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Newest Drugs for Chronic Unexplained Nausea and Vomiting
1Division of Gastroenterology, University of Michigan Health System, 3912 Taubman Center, SPC 5362, Ann Arbor, MI, 48109, USA. whasler@umich.edu.
Current Treatment Options in Gastroenterology
|October 12, 2016
Summary
Chronic unexplained nausea and vomiting (CUNV) is diagnosed when symptoms persist despite normal tests. Research explores antiemetics, neuromodulators, and prokinetics to improve treatment options for this condition.
Area of Science:
- Gastroenterology
- Neurogastroenterology
Background:
- Chronic unexplained nausea and vomiting (CUNV) presents with persistent nausea and vomiting, even after normal diagnostic evaluations.
- The underlying cause is thought to involve abnormal neurohumoral signaling in the peripheral or central nervous system.
- A significant portion of patients referred for testing show normal gastric emptying, highlighting the complexity of CUNV.
Approach:
- Review of existing and emerging therapeutic strategies for CUNV.
- Exploration of antiemetic drugs, including novel serotonin and neurokinin antagonists.
- Consideration of neuromodulatory agents and prokinetic medications targeting upper gastrointestinal motility.
Key Points:
- No randomized, placebo-controlled trials currently exist for CUNV treatments.
- Potential therapies include antiemetics, neuromodulators reducing gastric sensitivity, and prokinetics enhancing gut motility.
- Investigational agents targeting gastroduodenal serotonin, motilin, and ghrelin receptors show promise.
Conclusions:
- Current treatment approaches for CUNV are largely empirical.
- Emerging research on receptor-specific agents may offer new avenues for managing refractory CUNV.
- Further investigation is needed to establish evidence-based treatment guidelines for CUNV.