiting without normal intervening periods. People with this syndrome often demonstrate frequent showering or bathing behavior.

Cannabis hyperemesis (hyperemesis means a lot of vomiting) syndrome can be confused with cyclic vomiting syndrome. To rule out cannabis hyperemesis syndrome, you need to stop using marijuana for at least one to two weeks to see if vomiting lessens. If it doesn't, your doctor will continue testing for cyclic vomiting syndrome.




Complications

Cyclic vomiting syndrome can cause these complications:

Dehydration. Excessive vomiting causes the body to lose water quickly. Severe cases of dehydration may need to be treated in the hospital.
Injury to the feeding tube. 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 vomit can corrode tooth enamel.




Prevention

Many people know what triggers their cyclic vomiting episodes. Avoiding those triggers can reduce the frequency of episodes. While you may feel well between episodes, it's very important to take medications as prescribed by your doctor.

If episodes occur more than once a month or require hospitalization, your doctor may recommend preventive medicine, such as amitriptyline, propranolol (Inderal), cyproheptadine and topiramate.



Lifestyle changes also may help, including:

Getting adequate sleep
Downplaying the importance of upcoming events because excitement can be a trigger
Avoiding trigger foods, such as caffeine, cheese and chocolate
Eating small meals and small carbohydrate-containing snacks daily at regular times




When to see a doctor

Call your doctor if you see blood in your or your child's vomit.

Continued vomiting may cause severe dehydration that can be life-threatening. Call your doctor if you or your child is showing symptoms of dehydration, such as:

Excess thirst
Less urination
Dry skin
Exhaustion and listlessness




Diagnosis

Cyclic vomiting syndrome can be difficult to diagnose. There's no specific test to confirm the diagnosis, and vomiting is a sign of many conditions that must be ruled out first.

The doctor will start by asking about your child's or your medical history and conducting a physical exam. The doctor will also want to know about the pattern of symptoms that you or your child experiences.


After that, the doctor may recommend:

Imaging studies — such as endoscopy, ultrasound or a CT scan — to check for blockages in the digestive system or signs of other digestive conditions
Motility tests to monitor the movement of food through your digestive system and to check for digestive disorders
Laboratory tests to check for thyroid problems and other metabolic conditions
Treatment
There's no cure for cyclic vomiting syndrome, though many children no longer have vomiting episodes by the time they reach adulthood. For those experiencing cyclic vomiting episode, treatment focuses on controlling the signs and symptoms. You or your child may be prescribed:

Anti-nausea drugs
Pain-relieving medications
Medications that suppress stomach acid
Antidepressants
Anti-seizure medications
The same types of medications used for migraines can sometimes help stop or even prevent episodes of cyclic vomiting. These medications may be recommended for people whose episodes are frequent and long lasting, or for people with a family history of migraine.

IV fluids may need to be given to prevent dehydration. Treatment is individualized based on the severity and duration of symptoms as well as the presence of complications.






Lifestyle and home remedies

Lifestyle changes can help control the signs and symptoms of cyclic vomiting syndrome. People with cyclic vomiting syndrome generally need to get adequate sleep. Once vomiting begins, it may help to stay in bed and sleep in a dark, quiet room.

When the vomiting phase has stopped, it's very important to drink fluids, such as an oral electrolyte solution (Pedialyte) or a sports drink (Gatorade, Powerade, others) diluted with 1 ounce of water for every ounce of sports drink. Some people may feel well enough to begin eating a normal diet soon after they stop vomiting. But if you don't or your child doesn't feel like eating right away, you might start with clear liquids and then gradually add solid food.

If vomiting episodes are triggered by stress or excitement, try during a symptom-free interval to find ways to reduce stress and stay calm. Eating small meals and small carbohydrate-containing snacks daily, instead of three large meals, also may help.




Alternative medicine

Alternative and complementary treatments may help prevent vomiting episodes, although none of these treatments has been well-studied.


These treatments include:

Coenzyme Q10 (ubiquinone), a natural substance made in the body that is available as a supplement. Coenzyme Q10 assists with the basic functions of cells.
L-carnitine, a natural substance that is made in the body and is available as a supplement. L-carnitine helps your body turn fat into energy.
L-carnitine and coenzyme Q10 may work by helping your body overcome difficulty in converting food into energy (mitochondrial dysfunction). Some researchers believe mitochondrial dysfunction may be a factor causing both cyclic vomiting syndrome and migraine.

