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CVS Research

Cyclical Vomiting Syndrome Research (based in the UK) is dedicated to providing information and advice to sufferers of CVS and their carers. We will try to keep things as simple as possible to help you through this debilitating illness.

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We're always pleased to hear your story - and what works best to help you get through an episode.

Treatment/Cycle

Signs of an impending episode can sometimes be treated and the episode stopped by use of preventative medication, which may be in the form of a suppository - as swallowing tablets with even a small amount of water may induce vomiting and loss of the medication. If caught early enough a tablet may be sufficient, or could be taken as a precautionary dose if known individual triggers have occurred.

Many people have said they get relief from hot showers/baths - but there's an interesting concept that an episode may be aborted by standing in a cold shower for at least fifteen minutes. The thinking is that the shock to the system forces the brain to work more on this new feeling rather than on the oncoming CVS episode.

It's also possible that the shock activates the amygdala to produce adrenaline which may act to abort the episode.

Another off-the-wall trick which may help abort during an episode is a total fast for 24 hours - nothing to eat or drink. This might seem counter-intuitive but can work for some people. You may wet your lips and mouth with ice cubes during this 24 hour period. This can force the body into ketosis, where the lack of carbohydrates makes the body burn fat - again, a shift of focus for the brain. It should be said, though, that might not be safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder - so check with your doctor before doing this.

Treatment of an ongoing episode during hospitalisation will include IV anti emetic to stop the vomiting, IV fluids to rehydrate, possibly added electrolytes if levels are low. Bed rest as the episode reduces will help. Indications that the patient is ready to safely be discharged are the return of appetite, and the ability to eat and drink without inducing nausea.

In the chart below the term P.O. indicates orally (by mouth); S-L is sublingual (under the tongue); treatment could also be by suppository.

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Below - with thanks to CVSUK - a small list of doctors with a good knowledge of CVS
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Medications

Preventative:
Amitriptyline It can treat depression, nerve pain, headaches, migraine.
May Treat: Depression · Migraine · Nerve pain
Brand Names: Elavil
Type of medicine: A tricyclic antidepressant
Availability: Prescription
Forms: Tablets, oral liquid medicine
Tell your doctor if any of these symptoms are severe or do not go away: nausea, vomiting, drowsiness, weakness or tiredness, nightmares, headaches, dry mouth, constipation.
Alcohol: Consult your doctor. Alcohol may increase risk of side-effects.
Driving: This medication may cause blurred vision. Use caution.

Abortive:
Zolmitriptan / Sumatriptan: Sumatriptan is a medicine to treat migraines and cluster headaches. It does not prevent these conditions. It belongs to a group of medicines called triptans, or serotonin (5-HT1) antagonists.
Availability: Prescription
Forms: Usually nasal spray.
Zolmatriptan/Sumatriptan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: flushing, tingling feeling, feeling warm or cold, drowsiness, tiredness, weakness, dizziness, upset stomach.

Ondansetron: It is used in prevention or treatment of sickness associated with chemotherapy, radiotherapy or surgery.
Brand Names: Ondemet, Setofilm, Zofran
Type of medicine: An anti-sickness medicine - a serotonin (5HT3) receptor antagonist
Availability: Prescription
Forms: Tablets, orodispersible (melt in the mouth) tablets, oral liquid medicine, suppositories, injection
Side effects. Tell your doctor if any of these symptoms are severe or do not go away: headache, constipation, weakness, tiredness, chills, drowsiness.
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or seek emergency medical treatment: blurred vision or vision loss, rash, hives, itching, difficulty breathing or swallowing, chest pain, shortness of breath, fast, slow or irregular heartbeat.

Cyclizine: It can treat sickness caused by balance or movement problems such as vertigo, travel sickness.
Brand Names: Ondemet, Setofilm, Zofran
Type of medicine: An antihistamine
Availability: Prescription
Forms: Tablets, injection
Alcohol: Do not drink. Alcohol may cause drowsiness.
Driving: This medication may cause blurred vision and drowsiness. Use caution.
Common side effects may include: drowsiness, weakness, loss of coordination; nausea, dry mouth, constipation; or blurred vision.

Oxynorm (Oxycodone): It can treat severe pain in adults.
Brand Names: Abtard, Candox, Carexil, Dolocodon, Longtec, Lynlor, Oxylan, OxyContin, Shortec, Targinact(contains oxycodone with naloxone)
Type of medicine: Strong opioid painkiller. It's used for other types of long-standing pain when weaker painkillers, such as paracetamol, ibuprofen and aspirin, have not worked.
Availability: Prescription
Forms: Capsules, modified-release tablets, oral liquid medicine, injection
Common side effects happen in more than 1 in 100 people. Talk to a doctor or pharmacist if these side effects bother you or do not go away: constipation, feeling or being sick (nausea or vomiting), stomach discomfort, feeling sleepy or tired, feeling dizzy and a sensation of spinning (vertigo), confusion, headaches, itchiness or rash.
Alcohol: Consult your doctor. Alcohol may increase risk of side-effects.
Driving: Do not drive. This medication may affect your reaction time.

Prochlorperazine is a phenothiazine antipsychotic medicine that is used to treat anxiety or schizophrenia.
Availability: Prescription
Do not use prochlorperazine if you have recently used large amounts of alcohol or medicine that makes you sleepy.
Prochlorperazine is also used to control severe nausea and vomiting.
Common side effects may include: headache, dizziness, drowsiness; dry mouth, stuffy nose; nausea, constipation; increased appetite, weight gain; blurred vision; agitation, feeling jittery, trouble sleeping; skin redness, itching, or rash; missed menstrual periods; or impotence, abnormal ejaculation.

Alternative ideas:
Acupressure may be useful for some people to stop nausea and vomiting.
Pressure point P-6, also called Neiguan, is located on your inner arm near your wrist.
To find pressure point P-6, position your hand so that your fingers are pointing up and your palm is facing you, place the first 3 fingers of your opposite hand across your wrist (see Figure 1). Then place your thumb on the inside of your wrist just below your index finger (see Figure 2). You should be able to feel 2 large tendons (tissue that connects muscles to bones) under your thumb. ​This is pressure point P-6.

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Use your thumb or forefinger to press on this point for 2 to 3 minutes. Move your thumb in a circle while applying pressure. Be firm, but don’t press so hard that it hurts.
Repeat the process on your other wrist.

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