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Current Treatment Options in Gastroenterology

Published in:

01-12-2018 | Motility (H Parkman and R Schey, Section Editors)

Migraine, Cyclic Vomiting Syndrome, and Other Gastrointestinal Disorders

Authors: Elliot S. Yu, MD, Yasodara Priyadharsini S.S., MBBS, Thangam Venkatesan, MD

Published in: Current Treatment Options in Gastroenterology | Issue 4/2018

Abstract

Purpose of review

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.

Recent findings

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.

Summary

Using migraine as a template should enable investigators to elucidate the mechanisms underlying this disorder, develop novel therapies, and direct future research in CVS.

•• Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic vomiting syndrome in 41 adults: the illness, the patients, and problems of management. BMC medicine. 2005;3:20. https://doi.org/10.1186/1741-7015-3-20 Establishes the four phases of CVS used in clinical practice currently and one of the first representations of CVS in the adult community.CrossRefPubMedPubMedCentral

Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71–80. https://doi.org/10.2147/CLEP.S40245.CrossRefPubMedPubMedCentral

Sandler RS, Drossman DA. Bowel habits in young adults not seeking health care. Dig Dis Sci. 1987;32(8):841–5.CrossRef

• Sagar RC, Sood R, Gracie DJ, Gold MJ, To N, Law GR, et al. Cyclic vomiting syndrome is a prevalent and under-recognized condition in the gastroenterology outpatient clinic. Neurogastroenterology and motility : the official journal of the European gastrointestinal motility society. 2018;30(1):10.1111/nmo.13174 Indication of the need for further recognition of CVS with an underestimation of CVS diagnosis in gastroenterology clinics leading to prolonged symptoms and initation of treatment.CrossRef

Aziz I, Palsson OS, Whitehead WE, Sperber AD, Simren M, Tornblom H. Epidemiology, clinical characteristics, and associations for Rome IV functional nausea and vomiting disorders in adults. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2018. https://doi.org/10.1016/j.cgh.2018.05.020.

Ertekin V, Selimoglu MA, Altnkaynak S. Prevalence of cyclic vomiting syndrome in a sample of Turkish school children in an urban area. J Clin Gastroenterol. 2006;40(10):896–8.CrossRef

Cullen K, MA WC. The periodic syndrome: its nature and prevalence. Med J Aust. 1963;50:167–73.PubMed

Abu-Arafeh I, Russell G. Cyclical vomiting syndrome in children: a population-based study. J Pediatr Gastroenterol Nutr. 1995;21(4):454–8.CrossRef

Namin F, Patel J, Lin Z, Sarosiek I, Foran P, Esmaeili P, et al. Clinical, psychiatric and manometric profile of cyclic vomiting syndrome in adults and response to tricyclic therapy. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2007;19(3):196–202. https://doi.org/10.1111/j.1365-2982.2006.00867.x.CrossRef

10.

• Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343–9. https://doi.org/10.1212/01.wnl.0000252808.97649.21 Interprets data from the American Migraine Prevalence and Prevention Study that conducted a nationwide cross sectional study to ascertain the profile of the American Migrane population from 120,000 households.CrossRefPubMed

11.

Venkatesan T, Sengupta J, Lodhi A, Schroeder A, Adams K, Hogan WJ, et al. An internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS). Exp Brain Res. 2014;232(8):2563–70. https://doi.org/10.1007/s00221-014-3967-0.CrossRefPubMedPubMedCentral

12.

Mak W, Tsang K, Tsoi T, Au Yeung K, Chan K, Cheng T, et al. Bath-related headache. Cephalalgia. 2005;25(3):191–8.CrossRef

13.

Ravishankar K. ‘Hair wash’or ‘head bath’triggering migraine-observations in 94 Indian patients. Cephalalgia. 2006;26(11):1330–4.CrossRef

14.

Abell TL, Adams KA, Boles RG, Bousvaros A, Chong SK, Fleisher DR, et al. Cyclic vomiting syndrome in adults. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2008;20(4):269–84. https://doi.org/10.1111/j.1365-2982.2008.01113.x.CrossRef

15.

