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Outcome for children with cyclical vomiting syndrome
E Fitzpatrick1, B Bourke, B Drumm
1UCD School of Medicine and Medical Science, The Children's Research Centre Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
Insights
Cyclical vomiting syndrome (CVS) in children often resolves, but many still experience other somatic symptoms like headaches and abdominal pain. A diagnosis and information significantly impacted vomiting severity for most families.
Area of Science:
- Pediatric Gastroenterology
- Childhood Functional Gastrointestinal Disorders
- Somatic Symptom Disorders
Background:
- Cyclical vomiting syndrome (CVS) significantly impacts children and their families.
- Understanding the long-term outcomes of CVS is crucial for effective management.
Purpose of the Study:
- To examine the long-term outcomes of children diagnosed with CVS between 1993 and 2003.
- To assess symptom resolution and the persistence of other somatic complaints.
Main Methods:
- Retrospective review of clinical records for children diagnosed with CVS.
- Follow-up contact with parents to determine current well-being.
- Analysis of demographic features and presenting symptoms.
Main Results:
- 61% of children experienced resolution of vomiting, with 39% resolving symptoms shortly after diagnosis.
- Persistent somatic symptoms were common, including headaches (42%) and abdominal pain (37%).
- Positive diagnosis and information positively impacted vomiting severity for 78% of parents.
Conclusions:
- While a majority of children achieve symptom resolution, a significant portion continue to experience other somatic issues.
- The long-term burden of CVS extends beyond vomiting episodes.
- Early diagnosis and supportive information appear beneficial for managing CVS severity.
Objective:
Cyclical vomiting syndrome (CVS) is a disorder that carries a significant burden of disease for children and their families. The aim of this study was to examine the outcome of a group of children diagnosed with CVS from 1993 to 2003.
Methods:
Children diagnosed with CVS over a 10-year period were identified and a review of the clinical records was carried out to define demographic features and the spectrum of disease at presentation. The patient's parent was contacted to establish the child's current well-being. Ethical approval for the study was obtained.
Results:
Fifty one children were diagnosed with CVS and 41 agreed to participate in follow-up. Mean age was 5.8 (SD 3.3) years at onset of CVS, 8.2 (SD 3.5) years at diagnosis, and 12.8 (SD 4.8) years at follow-up. Vomiting had resolved at the time of follow-up in 25/41 (61%) children. Sixteen of 41 (39%) children reported resolution of symptoms either immediately or within weeks of diagnosis. However, a large number of children from the group whose vomiting resolved and the group that were still vomiting continued to have somatic symptoms, with 42% of children suffering regular headaches and 37% having abdominal pain. 32 (78%) parents felt that the provision of a positive diagnosis and information made a significant impact on the severity of vomiting.
Conclusions:
While 60% of children with CVS have resolution of symptoms, a significant proportion of both those in whom symptoms have resolved and those in whom vomiting persists continue to suffer from other somatic symptoms.
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