Our 7-year-old son has repeated episodes of frequent and severe vomiting. He has just been seen by a paediatrician who diagnosed cyclical vomiting. Our boy is often hospitalized, as he needs a drip to treat dehydration. Can you tell us more about cyclical vomiting?
Cyclic or cyclical vomiting is a most unpleasant condition, the cause of which is unknown. To accept this diagnosis, your child should be completely well between episodes. Cases due to psychological upset have been described but are very much in the minority. Rarely the use of preventative anti-migraine therapy has proved beneficial suggesting that the episodes are due to abdominal migraine – again these are very much in the minority.
So what can be done for the majority of cyclic vomiters for whom no underlying cause is found? Dehydration is the life-threat in these patients and if it occurs an intravenous drip is necessary. To try and stop this from happening a very powerful anti-vomiting agent ondansteron is given. It is a very expensive drug but is worth it if it can reduce the vomiting so that a drip &/or hospital admission is avoided. Sometimes corticosteroids are also given. Despite these measures the patient still has to be hospitalized in many instances in my experience.Fortunately most children (but not all) “grow out” of the condition, so that it ceases after some years without any reason for the cessation. This condition is very frustrating for the patient, the parents and the conscientious medical practitioner who spends much time considering other possible causes, trying anti-migraine and other treatments while feeling very sorry for the families