Pavlovic JM, Buse DC, Sollars CM, Haut S, Lipton RB. Trigger factors and premonitory features of migraine attacks: summary of studies. Headache. 2014;54(10):1670–9. https://doi.org/10.1111/head.12468.CrossRefPubMed

16.

•• Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380–92The most recent revision of the ROME IV criteria used for clinical diagnosis in cyclic vomiting syndrome and other functional gastrointestinal disorders.CrossRef

17.

Lipton RB, Stewart WF, Simon D. Medical consultation for migraine: results from the American migraine study. Headache: The Journal of Head and Face Pain. 1998;38(2):87–96.CrossRef

18.•

Bhandari S, Venkatesan T. Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Digestive diseases and sciences. 2017;62(8):–2035, 44 Large scale study of hospitalized patients that met ROME criteria for CVS and highlighted the comorbidities of the adult CVS population on a wide scale of 10952 patients.CrossRef

19.

Venkatesan T, Prieto T, Barboi A, Li B, Schroeder A, Hogan W, et al. Autonomic nerve function in adults with cyclic vomiting syndrome: a prospective study. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2010;22(12):1303–7, e339 https://doi.org/10.1111/j.1365-2982.2010.01577.x.CrossRef

20.

Hejazi RA, Lavenbarg TH, Pasnoor M, Dimachkie M, Foran P, Herbelin L, et al. Autonomic nerve function in adult patients with cyclic vomiting syndrome. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2011;23(5):439–43. https://doi.org/10.1111/j.1365-2982.2011.01679.x.CrossRef

21.

Rashed H, Abell TL, Familoni BO, Cardoso S. Autonomic function in cyclic vomiting syndrome and classic migraine. Digestive diseases and sciences. 1999;44(8 Suppl):74s–8s.PubMed

22.

Miglis MG. Migraine and autonomic dysfunction: which is the horse and which is the jockey? Curr Pain Headache Rep. 2018;22(3):19. https://doi.org/10.1007/s11916-018-0671-y.CrossRefPubMed

23.

Hejazi RA, Lavenbarg TH, Foran P, McCallum RW. Who are the nonresponders to standard treatment with tricyclic antidepressant agents for cyclic vomiting syndrome in adults? Aliment Pharmacol Ther. 2010;31(2):295–301. https://doi.org/10.1111/j.1365-2036.2009.04165.x.CrossRefPubMed

24.

Dindo LN, Recober A, Haddad R, Calarge CA. Comorbidity of migraine, major depressive disorder, and generalized anxiety disorder in adolescents and young adults. International journal of behavioral medicine. 2017;24(4):528–34. https://doi.org/10.1007/s12529-016-9620-5.CrossRefPubMedPubMedCentral

25.

Buse DC, Rupnow MFT, Lipton RB. Assessing and managing all aspects of migraine: migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc. 2009;84(5):422–35.CrossRef

26.

Nguyen TV, Low NC. Comorbidity of migraine and mood episodes in a nationally representative population-based sample. Headache. 2013;53(3):498–506. https://doi.org/10.1111/j.1526-4610.2012.02264.x.CrossRefPubMed

27.

• Buse D, Manack A, Serrano D, Turkel C, Lipton R. Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. Journal of neurology, Neurosurgery & Psychiatry. 2010;81(4):428–32 Analyzes the comorbidity data from the American Migraine Prevalence and Prevention study classifying findings of episodic and chronic migraine and their related comorbidities.CrossRef

28.

Menon V, Uddin LQ. Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 2010;214(5–6):655–67. https://doi.org/10.1007/s00429-010-0262-0.CrossRefPubMedPubMedCentral

29.

Ellingsen DM, Garcia R, Lee J, Lin R, Kim J, Thurler A et al. Cyclic vomiting syndrome is characterized by altered functional brain connectivity of the insular cortex: a cross-comparison with migraine and healthy adults. Neurogastroenterology & Motility. 2017;29(6).CrossRef

30.

Ho TW, Edvinsson L, Goadsby PJ. CGRP and its receptors provide new insights into migraine pathophysiology. Nat Rev Neurol. 2010;6(10):573–82. https://doi.org/10.1038/nrneurol.2010.127.CrossRefPubMed

31.

