Are Individuals with IBS More Likely to Have Migraines?
Irritable bowel syndrome (IBS) is a functional digestive condition defined by abdominal pain, bloating, and constipation and/or diarrhea. It is so common that you likely know at least one person who has it, yet people rarely speak about having IBS due to the taboo nature of digestive symptoms. IBS symptoms are chronic and can be difficult to treat in some people, and it can affect many areas of life, including physical health, mental health, social activities, and work.
Migraine is a neurological condition that results in painful, throbbing headaches. These episodes are recurring, typically felt on one side of the head, and generally cause moderate to severe pain. Most individuals experience several other symptoms with the migraine headache, including nausea, vomiting, dizziness, and sensitivity to light and sound. In addition, many can tell when a migraine is coming because they experience symptoms up to a day before the headache, known as the prodromal phase, including fatigue, mood changes, muscle stiffness, difficulty sleeping, nausea, constipation, and diarrhea. Some individuals also experience an aura phase between the prodromal phase and the headache, which typically involves visual disturbances such as wavy lines, blurring, or loss of part of the visual field, and can also include difficulty speaking and sensory disturbances such as tingling or numbness in the extremities. A migraine can last anywhere from a few hours to several days. As with IBS, migraine can affect many areas of life, as the symptoms can lead to missed work and social events.
In a recent study,1 researchers analyzed data obtained from the UK Biobank, a biomedical database and research resource that contains detailed information from nearly half a million individuals, to look for connections between migraine and gastrointestinal diseases and disorders. Past research has shown a potential link between migraine and a variety of digestive conditions, including IBS, peptic ulcers, Helicobacter pylori infection, Crohn’s disease, ulcerative colitis, and celiac disease.
The study involved 489,753 participants between the ages of 37 and 69 years, so while it is a very large cohort, it is lacking data on children, young adults, and seniors. Another possible limitation of this study is a healthy participant bias, as those who participated in the study tended to have fewer health conditions than those found in an average population. The rates of gastrointestinal conditions and migraine in this group were both lower than expected in a random selection of people.
After analyzing the data, the researchers found that those with IBS were 2.25 times more likely than the control subjects to experience migraines. The research also showed that individuals with peptic ulcer disease were 1.63 times more likely to suffer from migraines than the control subjects. However, despite H. pylori infection being a primary cause of peptic ulcers, individuals who had H. pylori infection without ulcers were not at an increased risk of migraines. While past research has shown a potential correlation, this study found that those who had Crohn’s disease, ulcerative colitis, or celiac disease were no more likely to suffer from migraine than the controls.
The study authors speculate that the correlation between IBS and migraine could be related to disruptions to the gut-brain axis. One possible mechanism is problems with serotonin levels. Previous research shows that migraine might be related to chronically low serotonin levels that increase during active migraines. In addition, it’s possible that some cases of IBS might occur due to low levels of serotonin in the gut, which is why selective serotonin reuptake inhibitors can be an effective treatment method for individuals with IBS. In addition, both IBS and migraine are more common in women than in men, so female hormones might also play a role.
Further research is needed to fully understand why this link exists, and whether individuals with other digestive conditions might be at an increased risk of experiencing migraine.
First published in the Inside Tract® newsletter issue 219 – 2021
Photo: Keira Burton | Pexels.com
1.Welander NZ et al. Migraine and gastrointestinal disorders in middle and old age: A UK Biobank study [published online ahead of print, 2021 Jul 21]. Brain Behav. 2021;10.1002/brb3.2291. doi:10.1002/brb3.2291.