Use of Amitriptyline to Improve Persistent Vomiting in Pediatrics: A Case Report

Cyclic Vomiting Syndrome (CVS) is a Functional Gastro-Intestinal Disorder (FGID) which remains under-recognized. In Indonesia, CVS has never been reported.

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 Gastro-Esophageal 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 test results were unremarkable. Symptoms were resolved after the administration of amitriptyline. She was discharged with continuous amitriptyline for two weeks and went into remission.

CVS should always be considered in repeated vomiting among children regardless of the rarity in daily practice. Recognition of this disorder is important to establish the prompt diagnosis and timely intervention, thus improving the quality of life of the children.