Lauritzen M. Pathophysiology of the migraine aura. The spreading depression theory. Brain : a journal of neurology. 1994;117(Pt 1):199–210.CrossRef

32.

Hadjikhani N. Mechanisms of migraine aura revealed by functional MRI in human. 2001;98(8):4687–92. doi:https://doi.org/10.1073/pnas.071582498.CrossRef

33.

Boles RG, Adams K, Li B. Maternal inheritance in cyclic vomiting syndrome. Am J Med Genet A. 2005;133(1):71–7.CrossRef

34.

Zaki E, Freilinger T, Klopstock T, Baldwin E, Heisner K, Adams K, et al. Two common mitochondrial DNA polymorphisms are highly associated with migraine headache and cyclic vomiting syndrome. Cephalalgia. 2009;29(7):719–28.CrossRef

35.

Boles R, Zaki E, Lavenbarg T, Hejazi R, Foran P, Freeborn J, et al. Are pediatric and adult-onset cyclic vomiting syndrome (CVS) biologically different conditions? Relationship of adult-onset CVS with the migraine and pediatric CVS-associated common mtDNA polymorphisms 16519T and 3010A. Neurogastroenterology & Motility. 2009;21(9):936.CrossRef

36.

Venkatesan T, Zaki EA, Kumar N, Sengupta J, Ali M, Malik B, et al. Quantitative pedigree analysis and mitochondrial DNA sequence variants in adults with cyclic vomiting syndrome. BMC Gastroenterol. 2014;14(1):181.CrossRef

37.

Stuart S, Griffiths LR. A possible role for mitochondrial dysfunction in migraine. Molecular genetics and genomics : MGG. 2012;287(11–12):837–44. https://doi.org/10.1007/s00438-012-0723-7.CrossRefPubMed

38.

Gormley P, Anttila V, Winsvold BS, Palta P, Esko T, Pers TH, et al. Meta-analysis of 375,000 individuals identifies 38 susceptibility loci for migraine. Nat Genet. 2016;48(8):856–66. https://doi.org/10.1038/ng.3598.CrossRefPubMedPubMedCentral

39.

Venkatesan T, Zadvornova Y, Raff H, Hillard CJ. Endocannabinoid-related lipids are increased during an episode of cyclic vomiting syndrome. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2016;28(9):1409–18. https://doi.org/10.1111/nmo.12843.CrossRef

40.

Wasilewski A, Lewandowska U, Mosinska P, Watala C, Storr M, Fichna J, et al. Cannabinoid receptor type 1 and mu-opioid receptor polymorphisms are associated with cyclic vomiting syndrome. Am J Gastroenterol. 2017;112(6):933.CrossRef

41.

Russo E. Hemp for headache: an in-depth historical and scientific review of cannabis in migraine treatment. Journal of Cannabis Therapeutics. 2001;1(2):21–92.CrossRef

42.

Moldrich G, Wenger T. Localization of the CB1 cannabinoid receptor in the rat brain. An immunohistochemical study☆. Peptides. 2000;21(11):1735–42. https://doi.org/10.1016/S0196-9781(00)00324-7.CrossRefPubMed

43.

Russo EB. Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research. 2016;1(1):154–65.CrossRef

44.

Sarchielli P, Pini LA, Coppola F, Rossi C, Baldi A, Mancini ML, et al. Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology. 2007;32(6):1384.CrossRef

45.

Goadsby P, Edvinsson L, Ekman R. Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1988;23(2):193–6.CrossRef

46.

Juhasz G, Zsombok T, Modos EA, Olajos S, Jakab B, Nemeth J, et al. NO-induced migraine attack: strong increase in plasma calcitonin gene-related peptide (CGRP) concentration and negative correlation with platelet serotonin release. Pain. 2003;106(3):461–70.CrossRef

47.

Lassen L, Haderslev P, Jacobsen V, Iversen HK, Sperling B, Olesen J. CGRP may play a causative role in migraine. Cephalalgia. 2002;22(1):54–61.CrossRef

48.

