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)

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 the following for children and adults:

• medicines for
  • nausea
  • migraines
  • anxiety
  • pain
• medicines that reduce the amount of acid your stomach makes

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