Short- and Long-Term Outcomes of Children with Cyclic Vomiting Syndrome
Suporn Treepongkaruna MD*, Chaowapong Jarasvaraparn MD*, Pornthep Tanpowpong MD, MPH*, Chatmanee Lertudomphonwanit MD*
Affiliation : * Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the efficacy of prophylactic pharmacotherapy on the short- and long-term outcomes of children
with cyclic vomiting syndrome (CVS).
Material and Method: Medical records were reviewed in 32 children who were diagnosed with CVS between 2000 and
2013. Efficacy of prophylactic medications was classified as good vs. no response after treatment for three to six months.
Long-term outcome was evaluated in patients who had been diagnosed for ≥2 years and classified as 1) excellent: no episode,
2) good: one to two episodes, and 3) poor: three episodes or more during the past year.
Results : At three to six months after treatment, good response to amitriptyline was significantly higher than propranolol
(73% vs. 36%, p = 0.04). Of the 24 CVS patients who had been diagnosed ≥2 years, data was available in 19 patients
(mean age, 11.34.9; and mean duration from diagnosis to follow-up, 6.33.3 years). Excellent outcome was achieved in
seven, good in seven, and poor in five children. Overall, the favorable long-term outcome (good and excellent) was 74%.
Most children (86%) who had favorable long-term outcome had good response to the prophylactic medications in the early
period of treatment.
Conclusion : Amitriptyline may be more effective than propranolol for prophylaxis of CVS. However, a randomized controlled
trial is required to confirm this result. Children with CVS have a relatively favorable long-term outcome, particularly those
who initially responded well to the prophylactic medications.
Keywords : Cyclic vomiting syndrome, Functional gastrointestinal disorder, Migraine, Vomiting