• Tso AR, Goadsby PJ. Anti-CGRP monoclonal antibodies: the next era of migraine prevention? Current treatment options in neurology. 2017;19(8):27 A review of the results of different CGRP monoclonal antibodies successfully reducing the period of migrraine duraiton in mulitple phase II trials.CrossRef

49.

•• Hejazi RA, Reddymasu SC, Namin F, Lavenbarg T, Foran P, McCallum RW. Efficacy of tricyclic antidepressant therapy in adults with cyclic vomiting syndrome: a two-year follow-up study. Journal of clinical gastroenterology. 2010;44(1):18–21. https://doi.org/10.1097/MCG.0b013e3181ac6489Two year study documenting the effectiveness of TCAs in CVS and establishing amitryptiline as first line prevention therapy for CVS.CrossRefPubMed

50.

Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M, et al. Tricyclic antidepressants and headaches: systematic review and meta-analysis. BMJ (Clinical research ed). 2010;341:c5222. https://doi.org/10.1136/bmj.c5222.CrossRef

51.

Boles RG, Lovett-Barr MR, Preston A, Li BU, Adams K. Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study. BMC Neurol. 2010;10(1):10.CrossRef

52.

Rozen TD, Oshinsky ML, Gebeline CA, Bradley KC, Young WB, Shechter AL, et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia. 2002;22(2):137–41. https://doi.org/10.1046/j.1468-2982.2002.00335.x.CrossRefPubMed

53.

Sandor PS, Di Clemente L, Coppola G, Saenger U, Fumal A, Magis D, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology. 2005;64(4):713–5. https://doi.org/10.1212/01.Wnl.0000151975.03598.Ed.CrossRefPubMed

54.

Sezer OB. A new approach to the prophylaxis of cyclic vomiting: topiramate. 2016;22(4):656–60. https://doi.org/10.5056/jnm16035.CrossRef

55.

Olmez A, Kose G, Turanli G. Cyclic vomiting with generalized epileptiform discharges responsive to topiramate therapy. Pediatr Neurol. 2006;35(5):348–51. https://doi.org/10.1016/j.pediatrneurol.2006.06.014.CrossRefPubMed

56.

Kumar N, Bashar Q, Reddy N, Sengupta J, Ananthakrishnan A, Schroeder A, et al. Cyclic vomiting syndrome (CVS): is there a difference based on onset of symptoms-pediatric versus adult? BMC Gastroenterol. 2012;12(1):52.CrossRef

57.

Calabresi P, Galletti F, Rossi C, Sarchielli P, Cupini LM. Antiepileptic drugs in migraine: from clinical aspects to cellular mechanisms. Trends Pharmacol Sci. 2007;28(4):188–95. https://doi.org/10.1016/j.tips.2007.02.005.CrossRefPubMed

58.

Cristofori F, Lindley K, Kumaraguru N, Kiparissi F, Elawad M, Saliakellis E, et al. Aprepitant use in children with cyclical vomiting syndrome. Dig Liver Dis. 2013;45:e269.

59.

Cristofori F, Thapar N, Saliakellis E, Kumaraguru N, Elawad M, Kiparissi F, et al. Efficacy of the neurokinin-1 receptor antagonist aprepitant in children with cyclical vomiting syndrome. Aliment Pharmacol Ther. 2014;40(3):309–17. https://doi.org/10.1111/apt.12822.CrossRefPubMed

60.

Goldstein D, Wang O, Saper J, Stoltz R, Silberstein S, Mathew N. Ineffectiveness of neurokinin-1 antagonist in acute migraine: a crossover study. Cephalalgia. 1997;17(7):785–90.CrossRef

61.

Olesen J, Diener H-C, Husstedt IW, Goadsby PJ, Hall D, Meier U, et al. Calcitonin gene–related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine. N Engl J Med. 2004;350(11):1104–10.CrossRef

62.

Ho T, Mannix L, Fan X, Assaid C, Furtek C, Jones C, et al. Randomized controlled trial of an oral CGRP receptor antagonist, MK-0974, in acute treatment of migraine. Neurology. 2008;70(16):1304–12.CrossRef

63.

