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Cyclic Vomiting Syndrome in Pediatric Patients: A Review of Therapeutics

Emma M Tillman1, Emily M Harvath2

  • 1Department of Medicine (EMT), Indiana University School of Medicine, Indianapolis, IN.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|January 10, 2022
PubMed

Insights

Cyclic vomiting syndrome (CVS) treatment in children involves standard prophylactic medications like amitriptyline and cyproheptadine. Nutritional supplements and specific drug combinations are also effective for managing acute episodes and improving overall patient outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Functional Gastrointestinal Disorders
  • Pharmacology

Background:

  • Cyclic vomiting syndrome (CVS) is a challenging functional gastrointestinal disorder in children.
  • Effective therapeutic interventions are crucial for both prophylaxis and acute management of CVS attacks.

Purpose of the Study:

  • To review therapeutic treatment recommendations for pediatric CVS based on the 2008 NASPGHN Consensus Statement.
  • To discuss contemporary studies evaluating CVS treatments alongside the consensus guidelines.

Main Methods:

  • Systematic search of medical databases for studies on therapeutic treatments for CVS.
  • Identification and analysis of 8 relevant studies evaluating various treatment modalities.

Main Results:

  • Amitriptyline and cyproheptadine are confirmed as standard prophylactic treatments for pediatric CVS.
  • Nutritional supplements (carnitine, coenzyme Q10) show promise in reducing episode frequency and severity.
  • Ondansetron and sumatriptan combination is recommended for acute attack abortion; aprepitant and sedatives are options for refractory cases.

Conclusions:

  • Established prophylactic agents remain the standard of care for pediatric CVS.
  • Emerging evidence supports the role of nutritional supplements and specific drug combinations in managing CVS.
  • A multi-faceted therapeutic approach is essential for optimal CVS management in children.

Keywords:
childfamilial cyclic vomiting syndromevomiting

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