Use of Amitriptyline to Improve Persistent Vomiting in Pediatrics


St. Rafael General Hospital, Cancar, Manggarai Regency, East Nusa Tenggara, Indonesia


Background: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder which remains under-recognized. In Indonesia, CVS has never been reported.
Case Presentation: A 10-year-old girl was frequently admitted due to her intense vomiting in a local, limited resource private hospital in Manggarai Regency, East Nusa Tenggara, Indonesia, and had always been diagnosed with gastroesophageal reflux disease (GERD). Her episodes were characterized by vomiting every 30-60 minutes at first, gradually declining over 3-4 days, and recurring in about 6-7 days. All the available tests results were unremarkable. Symptoms were resolved after administration of amitriptyline. She was discharged with continuous amitriptyline for 2 weeks and went into remission.
Conclusion: CVS should always be considered in repeated vomiting in children regardless of the rarity in daily practice. Recognition of this disorder is important to establish prompt diagnosis and convenient intervention, thus improving the quality of life of the children.