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Pathophysiology of Vomiting

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Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through interaction...

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Cyclic vomiting syndrome responding to amitryptiline.

J B Ghosh¹, Mahua Roy, Tanushree Peters

¹Department of Pediatric Medicine, IPGME&R Kolkata and North Bengal Medical College & Hospital, Darjeeling, India.

Indian Journal of Pediatrics

|December 17, 2009

Summary

Cyclic vomiting syndrome, a condition causing recurrent vomiting, was diagnosed in a 7-year-old girl. Treatment with amitriptyline provided significant symptom relief.

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Area of Science:

Pediatric Gastroenterology
Neurology

Background:

Cyclic vomiting syndrome (CVS) is a debilitating functional gastrointestinal disorder characterized by recurrent, stereotypic episodes of nausea and vomiting.
The etiology of CVS remains poorly understood, but autonomic dysfunction and central nervous system pathways are implicated.

Observation:

A 7-year-old female presented with a history of recurrent vomiting and altered sensorium.
Initial laboratory investigations were unremarkable, ruling out common metabolic and infectious causes.

Findings:

A diagnosis of cyclic vomiting syndrome was established based on the clinical presentation.
The patient responded favorably to treatment with amitriptyline, a tricyclic antidepressant.

Implications:

This case highlights the importance of considering CVS in the differential diagnosis of recurrent unexplained vomiting in children.
Amitriptyline appears to be an effective therapeutic option for managing cyclic vomiting syndrome in pediatric patients.
Further research into the pathophysiology of CVS may lead to novel treatment strategies.