Adult Cyclic Vomiting Syndrome Successfully Treated with Intranasal Sumatriptan

Cyclic vomiting syndrome is an increasingly recognized cause of nausea and vomiting in adults. We report the case of a 47-year-old man with recurrent episodes of intractable nausea and vomiting for one year. His symptoms persisted for 4–7 days and then resolved spontaneously, only to return after periods of time ranging from one week up to a month. After an extensive workup, which failed to determine any causative explanation for his symptoms, he was diagnosed with cyclic vomiting syndrome. His episodes of vomiting were successfully terminated with the use of intranasal sumatriptan. In this case, we highlight that sumatriptan effectively aborted symptoms in an adult patient with cyclic vomiting syndrome. Increasing physicians’ awareness of adult cyclic vomiting syndrome may improve care of patients suffering from this debilitating condition

Rumination syndrome in children and adolescents: a school survey assessing prevalence and symptomatology

<p>Abstract</p> <p>Background</p> <p>Rumination syndrome (RS) is a functional gastrointestinal disorder (FGD) increasingly recognized in children and adolescents. The epidemiology of this condition in school aged children is poorly understood. The main objective of this study was to assess the prevalence of rumination and other related associations in a cohort of Sri Lankan children.</p> <p>Methods</p> <p>Children aged 10-16 years were randomly selected from 8 schools in 4 provinces in Sri Lanka. RS was diagnosed using Rome III criteria. Data was collected using a self administered questionnaire distributed in an examination setting. It was translated into Sinhala, the native language and pretested before distribution.</p> <p>Results</p> <p>A total of 2163 children were included in the study (55% boys, mean age 13.4 years, SD 1.8 years). Prevalence of RS was 5.1% (<it>n</it> = 110); boys 5.1% and girls 5.0%. When symptoms were analyzed, 73.6% reported re-swallowing of regurgitated food, while the rest spat it out. In 94.5% regurgitation occurred during the first hour after the meal. Only 8.2% had daily symptoms while 62.7% had symptoms weekly. Abdominal pain, bloating and weight loss were the commonest symptoms associated with RS (19.1%, 17.3% and 11.8% respectively). No significant association was observed between exposure to stressful events and rumination (<it>p</it> > 0.05). Twenty (18.2%) with RS fulfilled Rome III criteria for at least one other FGD. School absenteeism was seen in 11.8% of affected children.</p> <p>Conclusion</p> <p>RS was reasonably common in this cohort of school-aged children and adolescents in Sri Lanka. However, symptoms were severe enough to affect schooling only in 12% of affected children. Around one fifth with RS had at least one other overlapping FGD.</p