Be sure to see a doctor and have the diagnosis of cyclic vomiting syndrome confirmed before starting any supplements. Always check with your doctor before taking any supplements to be sure you or your child is taking a safe dose and that the supplement won't adversely interact with any medications you're taking. Some people may experience side effects from L-carnitine and coenzyme Q10 that are similar to the symptoms of cyclic vomiting syndrome, including nausea, diarrhea and loss of appetite.





Coping and support

Because you never know when the next episode might occur, cyclic vomiting syndrome can be difficult for the whole family. Children may be especially concerned, and may worry constantly that they'll be with other children when an episode happens.

You or your child may benefit from connecting with others who understand what it's like to live with the uncertainty of cyclic vomiting syndrome. Ask your doctor about support groups in your area.






Preparing for your appointment

You're likely to start by seeing your primary care doctor or your child's pediatrician. But you may be referred immediately to a digestive diseases specialist (gastroenterologist). If you or your child is in the middle of a severe vomiting episode, the doctor may recommend immediate medical care.

Here's some information to help you get ready for your appointment and know what to expect from the doctor.



What you can do

Keep a record of any symptoms, including how often vomiting occurs and any typical triggers you may have noticed, such as food or activity.
Write down key medical information, including other diagnosed conditions.
Write down key personal information, including dietary habits and any major stresses or recent changes — both positive and negative — in your child's life or yours.
Bring a list of all medications, vitamins or supplements that you or your child takes.
Write down questions to ask the doctor.
Questions to ask the doctor




Some basic questions to ask the doctor include:

What's the most likely cause of these symptoms?
Are any tests needed?
Do you think this condition is temporary or long lasting?
What treatments do you recommend?
Is there a medication that can help?
Are there any dietary restrictions that can help?
Don't hesitate to ask other questions that occur to you during your appointment.






What to expect from the doctor

Be ready to answer questions your doctor may ask:

When did you or your child begin experiencing symptoms?
How often does an episode of severe vomiting occur, and how many times do you or does your child typically vomit?
How long do the episodes typically last?
Do you or does your child experience abdominal pain?
Have you noticed any warning signs that an episode is coming, such as loss of appetite or feeling unusually tired, or any common triggers, such as intense emotions, illness or menstruation?
Have you or has your child been diagnosed with any other medical problems, including mental health conditions?
What treatments, including over-the-counter medications and home remedies, are you or your child taking for other conditions?
Does anything seem to improve the symptoms or shorten the duration of an episode?
Do you or does your child have any history of severe headaches?
Does anyone in your family have a history of cyclic vomiting syndrome or of migraines?
Do you or your child use cannabis in any form? If so, how often?
What you can do in the meantime
The doctor will likely want to see you or your child immediately if an episode of severe vomiting is underway. But if the vomiting has passed, get plenty of rest, drink extra fluids and follow an easy-to-digest diet. It's also a good idea to avoid caffeinated beverages or foods containing caffeine, as these may trigger symptoms."






The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting. Source: https://www.niddk.nih.gov/health-information/digestive-diseases/cyclic-vomiting-syndrome/symptoms-causes






According to the National Institute of Diabetes and Digestive and Kidney Diseases,

"Definitions & Facts for Cyclic Vomiting Syndrome

What is cyclic vomiting syndrome?

Cyclic vomiting syndrome, or CVS, is a functional gastrointestinal (GI) disorder that causes sudden, repeated attacks—called episodes—of severe nausea and vomiting. Episodes can last from a few hours to several days. The episodes are separated by periods without nausea or vomiting. The time between episodes can be a few weeks to several months. Episodes can happen regularly or at random. Episodes can be so severe that you may have to stay in bed for days, unable to go to school or work. You may need treatment at an emergency room or a hospital during episodes. Cyclic vomiting syndrome can affect you for years or decades.

CVS is not chronic vomiting that lasts weeks without stopping. CVS is not a condition that has a definite cause, such as chemotherapy.



How common is cyclic vomiting syndrome?

Experts don’t know how common cyclic vomiting syndrome is in adults. However, experts believe that cyclic vomiting syndrome may be just as common in adults as in children. Doctors diagnose about 3 out of 100,000 children with cyclic vomiting syndrome every year.



You may be more likely to get cyclic vomiting syndrome if you have:

migraines or a family history of migraines
a history of long-term marijuana use
a tendency to get motion sickness
Among adults with cyclic vomiting syndrome, about 6 out of 10 are Caucasian.


People with cyclic vomiting syndrome may have other health problems, including:

migraines
anxiety and depression
gastroparesis
autonomic nervous system disorders
high blood pressure
gastroesophageal reflux disease
irritable bowel syndrome




What are the complications of cyclic vomiting syndrome?

