- EMBARGOED FOR RELEASE UNTIL 4 PM ET, February 23, 2016
- Could IBS, migraines and tension headaches be genetically linked?
- Genes in IBS, headache groups differed to those of healthy controls
- Is nausea a symptom of IBS?
- The Relationship Between IBS and Migraines
- IBS and Migraines: Timing Is Everything
- Strategies to Break the Mind-Gut Pain Connection
- Migraine, Tension Headaches, and Irritable Bowel Syndrome: What’s the Connection?
- Symptoms of IBS
- Go Deeper…There’s a Lot More to Discover About IBS
- Can Constipation Cause a Headache?
- Constipation and headaches at the same time
EMBARGOED FOR RELEASE UNTIL 4 PM ET, February 23, 2016
MINNEAPOLIS – Migraine and tension-type headaches may share genetic links with irritable bowel syndrome (IBS), according to a preliminary study released today that will be presented at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, Canada, April 15 to 21, 2016. Irritable bowel syndrome is the most common gastrointestinal disorder worldwide and affects up to 45 million people in the United States. Many people remain undiagnosed and the exact cause of the chronic condition is not known. Common symptoms include abdominal pain or cramping, a bloated feeling, gas and diarrhea or constipation. “Since headache and irritable bowel syndrome are such common conditions, and causes for both are unknown, discovering a possible link that could shed light on shared genetics of the conditions is encouraging,” said study author Derya Uluduz, MD, of Istanbul University in Turkey. The study involved 107 people with episodic migraine, 53 with tension-type headache, 107 people with IBS and 53 healthy people. Migraine and tension headache participants were examined for IBS symptoms and participants with IBS were asked about headaches. People with migraine were twice as likely to also have IBS as people with tension headache. A total of 54 percent of those with migraine also had IBS, compared to 28 percent of those with tension headache. Of the participants with IBS, 38 also had migraine and 24 also had tension headache. When researchers looked at the serotonin transporter gene and the serotonin receptor 2A gene, they found that the IBS, migraine and tension headache groups had at least one gene that differed from the genes of the healthy participants. “Further studies are needed to explore this possible link,” said Uluduz. “Discovering shared genes may lead to more future treatment strategies for these chronic conditions.” The study was supported by Mersin University. Learn more about brain health at www.aan.com/patients.
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, LinkedIn, Instagram and YouTube.
New research due to be presented at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, Canada, has found that there may be a genetic association between migraines, tension-type headaches and irritable bowel syndrome.
Share on PinterestThe new research suggests there may be a genetic link between IBS, migraines and tension-type headaches.
Irritable bowel syndrome (IBS) is a disorder of the digestive system, characterized by abdominal pain and discomfort and changes in bowel movement patterns.
It is estimated that around 25-45 million people in the US have IBS, with the condition being more common among men than women.
The exact cause of IBS is unclear, though researchers have suggested the condition may arise as a result of changes to the way the gut, brain and nervous system communicate.
Additionally, previous research has shown that people with IBS and other gastrointestinal disorders often have more headaches or migraines than those without such disorders. Could the conditions be linked?
This is what study coauthor Dr. Derya Uluduz, of Istanbul University in Turkey, and colleagues set out to establish with their latest study.
Genes in IBS, headache groups differed to those of healthy controls
To reach their findings, the researchers enrolled 107 patients with episodic migraine, 53 patients with episodic tension-type headache (ETTH), 107 patients with IBS and 53 healthy controls.
Fast facts about IBS
- Worldwide, between 9-23% of people have IBS
- The majority of people who have IBS are under the age of 50, though the condition can also affect older adults
- Around 2 in 3 people with IBS are female.
Learn more about IBS
The team assessed the patients with IBS for any incidence of migraine and ETTH, while incidence of IBS was assessed among patients with migraine or ETTH.
Compared with patients who had ETTH, those with migraine were almost twice as likely to have IBS; 54.2% of patients with migraine also had IBS, compared with 28.3% of those with ETTH.
