For most people, an unsettled stomach is a passing inconvenience; at its worst, a vomiting episode is at least followed by relief.
But for those who suffer from a seemingly rare chronic vomiting illness, no amount of throwing up can stop the nausea.
Such is the case with Natalie Robertson of Chico, Calif. One of the most distinct memories Robertson has about her first week as a freshman at Chico State University was enduring daylong episodes of uncontrollable vomiting.
"She would throw up in the bushes on the way to class," said Lynne Bussey, Robertson's mother. "Sometimes she would have to run out the door in the middle of class."
Initially, some thought Robertson, who was 18 at the time, was hung over from a night of heavy drinking. Others believed she was bulimic. And although Robertson claimed her vomiting episodes would come without warning, many did not believe her mystery illness, she said. Teachers warned Robertson that excessive absences from class put her at risk of failing.
"I've had to drop classes because [my illness] has been too overwhelming," Robertson said.
Many doctors diagnosed Robertson with the stomach flu or food poisoning, Bussey said. Yet, Robertson's symptoms persisted for two years.
"We knew something was wrong," said Bussey. "There was just a lot of guessing."
After dozens of hospital visits, Robertson was diagnosed with cyclic vomiting syndrome, or CVS, a neurological disorder characterized by a series of prolonged attacks of severe nausea and vomiting, with no apparent cause. Symptoms usually begin with severe abdominal pain or a migraine headache, followed by episodes of vomiting that can last for hours or even days.
However, once an episode is over, the sufferer inexplicably returns to normal health, often with no remnants of the disease.
Unlike with bulimia, which is a cycle of binge eating followed by purging, those with CVS have repeated episodes of vomiting that can begin and continue on an empty stomach. Also, CVS episodes are induced by overwhelming nausea, while individuals with bulimia often vomit without feeling nauseated.
While the actual number of cases is unknown because of sparse research on the syndrome, estimates indicate that CVS may not be as rare as many believe. Rather, according to the Cyclic Vomiting Syndrome Association, more often it is misdiagnosed. The two surveys that have been conducted on the condition suggest that as many as 2 percent of children worldwide may suffer from CVS.
And while initially identified as a pediatric disease and believed that children would outgrow the disorder, researchers now say it can persist into adulthood and even appear in adults for the first time.
Robertson, now 25, has been hospitalized more than 40 times in the last seven years. Like clockwork, Robertson wakes up with a headache or nausea; oftentimes she starts her day after she vomits. Her symptoms ease in the evening, but recur early the following morning.
And Robertson is not alone. In fact, Bussey said she has connected with at least 15 others in Butte County who have the disease and also claim that they are not believed.