Maasumi K, Michael RL, Rapoport AM. CGRP and migraine: the role of blocking calcitonin gene-related peptide ligand and receptor in the management of migraine. Drugs. 2018;78(9):913–28. https://doi.org/10.1007/s40265-018-0923-5.CrossRefPubMed

64.

Efficacy, Safety, and Tolerability of Oral Ubrogepant in the Acute Treatment of Migraine. https://ClinicalTrials.gov/show/NCT02867709.

65.

Efficacy, Safety, and Tolerability Study of Oral Ubrogepant in the Acute Treatment of Migraine. https://ClinicalTrials.gov/show/NCT02828020.

66.

• Goadsby PJ, Reuter U, Hallström Y, Broessner G, Bonner JH, Zhang F, et al. A controlled trial of erenumab for episodic migraine. New England Journal of Medicine. 2017;377(22):2123–32 Phase III trial of erenumab, a CGRP receptor direct antagonist, that illustrated > 50% improvement in monthly migraine duration leading to its approval by the FDA for migraine treatment.CrossRef

67.•

Efficacy and Safety of Subcutaneous Administration of TEV-48125 for the Preventive Treatment of Migraine. https://ClinicalTrials.gov/show/NCT02638103Phase III trial of Fremanezumab, a CGRP ligand antagonist that showed significantly lower headaches per month compared to placebo leading to FDA approval for migraine treatment.

68.

Ho TW, Olesen J, Dodick DW, Kost J, Lines C, Ferrari MD. Antimigraine efficacy of telcagepant based on patient's historical triptan response. Headache: The Journal of Head and Face Pain. 2011;51(1):64–72 Phase III trial of fremanezumab, a CGRP ligand antagonist that showed significantly lower headches per month compared to placebo leading to FDA approval for migraine treatment.CrossRef

69.

Silberstein SD. Migraine pathophysiology and its clinical implications. Cephalalgia. 2004;24(Suppl 2):2–7. https://doi.org/10.1111/j.1468-2982.2004.00892.x.CrossRefPubMed

70.

Kowalczyk M, Parkman H, Ward L. Adult cyclic vomiting syndrome successfully treated with intranasal sumatriptan. J Gen Intern Med. 2010;25(1):88–91.CrossRef

71.

Benson JM, Zorn SL, Book LS. Sumatriptan in the treatment of cyclic vomiting. Ann Pharmacother. 1995;29(10):997–9. https://doi.org/10.1177/106002809502901008.CrossRefPubMed

72.

Olden KW, Chepyala P. Functional nausea and vomiting. Nature clinical practice Gastroenterology & hepatology. 2008;5(4):202–8. https://doi.org/10.1038/ncpgasthep1094.CrossRef

73.

Bhandari S, Venkatesan T. Novel treatments for cyclic vomiting syndrome: beyond ondansetron and amitriptyline. Current treatment options in gastroenterology. 2016;14(4):495–506. https://doi.org/10.1007/s11938-016-0114-y.CrossRefPubMed

74.

Burstein R, Collins B, Jakubowski M. Defeating migraine pain with triptans: a race against the development of cutaneous allodynia. Ann Neurol. 2004;55(1):19–26. https://doi.org/10.1002/ana.10786.CrossRefPubMed

75.

Taylor FR, Kaniecki RG. Symptomatic treatment of migraine: when to use NSAIDs, triptans, or opiates. Curr Treat Options Neurol. 2011;13(1):15–27.CrossRef

76.

Su J, Zhou XY, Zhang GX. Association between Helicobacter pylori infection and migraine: a meta-analysis. World J Gastroenterol. 2014;20(40):14965–72. https://doi.org/10.3748/wjg.v20.i40.14965.CrossRefPubMedPubMedCentral

77.

Alvarez-Arellano L, Maldonado-Bernal C. Helicobacter pylori and neurological diseases: married by the laws of inflammation. World journal of gastrointestinal pathophysiology. 2014;5(4):400–4. https://doi.org/10.4291/wjgp.v5.i4.400.CrossRefPubMedPubMedCentral

78.