The severe vomiting and retching that happen during cyclic vomiting episodes may cause the following complications:

dehydration
esophagitis
Mallory-Weiss tears
tooth decay or damage to tooth enamel
References
[1] Drumm BR, Bourke B, Drummond J, et al. Cyclical vomiting syndrome in children: a prospective study. Neurogastroenterology and Motility. 2012;24(10):922–927.

[2] Bhandari S, Venkatesan T. Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Digestive Diseases and Sciences. 2017;62(8):2035–2044.

December 2017




Symptoms & Causes of Cyclic Vomiting Syndrome


What are the main symptoms of cyclic vomiting syndrome?

The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting. You may vomit several times an hour. Episodes can last from a few hours to several days. Episodes may make you feel very tired and drowsy.

Each episode of cyclic vomiting syndrome tends to start at the same time of day, last the same length of time, and happen with the same symptoms and intensity as previous episodes. Episodes may begin at any time but often start during the early morning hours.

The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting.





What are some other symptoms of cyclic vomiting syndrome?


Other symptoms of cyclic vomiting syndrome may include one or more of the following:

retching—trying to vomit but having nothing come out of your mouth, also called dry vomiting
pain in the abdomen
abnormal drowsiness
pale skin
headaches
lack of appetite
not wanting to talk
drooling or spitting
extreme thirst
sensitivity to light or sound
dizziness
diarrhea
fever



What are the phases of cyclic vomiting syndrome?

Cyclic vomiting syndrome has four phases:

prodrome phase
vomiting phase
recovery phase
well phase






Source: https://www.researchgate.net/figure/Schematic-representation-of-the-four-phases-of-Cyclic-Vomiting-Syndrome-and-their_fig2_7402882





How do the symptoms vary in the phases of cyclic vomiting syndrome?

The symptoms will vary as you go through the four phases of cyclic vomiting syndrome:

Prodrome phase. During the prodrome phase, you feel an episode coming on. Often marked by intense sweating and nausea—with or without pain in your abdomen—this phase can last from a few minutes to several hours. Your skin may look unusually pale.
Vomiting phase. The main symptoms of this phase are severe nausea, vomiting, and retching. At the peak of this phase, you may vomit several times an hour. You may be quiet and able to respond to people around you and unable to move and unable to respond to people around you. You may have twisting and moaning with intense pain in your abdomen. The nausea and vomiting can last from a few hours to several days.

Recovery phase. Recovery begins when you stop vomiting and retching and you feel less nauseated. You may feel better gradually or quickly. The recovery phase ends when your nausea stops and your healthy skin color, appetite, and energy return.

Well phase. The well phase happens between episodes. You have no symptoms during this phase.



When should I seek medical help?


You should seek medical help if:

the medicines your doctor recommended or prescribed for the prodrome phase don’t relieve your symptoms
your episode is severe and lasts more than several hours
you are not able to take in foods or liquids for several hours
You should seek medical help right away if you have any signs or symptoms of dehydration during the vomiting phase.


These signs and symptoms may include:

extreme thirst and dry mouth
urinating less than usual
dark-colored urine
dry mouth
decreased skin turgor, meaning that when your skin is pinched and released, the skin does not flatten back to normal right away
sunken eyes or cheeks
light-headedness or fainting


If you are a parent or caregiver of an infant or child, you should seek medical care for them right away if they have any signs and symptoms of dehydration during the vomiting phase.


These signs and symptoms may include:

thirst
urinating less than usual, or no wet diapers for 3 hours or more
lack of energy
dry mouth
no tears when crying
decreased skin turgor
sunken eyes or cheeks
unusually cranky or drowsy behavior




Source: On Image.







What causes cyclic vomiting syndrome?

Experts aren’t sure what causes cyclic vomiting syndrome.


However, some experts believe the following conditions may play a role:

problems with nerve signals between the brain and digestive tract
problems with the way the brain and endocrine system react to stress
mutations in certain genes that are associated with an increased chance of getting CVS



What may trigger an episode of cyclic vomiting?

Triggers for an episode of cyclic vomiting may include:

emotional stress
anxiety or panic attacks , especially in adults
infections, such as colds, flu, or chronic sinusitis
intense excitement before events such as birthdays, holidays, vacations, and school outings, especially in children
lack of sleep
physical exhaustion
allergies
temperature extremes of hot or cold
drinking alcohol
menstrual periods
motion sickness
periods without eating (fasting)
Eating certain foods, such as chocolate, cheese, and foods with monosodium glutamate (MSG) may play a role in triggering episodes.




Diagnosis of Cyclic Vomiting Syndrome


How do doctors diagnose cyclic vomiting syndrome?

