Children's Cyclic Vomiting Syndrome

Author(s): Erina Karol

An underdiagnosed episodic syndrome, Cyclic Vomiting Syndrome (CVS) is characterized by frequent hospitalizations, multiple comorbidities, and poor quality of life. Due to the absence of confirmatory testing and the overlooked pattern of recurrence, it is frequently misdiagnosed. Although cases of CVS have also been reported in infants and the elderly, the majority of cases occur in children or young adults. Although the etiopathogenesis is unknown for the most part, it is likely multifactorial. Abnormal brain-gut pathways, mitochondrial enzymopathies, disorders of gastrointestinal motility, abnormalities in calcium channels, and hyperactivity of the hypothalamic-pituitary-adrenal axis in response to a triggering environmental stimulus are all implicated, according to recent research. CVS is portrayed by intense, generalized and repetitive episodes of extreme sickness and incoercible retching with unsurprising periodicity and return to standard wellbeing between episodes. Clinicians face difficulties distinguishing themselves from other differential diagnoses. In all children with CVS, baseline testing to identify organic causes is recommended, but extensive and invasive investigations should be avoided. CVS management necessitates individualized treatment. The primary focus of acute phase management is supportive and symptomatic care. During the brief prodromal phase, early intervention with abortive agents can be used to try to stop the attack. Non-pharmacologic measures like altering one’s lifestyle and employing reassuring and anticipatory guidance appear to be effective as preventative treatments during the interictal period.