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Cyclical vomiting syndrome in children: a prospective study
B R Drumm1, B Bourke, J Drummond
1UCD School of Medicine and Medical Sciences, Dublin Academic Medical Centre, Dublin 7, Ireland.
Insights
Cyclical vomiting syndrome (CVS) in children often persists after diagnosis, but symptom frequency and severity decrease. Early diagnosis and family education are key to managing CVS and reducing medical service use.
Area of Science:
- Pediatrics
- Gastroenterology
- Child Psychology
Background:
- Cyclical vomiting syndrome (CVS) is a disorder characterized by severe nausea and vomiting episodes with symptom-free intervals.
- It affects all age groups, with an incidence of 3.15 per 100,000 children annually.
- The natural history and factors predicting symptom resolution in pediatric CVS require further evaluation.
Purpose of the Study:
- To evaluate the natural history of cyclical vomiting syndrome in children.
- To identify factors that predict symptom resolution in pediatric CVS cases.
Main Methods:
- Thirty newly diagnosed children with CVS (mean age 9.15 years) were enrolled.
- Follow-up interviews were conducted at 3, 6, and 9 months post-diagnosis.
- Psychological assessments (CBCL) and quality of life scores (PedsQL) were utilized.
Main Results:
- At 9 months, 77.3% of children continued to experience vomiting episodes.
- Hospital admissions significantly decreased post-diagnosis (1/22 children) compared to the prior year (15/30 children).
- Children with persistent vomiting showed poorer quality of life at diagnosis (P < 0.05).
Conclusions:
- A prompt diagnosis and family education are crucial for managing pediatric CVS.
- While many children continue to experience vomiting, symptom frequency and severity significantly reduce.
- Medical service utilization markedly decreases following diagnosis and management.
Background:
Cyclical vomiting syndrome (CVS) is a disorder that affects all ages and is characterized by episodes of severe nausea and vomiting with symptom-free intervals between episodes. The incidence in children is 3.15/100 000 children per year. Our objective was to evaluate the natural history of CVS and examine factors that predict symptom resolution.
Methods:
Thirty newly diagnosed children (mean 9.15 years, SD 3.31 range 3.5-15.7) were enrolled. All children had a follow-up interview at 3 months, 27/30 at 6 months, and 22/30 at 9 months.
Key Results:
Following diagnosis of CVS, only 5/22(22.7%) children had no further episodes of vomiting at 9 months, whereas 17/22 (77.3%) continued to vomit. In the year prior to diagnosis, 15/30 (50%) children were admitted to hospital. Of the 22 children with follow-up for 9 months, only one child required hospital admission. Children who continued to vomit had higher internalizing scores on CBCL compared with those who stopped vomiting (P = NS). The Pediatric Quality-of-Life Score suggested those who continued to vomit had a poorer quality of life at diagnosis compared with those who stopped vomiting (P < 0.05).
Conclusions & Inferences:
Making a positive diagnosis of CVS and providing families with information is very important in the management of CVS. Although 75% of children reported regular episodes of vomiting 9 months after diagnosis, there was a significant reduction in the frequency and severity of symptoms in addition to a marked reduction in the use of medical services.
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