Doctors diagnose cyclic vomiting syndrome based on family and medical history, a physical exam, pattern of symptoms, and medical tests. Your doctor may perform medical tests to rule out other diseases and conditions that may cause nausea and vomiting.



Family and medical history

Your doctor will ask about your family and medical history. He or she may ask for details about your history of health problems such as migraines , irritable bowel syndrome, and gastroparesis. Your doctor may also ask about your history of mental health problems, use of substances such as marijuana, and cigarette smoking.



Physical exam


During a physical exam, your doctor will:

examine your body
check your abdomen for unusual sounds, tenderness, or pain
check your nerves, muscle strength, reflexes, and balance
Pattern or cycle of symptoms in children




A doctor will often suspect cyclic vomiting syndrome in a child when all of the following are present[3]:

at least five episodes over any time period, or a minimum of three episodes over a 6-month period
episodes lasting 1 hour to 10 days and happening at least 1 week apart
episodes similar to previous ones, tending to start at the same time of day, lasting the same length of time, and happening with the same symptoms and intensity
vomiting during episodes happening at least four times an hour for at least 1 hour
episodes are separated by weeks to months, usually with no symptoms between episodes
after appropriate medical evaluation, symptoms cannot be attributed to another medical condition
Pattern or cycle of symptoms in adults





A doctor will often suspect cyclic vomiting syndrome in adults when all of the following are present[4]:

three or more separate episodes in the past year and two episodes in the past 6 months, happening at least 1 week apart
episodes that are usually similar to previous ones, meaning that episodes tend to start at the same time of day and last the same length of time—less than 1 week
no nausea or vomiting between episodes, but other, milder symptoms can be present between episodes
no metabolic , gastrointestinal , central nervous system , structural, or biochemical disorders
A personal or family history of migraines supports the doctor’s diagnosis of cyclic vomiting syndrome.

Your doctor may diagnose cyclic vomiting syndrome even if your pattern of symptoms or your child’s pattern of symptoms do not fit the patterns described here. Talk to your doctor if your symptoms or your child’s symptoms are like the symptoms of cyclic vomiting syndrome.





Source on Image.






What medical tests do doctors use to diagnose cyclic vomiting syndrome?

Doctors use lab tests, upper GI endoscopy, and imaging tests to rule out other diseases and conditions that cause nausea and vomiting. Once other diseases and conditions have been ruled out, a doctor will diagnose cyclic vomiting syndrome based on the pattern or cycle of symptoms.





Lab tests

Your doctor may use the following lab tests:

Blood tests can show signs of anemia, dehydration, inflammation, infection, and liver problems.
Urine tests can show signs of dehydration, infection, and kidney problems.
Blood and urine tests can also show signs of mitochondrial diseases .


Upper GI endoscopy

Your doctor may perform an upper GI endoscopy to look for problems in your upper digestive tract that may be causing nausea and vomiting.


Imaging tests

A doctor may perform one of more of the following imaging tests:

Ultrasound of the abdomen.
Gastric emptying test, also called gastric emptying scintigraphy. This test involves eating a bland meal, such as eggs or an egg substitute, that contains a small amount of radioactive material. An external camera scans the abdomen to show where the radioactive material is located. A radiologist can then measure how quickly the stomach empties after the meal. Health care professionals perform gastric emptying tests only between episodes.
Upper GI series.
MRI scan or CT scan of the brain.
References
[3] Li BU, Lefevre F, Chelimsky GG, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition consensus statement on the diagnosis and management of cyclic vomiting syndrome. Journal of Pediatric Gastroenterology and Nutrition. 2008;47(3):379–393.

[4] Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380–1392.



Treatment of Cyclic Vomiting Syndrome


How do doctors treat cyclic vomiting syndrome?


How doctors treat cyclic vomiting syndrome depends on the phase. Your doctor may:

prescribe medicines
treat health problems that may trigger the disorder
recommend
staying away from triggers
ways to manage triggers
getting plenty of sleep and rest
Prodrome phase
Taking medicines early in this phase can sometimes help stop an episode from happening.



Your doctor may recommend over-the-counter medicines or prescribe medicines such as:

ondansetron (Zofran) or promethazine (Phenergan) for nausea
sumatriptan (Imitrex) for migraines
lorazepam (Ativan) for anxiety
ibuprofen for pain




Your doctor may recommend over-the-counter medicines to reduce the amount of acid your stomach makes, such as:

famotidine (Pepcid)
ranitidine (Zantac)
omeprazole (Prilosec)
esomeprazole (Nexium)






Source (and to read this study): https://www.researchgate.net/publication/263779154_Resistant_Cyclic_Vomiting_Syndrome_Successfully_Responding_to_Chlorpromazine






Vomiting phase
During this phase, you should stay in bed and sleep in a dark, quiet room. You may have to go to a hospital if your nausea and vomiting are severe or if you become severely dehydrated.




