Treating children's cyclic vomiting.

QUESTION: One of my pediatric patients was diagnosed with cyclic vomiting syndrome, and the parents are understandably frustrated with the recurrent yet unpredictable episodes that control and disrupt their family life. Are there any effective treatments for this condition? ANSWER: There is currently no evidence-based treatment regimen for cyclic vomiting syndrome. Pharmacologic remedies, according to anecdotal cases, retrospective reports, and open-label trials, have found that some antimigraine, antiemetic, prokinetic, and anticonvulsant agents have been effective. Management focuses on correct diagnosis of the syndrome, avoidance of potential triggers, prophylactic pharmacotherapy, and supportive care for children and their families during episodes.