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Outcome for children with cyclical vomiting syndrome

UCD School of Medicine and Medical Science, The Children's Research Centre Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland

Correspondence to:
Dr Marion Rowland, UCD School of Medicine and Medical Science, The Children’s Research Centre, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland; marion.rowland{at}ucd.ie

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.