Maternal and Child Health Department, Santa Maria Goretti Hospital, Sapienza-University of Rome, Latina, Italy.
Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00189, Rome, Lazio, Italy.
Ital J Pediatr. 2022 Aug 30;48(1):156. doi: 10.1186/s13052-022-01346-y.
Cyclic Vomiting Syndrome (CVS) is a rare functional gastrointestinal disorder, which has a considerable burden on quality of life of both children and their family. Aim of the study was to evaluate the diagnostic modalities and therapeutic approach to CVS among Italian tertiary care centers and the differences according to subspecialties, as well as to explore whether potential predictive factors associated with either a poor outcome or a response to a specific treatment.
Cross-sectional multicenter web-based survey involving members of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP).
A total of 67 responses were received and analyzed. Most of the respondent units cared for less than 20 patients. More than half of the patients were referred after 3 to 5 episodes, and a quarter after 5 attacks. We report different diagnostic approaches among Italian clinicians, which was particularly evident when comparing gastroenterologists and neurologists. Moreover, our survey demonstrated a predilection of certain drugs during emetic phase according to specific clinic, which reflects the cultural background of physicians.
In conclusion, our survey highlights poor consensus amongst clinicians in our country in the diagnosis and the management of children with CVS, raising the need for a national consensus guideline in order to standardize the practice.
周期性呕吐综合征(CVS)是一种罕见的功能性胃肠道疾病,会对儿童及其家庭的生活质量造成相当大的负担。本研究旨在评估意大利三级保健中心对 CVS 的诊断方式和治疗方法,以及根据亚专科的差异,探讨是否存在与不良预后或对特定治疗有反应相关的潜在预测因素。
这是一项涉及意大利儿科学会胃肠病学、肝病学和营养学分会(SIGENP)和意大利儿科学会神经学分会(SINP)成员的跨中心、基于网络的横断面调查。
共收到并分析了 67 份回复。大多数参与调查的单位所诊治的患者少于 20 例。超过一半的患者在出现 3-5 次发作后被转介,四分之一的患者在出现 5 次发作后被转介。我们报告了意大利临床医生之间不同的诊断方法,这在比较胃肠病学家和神经科医生时尤为明显。此外,我们的调查还表明,根据特定的临床情况,在呕吐发作期间,某些药物的使用更为普遍,这反映了医生的文化背景。
总之,我们的调查突出表明,在我国,临床医生在 CVS 患儿的诊断和管理方面存在共识不足,这就需要制定国家共识指南,以规范实践。