Faraji F, Zarinfar N, Zanjani AT, Morteza A. The effect of Helicobacter pylori eradication on migraine: a randomized, double blind, controlled trial. Pain physician. 2012;15(6):495–8.PubMed

79.

Chang FY, Lu CL. Irritable bowel syndrome and migraine: bystanders or partners? Journal of Neurogastroenterology and Motility. 2013;19(3):301–11. https://doi.org/10.5056/jnm.2013.19.3.301.CrossRefPubMedPubMedCentral

80.

Cole JA, Rothman KJ, Cabral HJ, Zhang Y, Farraye FA. Migraine, fibromyalgia, and depression among people with IBS: a prevalence study. BMC Gastroenterol. 2006;6:26. https://doi.org/10.1186/1471-230x-6-26.CrossRefPubMedPubMedCentral

81.

Jones R, Lydeard S. Irritable bowel syndrome in the general population. BMJ (Clinical research ed). 1992;304(6819):87–90.CrossRef

82.

Vandvik PO, Wilhelmsen I, Ihlebaek C, Farup PG. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther. 2004;20(10):1195–203. https://doi.org/10.1111/j.1365-2036.2004.02250.x.CrossRefPubMed

83.

Aydinlar EI, Dikmen PY, Tiftikci A, Saruc M, Aksu M, Gunsoy HG, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013;53(3):514–25. https://doi.org/10.1111/j.1526-4610.2012.02296.x.CrossRefPubMed

84.

Aurora SK, Kori SH, Barrodale P, McDonald SA, Haseley D. Gastric stasis in migraine: more than just a paroxysmal abnormality during a migraine attack. Headache. 2006;46(1):57–63. https://doi.org/10.1111/j.1526-4610.2006.00311.x.CrossRefPubMed

85.

Aurora SK, Papapetropoulos S, Kori SH, Kedar A, Abell TL. Gastric stasis in migraineurs: etiology, characteristics, and clinical and therapeutic implications. Cephalalgia. 2013;33(6):408–15. https://doi.org/10.1177/0333102412473371.CrossRefPubMedPubMedCentral

86.

Carstairs LS. Headache and gastric emptying time. Proceedings of the Royal Society of Medicine. 1958;51(10):790–1 discussion 1-3.PubMedPubMedCentral

87.

Volans GN. Migraine and drug absorption. Clin Pharmacokinet. 1978;3(4):313–8.CrossRef

88.

De Ponti F. Pharmacology of emesis and gastrointestinal motility: implications for migraine. Funct Neurol. 2000;15(Suppl 3):43–9.PubMed

89.

Yalcin H, Okuyucu EE, Ucar E, Duman T, Yilmazer S. Changes in liquid emptying in migraine patients: diagnosed with liquid phase gastric emptying scintigraphy. Intern Med J. 2012;42(4):455–9. https://doi.org/10.1111/j.1445-5994.2012.02741.x.CrossRefPubMed

90.

Hejazi RA, Lavenbarg TH, McCallum RW. Spectrum of gastric emptying patterns in adult patients with cyclic vomiting syndrome. Neurogastroenterol Motil. 2010;22(12):1298–302, e338.https://doi.org/10.1111/j.1365-2982.2010.01584.x.CrossRefPubMed

91.

Cicarelli G, Della Rocca G, Amboni M, Ciacci C, Mazzacca G, Filla A, et al. Clinical and neurological abnormalities in adult celiac disease. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003;24(5):311–7. https://doi.org/10.1007/s10072-003-0181-4.CrossRef

92.

Kurth T, Holtmann G, Neufang-Huber J, Gerken G, Diener HC. Prevalence of unexplained upper abdominal symptoms in patients with migraine. Cephalalgia. 2006;26(5):506–10. https://doi.org/10.1111/j.1468-2982.2005.01076.x.CrossRefPubMed

93.

Nilsson S, Edvinsson L, Malmberg B, Johansson B, Linde M. A relationship between migraine and biliary tract disorders: findings in two Swedish samples of elderly twins. Acta Neurol Scand. 2010;122(4):286–94. https://doi.org/10.1111/j.1600-0404.2009.01310.x.CrossRefPubMed

94.

