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Vomiting, Cyclic

Vomiting, Cyclic is a topic covered in the 5-Minute Emergency Consult.

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  • A chronic, idiopathic disorder characterized by recurrent, discrete episodes of disabling nausea and vomiting separated by symptom-free intervals lasting a few days to months
  • Adult population – average age of diagnosis is 31:
    • Average age of onset is 21
  • Pediatric population – average age of diagnosis is 5
  • General characteristics:
    • Phase 1: Interepisodic phase:
      • Symptom free
    • Phase 2: Prodrome:
      • Varying intensity of nausea and diaphoresis
    • Phase 3: Emetic phase:
      • Intense nausea/vomiting/retching/dry heaving up to 7 days
    • 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, increasing recognition in 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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Rosen, Peter, et al., editors. "Vomiting, Cyclic." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307673/all/Vomiting__Cyclic.
Vomiting, Cyclic. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307673/all/Vomiting__Cyclic. Accessed April 25, 2019.
Vomiting, Cyclic. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307673/all/Vomiting__Cyclic
Vomiting, Cyclic [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307673/all/Vomiting__Cyclic.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Vomiting, Cyclic ID - 307673 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307673/all/Vomiting__Cyclic PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -