Cyclic Vomiting Syndrome

Cyclic vomiting syndrome may sometimes be caused by the 'belch button' - a little-known or undertood trigger point:

It all started when Janet (not her real name), had to undergo surgery to have fibroids removed.

As she'd had abdominal surgery some years before the surgeon decided to re open the old scar down the linear alba, that is right down the middle of the abdomen.

The operation went well, even though the fibroid was rather large, as the surgeon said afterwards almost as big as a football; still all went well until the third day into recovery.

That is when the vomiting started, every thirty minutes, regardless of whether there was food in her stomach or not. Of course the first suspicion was that a piece of intestine was caught up on the wound closure, still x-rays showed nothing, neither did ultra sound, MRI,  or any of the other tests they did, and still the vomiting continued round the clock.

Her husband Frank was so concerned that he spent all his spare time with her, so much so that the ward sister set up a camp stretcher for him so he could sleep in her room.

The doctor in charge called in specialists to solve this problem, and still the vomiting continued. Every morning a collection of five or six doctors would gather at the foot of her bed and discuss the case, then leave, without so much as even speaking to either the patient or her husband.

After this had been going on for several weeks, Frank collared the doctor who seemed to be in charge and said to him.

" Correct me if I am wrong, but I gather that you believe that there is an obstruction to the intestine that doesn't show up on the x-rays." The doctor agreed that this was so.

" Then why don't you operate to correct it?"  Frank asked.

"Oh we couldn't do that," the doctor said, "she is too weak and probably wouldn't survive the operation."

As Frank said to me much later, "That came as something of a shock, I realized that my wife was starving, and dehydrating and no one could help."

"So what are you going to do" he asked the doctor, expecting some profound answer to the problem.

"We are waiting," said the doctor, "sometimes nature fixes these things itself."

As Frank said to me afterwards.

"I was stunned, here we had a modern hospital with all the latest equipment, and six of the states top specialists, and they were waiting for nature to fix it!"  "I can tell you, on that day my faith in the medical profession reached an all time low."

After eight weeks of vomiting it did actually stop one day, so they discharged her as quickly as they could. And just as well too because 48 hours later it started again, but this time Janet stayed home at her own request. As she said, "Why go back? They cant do anything for me, and my bed at home is much more comfortable than a hospital bed."

After several more days of repeated vomiting, Frank came to me as a friend, with the problem, wanting to know if I knew of any treatment that just might help.

I remembered seeing a mention of "projectile vomiting" mentioned in the Travell & Simons Trigger Point manual, so I looked it up. (Its in volume one, chapter 49: abdominal muscles.) Travell calls it a "Belch Button" she says

"The Belch Button is a trigger point (TP) that is uncommon but may be of critical importance to the patient who has one. It is found on the left or right at or just below the angle of the 12th rib. When sufficiently active, this TP. Causes spontaneous belching and in severe cases projectile vomiting, which can be deeply embarrassing and a serious postoperative complication."

Could this be the cause of the problem, after all it is an abdominal trigger point and it's the abdominal muscles that contract to cause vomiting. I decided to check it out and see.

I went to their house, Frank seated me in the living room while he went to get Janet. She arrived a few minutes later carrying her vomit bowl in front of her, (projectile vomiting gives you no warning, so you have to be always ready). As she approached a vomiting episode struck, and she turned her back on me presumably to avoid splashing me. I thought "well, this is it!."

I rose to my feet stepping up to her wrapped my left arm around her waist and pressed the first two knuckles of my right hand into her back just either side of the spine at about the 12th rib.

The results were dramatic, she stopped vomiting instantly, mid heave!!!

So we stood there with my knuckles in her back and an arm around her waist and waited for it to start again, after about a half a minute she turned her head to look at me, with tears in here eyes, she said " I think it's stopped"

That was seven years ago and it still hasn't returned - I think it really has gone for good.

It's at times like these that I feel truly privileged to be able to help.

I sincerely hope this information may help someone else with a similar problem.

Gary Clark

PS. Thinking back on this episode it sometimes amazes me that I could do in 3 seconds what the doctors puzzled over for weeks. Still to me the real heroes are Drs Travell & Simon. They worked for forty years researching muscular trigger points and then wrote the books so that people like me could use their knowledge to help others. They are my heroes.

Cyclic Vomiting Syndrome: Tests, Causes and Treatment Options Author: John Smith MA Description Cyclic Vomiting Syndrome (CVS) is a condition in which a person suffers from severe attacks of nausea and vomiting. CVS was first noted by Samuel Gee in 1982. Although a long time has passed, doctors are still unable to determine what causes CVS...

The Official Patient's Sourcebook on Cyclic Vomiting Syndrome: A Revised and Updated Directory for the Internet Age Author: Icon Health Publications Description This sourcebook has been created for patients who have decided to make education and Internet-based research an integral part of the treatment process. Although it gives information useful to doctors, caregivers and other health professionals, it also tells patients where and how to look for information covering virtually all topics related to cyclic vomiting syndrome, from the essentials to the most advanced areas of research...

Cyclic Vomiting Syndrome: Causes, Tests and Treatment Options Author: John Smith MA Description Cyclic Vomiting Syndrome (CVS) is a condition in which a person suffers from severe attacks of nausea and vomiting. CVS was first noted by Samuel Gee in 1982. Although a long time has passed, doctors are still unable to determine what causes CVS...

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