These measures facilitate a return to gastroin-
testinal regularity for most people. Constipation
that extends beyond two or three weeks, occurs
with rectal bleeding, or causes ABDOMINAL PAINor
ABDOMINAL DISTENTION requires prompt medical
evaluation.
See also AGING, GASTROINTESTINAL CHANGES THAT
OCCUR WITH; ANAL FISSURE; DIARRHEA; FECAL
IMPACTION; FECAL INCONTINENCE; FIBER AND GASTROIN-
TESTINAL HEALTH; SITZ BATH.
Crohn’s disease See INFLAMMATORY BOWEL DISEASE
(IBD).
cyclic vomiting syndrome Episodes of uncon-
trolled VOMITING and NAUSEA, sometimes called
abdominal migraine, that occur in cycles of symp-
toms and relief. Each episode may last hours and
often repeats over a period of time after which
there is an extended period without symptoms.
Many people experience prodrome, a short period
of time during which they have nausea, ABDOMI-
NAL PAIN, a sense of the impending episode, or
other symptoms that consistently occur before an
episode. During an active episode, the person has
persistent nausea and repeated vomiting that can
last for hours to days.
Researchers believe the physiologic mecha-
nisms of cyclic vomiting syndrome are similar to
those of migraine headaches. Episode triggers may
include infections and other physiologic stress,
emotional stress, and certain foods such as choco-
late. There are no conclusive diagnostic markers
or tests for cyclic vomiting syndrome, making
diagnosis a challenge. Generally the gastroenterol-
ogist strives to rule out other conditions that could
cause the symptoms, resulting in diagnosis by
exclusion.
Treatment targets symptom relief to the extent
possible, which for many people is minimal, and
supportive measures such as drinking plenty of
fluids to replace those lost through vomiting.
Some people experience relief with medications
intended to head off migraine HEADACHE. Though
some people can avert active episodes with med-
ications or by altering their activities during the
prodrome stage, there are no certain methods for
preventing episodes. There is no known cure for
cyclic vomiting syndrome, though episodes often
diminish with aging. Cyclic vomiting syndrome is
more common in children than adults, and can
manifest in children as young as two or three
years old.
See also GASTROENTERITIS.cyclic vomiting syndrome 33