Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jun 5, 2025; 16(2): 103971
Published online Jun 5, 2025. doi: 10.4292/wjgpt.v16.i2.103971
Disease characteristics and long-term outcomes of cyclic vomiting syndrome in Singaporean children
Lynette Goh, Jeremy Meng Dao Ho, Fang Kuan Chiou
Lynette Goh, Fang Kuan Chiou, Department of Gastroenterology, Hepatology and Nutrition, KK Women's and Children's Hospital, Singapore 229899, Singapore
Jeremy Meng Dao Ho, Department of Paediatrics, KK Women's and Children's Hospital, Singapore 229899, Singapore
Author contributions: Goh L, Ho JMD performed research and analyzed data; Goh L, Ho JMD, Chiou FK wrote the paper; All authors read and approved the final manuscript.
Institutional review board statement: Ethics approval was obtained from Singhealth Institutional Review Board (2021/2657).
Informed consent statement: Informed consent and assent was obtained.
Conflict-of-interest statement: There are no conflict of interests to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data sharing not applicable due to ethical restrictions.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lynette Goh, Department of Gastroenterology, Hepatology and Nutrition, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore. lynette.goh.s.h@singhealth.com.sg
Received: December 12, 2024
Revised: March 13, 2025
Accepted: March 26, 2025
Published online: June 5, 2025
Processing time: 174 Days and 5 Hours
Abstract
BACKGROUND

Cyclic vomiting syndrome (CVS) and its effect on nutritional status has not been well described.

AIM

To describe the clinical characteristics, treatment and outcomes of children with CVS in Singapore.

METHODS

Retrospective cohort study of pediatric patients aged 1 to 18 years old with CVS diagnosed at KK Women’s and Children’s Hospital in Singapore from 2011 to 2021.

RESULTS

Thirty-two children (69% female) with CVS were included in the study, with mean age of onset of symptoms at 7 (± 4) years and mean follow up duration of 5 years. Forty percent (12/32) of patients were underweight at diagnosis with no other identifiable organic cause, with a median body mass index (BMI) z score -3.2 (range -2 to -7.5). The incidence of systemic hypertension was 10% (3/32). The overall mean frequency of exacerbations in this cohort of patients was 4 (± 4) episodes per year. In total, 16 (50%) patients, who had mean baseline frequency of 6 (± 5) attacks per year, were commenced on prophylactic treatment. Twelve patients (75%) responded to first-line therapy, whereas 4 (25%) required escalation to second-line treatment. With prophylactic treatment, there was an overall improvement in the frequency of attacks with a mean reduction of 5 (± 3) attacks per year. Also, there was improvement in the BMI z score of these patients from a median of -2.9 to -0.9.

CONCLUSION

Prophylactic treatment is effective in improving nutritional status as well as reducing symptom frequency and should be considered for patients with complications such as growth failure and significant hypertension.

Keywords: Cyclic vomiting syndrome; Nutritional status; Hypertension; Prophylactic medication; Response to prophylactic medications

Core Tip: Cyclic vomiting syndrome (CVS) in children can be debilitating. However, there are prophylactic medications available. The nutritional status of children with CVS before and after starting prophylactic medications is unknown. The incidence of CVS associated hypertension has also not been well described. The improvement in nutritional status after starting prophylactic medications should be a consideration for providers to propose prophylactic medications for poor nutritional status.