Cyclical vomiting transient in most kids: study

NEW YORK (Reuters Health) - Parents of cyclical vomiters rest assured: Results of a study suggest that cyclical vomiting in children resolves in most cases, often soon after a formal diagnosis has been made, although other somatic symptoms -- that is, physical symptoms believed to be caused by psychological stress -- may persist.

Cyclical vomiting syndrome describes periods of intense vomiting lasting hours to days with symptom-free intervals spanning weeks to months, the authors explain, but little is known about the outcome of cyclical vomiting in children.

Dr. Marion Rowland and colleagues from UCD School of Medicine and Medical Science, Dublin, Ireland investigated the current status of 41 children diagnosed with cyclical vomiting syndrome between 1993 and 2003.

At the time of diagnosis, 41 percent of children had monthly vomiting episodes, 37 percent had at least one episode every 3 months, and 22 percent had intervals between episodes exceeding 3 months.

More than 70 percent of the children could identify a trigger factor, more often a non-noxious exciting event (44 percent) than a noxious trigger (22 percent) for their episodes, Rowland and colleagues report. Specific foodstuffs triggered cyclical vomiting in only two children (5 percent).

By an average of about 4.5 years after diagnosis, 61 percent of children had been free of vomiting episodes for at least a year, while only 39 percent continued to vomit.

Among the children in whom cyclical vomiting had ceased, resolution had occurred within weeks of diagnosis in 16 (39 percent overall).

Resolution of cyclical vomiting did not correlate with duration or severity of the condition or with any other variable analyzed, the investigators say.

Even after resolution of cyclical vomiting, most children continued to experience a variety of somatic symptoms, including headache (40 percent) and stomachache (36 percent).

In the 39 percent of children with persistent cyclical vomiting syndrome, the caregiver felt that the symptoms were easier to deal with after a diagnosis had been made and information about the syndrome had been provided, the researchers note.

SOURCE: Archives of Disease in Childhood, November 2007.