Cyclical Vomiting Syndrome?

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I have a third grade student that has always vomited easily (since K when I met him) and often for a variety of reasons, mostly related to sensory issues.   Within the last few months it has gotten much much worse with him nearly daily vomiting/wretching repeatedly every few minutes for hours.  Both his teacher and I try to keep him in class for as much as we can but lately he has been missing more and more learning time.  Parents have appt with GI specialist but it's not for a few months.  I am wondering if he has Cyclical Vomiting Syndrome.  Has anyone dealt with this before? It is so hard to watch.   We've tried many interventions-- suck on hard candy, smell alcohol, gingerale-- with no success.  He does well if we go outside but immediately starts again upon return.  His teacher and I are at a loss.  Any suggestions would be welcome.

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Specializes in pediatrics, school nursing.

Have they tried any meds? Omeprazole and hyoscyamine come to mind as fairly "mild" meds that could help if there's any reflux involved...

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k1p1ssk said:

Have they tried any meds? Omeprazole and hyoscyamine come to mind as fairly "mild" meds that could help if there's any reflux involved...

MD tried ondansetron (upon my suggestion) but it seems to make it worse.  To be honest I am surprised the MD hadn't tried more but hopefully the GI specialist will be more helpful.

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As an adult with CVS, it's horrible. The only combo that has ever worked (thank god) is propranolol and cyproheptadine, both TID. When I feel an actual episode coming on, I take Marinol, but that's a rare occasion. 

Until we found the right combo for me, I had a mediport and had to do a daily banana bag to stay out of the ER. That lasted 3 years. 

Oh, and hot baths!! I lived in a hot bath for years during episodes. This is why CVS is often confused with CHS. 

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Specializes in pediatrics, school nursing.
PaddedCellLPN said:

As an adult with CVS, it's horrible. The only combo that has ever worked (thank god) is propranolol and cyproheptadine, both TID. When I feel an actual episode coming on, I take Marinol, but that's a rare occasion. 

Until we found the right combo for me, I had a mediport and had to do a daily banana bag to stay out of the ER. That lasted 3 years. 

Oh, and hot baths!! I lived in a hot bath for years during episodes. This is why CVS is often confused with CHS. 

Wow, I completely forgot about Marinol! You just brought back a flood of memories - I had a patient in LTC about 12 years ago that had that prescribed before bed - it always felt so weird to be giving it to her, but she slept well! I'm so sorry you've had to deal with that... 

We have a lot of sensory-vomiters in my school - not to that extreme, but unfortunately, it's hard to predict what will trigger the gagging/vomiting. 

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k1p1ssk said:

Wow, I completely forgot about Marinol! You just brought back a flood of memories - I had a patient in LTC about 12 years ago that had that prescribed before bed - it always felt so weird to be giving it to her, but she slept well! I'm so sorry you've had to deal with that... 

We have a lot of sensory-vomiters in my school - not to that extreme, but unfortunately, it's hard to predict what will trigger the gagging/vomiting. 

This reminds me of kids during fire or earthquake drills. The alarms can overload them and they start vomiting. During planned drills they can prepare for it by using noise-cancelling headphones, but during false alarms or unplanned ones it's hard. Always have to be in the lookout during their days. 

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