Your doctor may recommend or prescribe medication for the following for children and adults:

nausea
migraines
anxiety
pain
medicines that reduce the amount of acid your stomach makes
During the vomiting phase, you should stay in bed and sleep in a dark, quiet room.



If you go to a hospital, your doctor may treat you with:

intravenous (IV) fluids for dehydration
medicines for symptoms
IV nutrition if an episode continues for several days


Recovery phase
During the recovery phase, you may need IV fluids for a while.



Your doctor may recommend that you drink plenty of water and liquids that contain glucose and electrolytes, such as:

broths
caffeine-free soft drinks
fruit juices
sports drinks
oral rehydration solutions, such as Pedialyte
If you’ve lost your appetite, start drinking clear liquids and then move slowly to other liquids and solid foods. Your doctor may prescribe medicines to help prevent future episodes.


Well phase
During the well phase, your doctor may prescribe medicines to help prevent episodes and how often and how severe they are, such as:

amitriptyline (Elavil)
cyproheptadine (Periactin)
propranolol (Inderal)
topiramate (Topamax)
zonisamide (Zonegran)
Your doctor may also recommend coenzyme Q10 , levocarnitine (L-carnitine), or riboflavin as dietary supplements to help prevent episodes.



How can I prevent cyclic vomiting syndrome?

Knowing and managing your triggers can help prevent cyclic vomiting syndrome, especially during the well phase.

You should also:

get enough sleep and rest
treat infections and allergies
learn how to reduce or manage stress and anxiety
avoid foods and food additives that trigger episodes



How do doctors treat the complications of cyclic vomiting syndrome?

Doctors treat the complications of cyclic vomiting syndrome as follows:

dehydration — plenty of liquids with glucose and electrolytes; or IV fluids and hospitalization for severe dehydration
esophagitis — medicines to reduce the amount of acid your stomach makes
Mallory-Weiss tears — medicines or medical procedures to stop bleeding if the tears don’t heal on their own, which they generally do
tooth decay - or damage to tooth enamel—dental fillings , fluoride toothpaste, or mouth rinses





Source: https://www.google.com/url?sa=i&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwi137Kl6vvcAhVI3FMKHYMFBewQjRx6BAgBEAU&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DxnC1M1mIPIE&psig=AOvVaw2TfxZE740rfSQwa0jNtRSk&ust=1534860908500786





Eating, Diet, & Nutrition for Cyclic Vomiting Syndrome

How can my diet help prevent or relieve cyclic vomiting syndrome?

Your diet will not help prevent or relieve episodes but will help you recover and keep you healthy.

Your doctor may recommend coenzyme Q10 , levocarnitine, (L-carnitine), or riboflavin as dietary supplements to help prevent episodes.



What should I eat and drink if I have cyclic vomiting syndrome?

When your nausea and vomiting stop, you can generally go back to your regular diet right away. In some cases, you may want to start with clear liquids and go slowly back to your regular diet. You should eat well-balanced and nutritious meals between your episodes. Your doctors will recommend that you not skip meals in between episodes.



If you are dehydrated, drink plenty of liquids that contain glucose and electrolytes, such as:

broths
caffeine-free soft drinks
fruit juices
sports drinks
oral rehydration solutions, such as Pedialyte
Family eating nutritious foods.
You should eat well-balanced and nutritious meals between your cyclic vomiting episodes.
What should I avoid eating if I have cyclic vomiting syndrome?
In between episodes, you should avoid eating foods that may have triggered past episodes. Eating certain foods such as chocolate, cheese, and foods with monosodium glutamate (MSG), may trigger an episode in some people. Adults should avoid drinking alcohol.


Clinical Trials for Cyclic Vomiting Syndrome

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.



What are clinical trials and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.


What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov."



My friend Jenny has CVS and Gastroparesis. She made this image and shared it with me, so I thought I would share it with you to share her story (she is updating her story and when I receive it, I will update it here, too:





During my research into CVS, I read that it can cause abdominal migraines. There are many different types of migraines but if you would like more information on abdominal migraines, please read my blog article here: http://www.emilysstomach.com/2018/06/abdominal-migraines.html






I found this online and the source should be located in the document, but it goes into detail about Cyclic Vomiting Syndrome (CVS) with diagrams and a bit more information than Mayo provides: