Yu Elliot S, Priyadharsini S S Yasodara, Venkatesan Thangam
Department of Internal Medicine, The Hub for Collaborative Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Division of Gastroenterology and Hepatology, The Hub for Collaborative Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Curr Treat Options Gastroenterol. 2018 Dec;16(4):511-527. doi: 10.1007/s11938-018-0202-2.
Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder characterized by episodic nausea and vomiting and is diagnosed using Rome IV criteria. CVS is being recognized more frequently in adults with a prevalence of 2%. It is associated with several functional disorders like autonomic dysfunction, anxiety, and depression, but the strongest association is with migraine. We will elucidate the close relationship between migraine and CVS and briefly discuss its association with other gastrointestinal disorders.
We highlight similarities in pathophysiology, clinical presentation, and response to medications between CVS and migraine (tricyclic antidepressants, triptans, antiepileptics). We also discuss novel therapies like CGRP inhibitors which are effective in migraine and have potential for adaptation in patients with CVS. Using migraine as a template should enable investigators to elucidate the mechanisms underlying this disorder, develop novel therapies, and direct future research in CVS.
周期性呕吐综合征(CVS)是一种慢性功能性胃肠疾病,其特征为发作性恶心和呕吐,采用罗马IV标准进行诊断。CVS在成人中越来越常见,患病率为2%。它与多种功能性疾病相关,如自主神经功能障碍、焦虑和抑郁,但与偏头痛的关联最为密切。我们将阐明偏头痛与CVS之间的密切关系,并简要讨论其与其他胃肠疾病的关联。
我们强调了CVS与偏头痛在病理生理学、临床表现和药物反应方面的相似之处(三环类抗抑郁药、曲坦类药物、抗癫痫药)。我们还讨论了新型疗法,如降钙素基因相关肽(CGRP)抑制剂,其对偏头痛有效,对CVS患者也有潜在的适用性。以偏头痛为模板应能使研究人员阐明该疾病的潜在机制,开发新型疗法,并指导未来对CVS的研究。