Cyclic Vomiting Syndrome: A Functional Disorder / 대한소아소화기영양학회지

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

Growing up in Qatif: child health profile of Qatif region in Eastern Province, Saudi Arabia

The health profiles of children can provide an insight into demographic characteristics, morbidity and mortality, attitudes and practices, people's resources and their motivation to stay healthy. Such studies help policy planners and health administrators in establishing priorities and help in defining objectives for the paediatric education of physicians. However, such studies are scarce. This presentation is part of an integrated multidisciplinary effort by a team of investigators at King Faisal University. The data were collected by trained medical students, technicians and social workers during 1983