Vomiting, Cyclic



  • An idiopathic disorder characterized by recurrent, discrete episodes of disabling nausea and vomiting, abdominal pain lasting hours to days, separated by symptom-free intervals
  • More common in pediatric population but increase in recognition of among adults
  • Adult population – average age of diagnosis is 31:
    • Average age of onset is 21
  • Pediatric population – average age of diagnosis is 9
  • General characteristics:
    • Phase 1: Interepisodic phase:
      • Symptom free
    • Phase 2: Prodrome:
      • Varying intensity of nausea, diaphoresis, abdominal pain
    • Phase 3: Emetic phase:
      • Intense nausea, vomiting, abdominal pain and lethargy up to 7 d
    • Phase 4: Recovery phase:
      • Improvement of nausea and tolerance of PO intake


Incidence and Prevalence Estimates
  • True incidence and prevalence in adult general population unknown due to limited data and research, but there is an increase in recognition of syndrome
  • In pediatric population, cyclic vomiting syndrome affects 0.04–2% of population with estimated new cases 3/100,000 annually


  • Etiology unknown
  • Pathophysiology is also unknown and is under research:
    • Limited research suggests multifactorial factors such as autonomic, central, and environmental to be involved

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