Published online Aug 8, 2014. doi: 10.5409/wjcp.v3.i3.54
Revised: June 16, 2014
Accepted: July 12, 2014
Published online: August 8, 2014
Processing time: 187 Days and 1.1 Hours
Cyclical vomiting syndrome (CVS) is a functional, debilitating disorder of childhood frequently leading to hospitalization. Affected children usually experience a stereotypical pattern of vomiting though it may vary between different individuals. The vomiting is intense often bilious, and accompanied by disabling nausea. Identifiable precipitating factors for CVS include psychosocial stressors, infections, lack of sleep and occasionally even food triggers. Often, it may be difficult to distinguish episodes of CVS from other causes of acute abdomen and altered consciousness. Thus, the diagnosis of CVS remains largely one of exclusion. Investigations routinely done during the work-up of a child with suspected CVS include both blood and imaging modalities. Plasma lactate, ammonia, amino acid and acylcarnitine profiles as well as urine organic acid profile are indicated to exclude inborn errors of metabolism. The treatment remains challenging and targeted at prevention or shortening of the attacks and can be considered as abortive, supportive and prophylactic. Use of non-pharmacological therapy is also part of the management of CVS. The prognosis of CVS is variable. More insight into the pathogenesis of this disorder as well as role of non-pharmacological therapy is needed.
Core tip: Cyclical vomiting syndrome (CVS) is a functional childhood disorder which has been increasingly reported in recent years. Much of its pathogenesis remains unknown. Diagnosis may be delayed if not considered by paediatricians. Management of CVS still remains a challenge.