Download Cyclical Vomiting Syndrome Association U.K. Individual health

CVSA U.K. Medical Advisors
Professor. Paul Andrews, St. George’s University Hospital, London
Dr. Ishaq Abu-Arafeh, Consultant paediatrician, Stirling Royal Infirmary
Dr. Sonny Chong, Consultant paediatrician, Queen Mary’s, Carshalton
Dr. Keith Lindley, Consultant gastroenterologist, Great Ormond St Hospital
Dr. A. Ravelli University of Brescia, Italy
Cyclical Vomiting Syndrome Association U.K.
Individual health/treatment record
www.cvsa.org.uk
Helpline 0151 342 1660
CVSA U.K. is a registered charity supporting sufferers of
Cyclical Vomiting Syndrome (CVS)
About CVS
CVS is characterised by recurrent, prolonged attacks of severe vomiting, nausea and
lethargy, with no apparent cause. Vomiting persists at frequent intervals, 5-6 times per hour
at the peak, for periods ranging from hours to 10 days or more. It most commonly lasts for
between 1 and 4 days. The episodes are self-limiting and tend to be similar to each other in
symptoms and duration. The sufferer is generally in good health between episodes.
There is no diagnostic clinical or laboratory tests for CVS itself, but when all specific conditions that could cause the symptoms have been eliminated by testing, doctors may classify
the illness as Cyclical Vomiting ‘Syndrome’. This means that people with CVS may show
a range of symptoms, one goal of the CVSA is to help develop better diagnostic criteria, so
that sufferers are diagnosed more quickly and accurately than has been the case previously.
It is thought that anyone can potentially get CVS. CVS sufferers are more likely than average to have a family history of migraine, and/or travel sickness, but the association is not
complete, and not all CVS sufferers have family histories of these problems.
For many with CVS there is nothing obvious that starts an attack, for others some specific
“triggers” can be identified which may initiate a CVS episode. Physical stress is one of the
most common triggers. Mild viruses e.g. colds or ‘flu, throat or chest infections and minor
injuries causing pain may initiate an episode. Going without food for too long and sleep
deprivation can also act as physical triggers. Less commonly, anaesthetics, cold and food
sensitivities, may start an episode. For some, excitement or emotional stress may play a role
too. Negative stress such as anxiety, family problems, etc. and the fear of being ill e.g. on a
birthday or on holiday can trigger episodes in some people. In a large proportion no obvious
triggering event can be recognised.
The onset of CVS can occur from infancy to adulthood. It most commonly develops between the age of 3-7 years and it can persist from months to decades. Although most commonly recognised in children, it is apparent that adult onset CVS is more common than was
once thought. It affects males and females equally. As the name suggests, cyclic activity is
often a feature of this condition. About 50% of sufferers show a strong regular pattern of
vomiting episodes. The episodes may occur as often as several times a month or as little as
several times a year, the frequency of episodes is relatively constant in any given individual, but varies between individuals.
Episodes are typically very consistent for any given individual (i.e. sterotypic) but can vary
from a few hours to days between individuals. Most commonly the duration is between
12 hours-2 days. Remember this is the duration of vomiting, sufferers often experience
symptoms prior to and following vomiting, including severe nausea, headache, dizziness
etc. Although the families often become expert at recognising the onset of an episode there
are few studies which try to quantitate this. It is important to realise that the symptoms even
in those with short vomiting durations can be spread over days.
Dates:
Start/End
Description of symptoms and any possible
trigger
Treatment
(include doses/frequency
if using prescribed
medication)
Comments
CVS Episodes at home
Dates:
Start/End
Description of
symptoms and any
possible trigger
Treatment
(include doses/frequency
if using prescribed
medication)
About this Booklet
Comments
As CVS is a syndrome, not a discrete well defined condition, treatment and diagnosis is problematic. Although awareness of CVS is increasing, it is still a poorly recognised condition,
surveys of our membership reveal an average time to diagnosis of 4 years. Patients and their
families attending hospital often encounter difficulties in having their condition recognised and
thus delaying effective treatment.
We hope that by collating records in this individual health record it will help those treating the
patient to understand clearly the health history and the previous treatments given and their effectiveness.
Please take the time to review the history and update the notes, this will help the patient and
their family
References
Abu-Arafeh I. & Russell G. Cyclical vomiting syndrome in children: A population based study.
Journal of Pediatric Gastroenterology and Nutrition, 21(4), 454-8 1995
Fleisher DR. The cyclic vomiting syndrome described. J Pediatr Gastroenterol Nutr 21(Suppl.
1):S1–5 1995
Fleisher DR. Empiric guidelines for the management of cyclical vomiting syndrome.
http://www.ch.missouri.edu/fleisher/
Gee S. On fitful or recurrent vomiting. St Bart’s Hospital Reports 18 1-6 1882
Li BU, Fleisher DR. Cyclic vomiting syndrome: features to be explained by a pathophysiologic
model. Dig Dis Sci 44: 13S–8S 1999.
Li, B U.K., Sarna,S. Issenman,R. (Eds.) (1999).
Proceedings of the Second Scientific Symposium on CVS, Held at the Medical College of Wisconsin, USA, April 17-18, 1998.
Digestive Diseases and Sciences. 44(Suppl.):1S-120S.
Lindley KJ, Andrews PL. Pathogenesis and Treatment of Cylical Vomiting. J Pediatric Gastroenterology and Nutrition 41 S38-S40 2005
These are selected references, a full list is available on our web site
Patient Details
Name
D.O.B.
Next of Kin
Telephone (Home & mobile)
Address
Tick: Parent q
Guardian q
Allergies
Medical Conditions Diagnosed
Medications
Dosage
Frequency
Date admitted
Treatment
Name
GP
Consultant
Doctor/Nurse’s notes
Address
Patient/Parent’s Notes
Hospital Number:
Telephone
Date discharged
Hospital Admission/Treatment records
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date admitted
Treatment
Doctor/Nurse’s notes
Patient/Parent’s Notes
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Patient/Parent’s Notes
Date discharged
Date discharged
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date discharged
Date discharged
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date discharged
Date discharged
Date admitted
Treatment
Date discharged
Doctor/Nurse’s notes
Patient/Parent’s Notes
Date admitted
Treatment
Date discharged
Date admitted
Treatment
Doctor/Nurse’s notes
Doctor/Nurse’s notes
Patient/Parent’s Notes
Patient/Parent’s Notes
Date discharged