Ferrara LA, Pacioni D, Di Fronzo V, Russo BF, Speranza E, Carlino V, et al. Low-lipid diet reduces frequency and severity of acute migraine attacks. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2015;25(4):370–5. https://doi.org/10.1016/j.numecd.2014.12.006.CrossRefPubMed

95.

Ornello R, Ripa P, Pistoia F, Degan D, Tiseo C, Carolei A, et al. Migraine and body mass index categories: a systematic review and meta-analysis of observational studies. The journal of headache and pain. 2015;16:27. https://doi.org/10.1186/s10194-015-0510-z.CrossRefPubMedPubMedCentral

96.

Verrotti A, Carotenuto M, Altieri L, Parisi P, Tozzi E, Belcastro V, et al. Migraine and obesity: metabolic parameters and response to a weight loss programme. Pediatric obesity. 2015;10(3):220–5. https://doi.org/10.1111/ijpo.245.CrossRefPubMed

97.

Aamodt AH, Stovner LJ, Hagen K, Zwart JA. Comorbidity of headache and gastrointestinal complaints. The Head-HUNT Study Cephalalgia. 2008;28(2):144–51. https://doi.org/10.1111/j.1468-2982.2007.01486.x.CrossRefPubMed

98.

Katic BJ, Golden W, Cady RK, Hu XH. GERD prevalence in migraine patients and the implication for acute migraine treatment. The journal of headache and pain. 2009;10(1):35–43. https://doi.org/10.1007/s10194-008-0083-1.CrossRefPubMed

99.

Mayer EA, Tillisch K, Gupta A. Gut/brain axis and the microbiota. J Clin Invest. 2015;125(3):926–38. https://doi.org/10.1172/jci76304.CrossRefPubMedPubMedCentral

100.

• Hindiyeh N, Aurora SK. What the gut can teach us about migraine. Current pain and headache reports. 2015;19(7):33. https://doi.org/10.1007/s11916-015-0501-4 Elucidates the pathophysiologic interlink and the neurotransmitters involved in the enteric nervous system and migraine disorder.CrossRefPubMed

101.

• de Roos NM, Giezenaar CG, Rovers JM, Witteman BJ, Smits MG, van Hemert S. The effects of the multispecies probiotic mixture Ecologic®Barrier on migraine: results of an open-label pilot study. Beneficial microbes. 2015;6(5):641–6. https://doi.org/10.3920/bm2015.0003 Supports the role of dysbiosis in migraine pathophysiology by showing a significant improvement in the number, intensity of attacks, and the MIDAS score of migraine patients with probiotic supplementation.CrossRefPubMed

102.

Prakash C, Clouse RE. Cyclic vomiting syndrome in adults: clinical features and response to tricyclic antidepressants. Am J Gastroenterol. 1999;94(10):2855–60. https://doi.org/10.1111/j.1572-0241.1999.01428.x.CrossRefPubMed

103.

Shearer J, Luthra P, Ford AC. Cyclic vomiting syndrome: a case series and review of the literature. Frontline gastroenterology. 2018;9(1):2–9. https://doi.org/10.1136/flgastro-2016-100705.CrossRefPubMed

104.

Chelimsky G, Madan S, Alshekhlee A, Heller E, McNeeley K, Chelimsky T. A comparison of dysautonomias comorbid with cyclic vomiting syndrome and with migraine. Gastroenterol Res Pract. 2009;2009.

105.

• Reed ML, Fanning KM, Serrano D, Buse DC, Lipton RB. Persistent frequent nausea is associated with progression to chronic migraine: AMPP study results. Headache: the journal of head and face pain. 2015;55(1):76–87 Highlights the interrelation of persistent nausea with migraine and the increased risk factor for further progression into chronic migraine.CrossRef

Title: Migraine, Cyclic Vomiting Syndrome, and Other Gastrointestinal Disorders
Authors: Elliot S. Yu, MD
Yasodara Priyadharsini S.S., MBBS
Thangam Venkatesan, MD
Publication date: 01-12-2018
Publisher: Springer US
Published in: Current Treatment Options in Gastroenterology / Issue 4/2018
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-018-0202-2

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STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

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