Among the patients with IBS, 35.5% also had migraine and 22.4% also had ETTH.
Next, the researchers analyzed presence of the serotonin transporter gene and the serotonin receptor 2A gene among all patient groups and healthy controls.
“In IBS patients with constipation, serotonin secretion in plasma is being decreased,” the authors explain. “There is defect in serotonin signaling in IBS and decrease in mucosal serotonin and immune-reactivity of serotonin transporter.”
The team found that patients with IBS, migraine or ETTH all had at least one gene that was different to those of the healthy controls, suggesting that the three conditions may share a genetic link.
Commenting on their findings, Dr. Uluduz says:
“Since headache and irritable bowel syndrome are such common conditions, and causes for both are unknown, discovering a possible link that could shed light on shared genetics of the conditions is encouraging.
Further studies are needed to explore this possible link. Discovering shared genes may lead to more future treatment strategies for these chronic conditions.”
Last December, Medical News Today reported on a study that suggested low vitamin D levels may be linked to IBS.
Is nausea a symptom of IBS?
So much of the information about IBS talks about the symptoms of diarrhea and constipation, but I was diagnosed with IBS several years ago and I also frequently experience nausea. Is nausea a symptom in IBS? Is there a way to treat it?
Answer – Nausea is a common symptom reported by patients with irritable bowel syndrome (IBS). In one of our studies conducted at UCLA, we found that about 4 out of 10 women (38%) with IBS and nearly 3 out of 10 men (27%) with IBS report nausea. Nausea may be due to several causes. It is a symptom reported in conditions which frequently overlap with IBS. These include coexistent functional dyspepsia, gastroesophageal reflux disease (GERD), and migraine headaches. Other symptoms of functional dyspepsia include pain or fullness in the upper middle section of the abdomen that can occur after meals, bloating, and feeling full earlier than usual. GERD is a common condition where affected individuals report heartburn (burning sensation in the upper abdomen that may radiate to the chest), or indigestion. Nausea may also be due to side effects of medications.
The likely cause of the nausea needs to be assessed in order to determine the best management approach. This can be accomplished by discussing your symptoms with your physician. For example, GERD can be treated with diet and lifestyle modifications, and with acid-suppressing medications. There are many effective treatment interventions for migraine headaches. There are also various treatments which can be considered for functional dyspepsia. In addition, individuals with nausea can also be treated in general with anti-nausea medications such as prochlorperazine (e.g., Compazine, Compro).
Lin Chang, MD, Professor of Medicine, Co-Director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience, and Vice-Chief of the Vatche and Tamar Manounkian Division of Digestive Diseases, University of California, Los Angeles, CA
Published in Digestive Health Matters, Vol. 17, No. 1.
The Relationship Between IBS and Migraines
Carol Stevens has had symptoms of IBS for as long as she can remember. Then, when she was in her thirties, she started getting migraine headaches as well. “The pain would last for days and sometimes a couple of weeks,” said the now 60-year-old public relations professional in Westchester, N.Y.
IBS is a common, chronic disorder with abdominal pain or discomfort, and diarrhea, constipation, or both. “Many IBS patients, especially women, also report symptoms unrelated to digestion such as fatigue, muscle pain, sleep disturbances, and sexual dysfunction,” said Bethany DeVito, MD, gastroenterologist at North Shore University Hospital in Manhasset, N.Y.
Migraine headaches are vascular headaches that cause severe pain around the eye or temple area, face, sinuses, jaw, or neck. For many migraine sufferers, these headaches are debilitating.
Though Stevens never saw her IBS and migraines as being related, there is an established connection between IBS and migraine headaches in the medical community, Dr. DeVito said.
A 2005 study, for example, published in the Polish Journal of Neurology and Neurosurgery found that 23 to 53 percent of people with IBS experience frequent headaches, and that 10 to 20 percent of the population suffers from both migraine headaches and IBS.
Another, published in BMC Gastroenterology the following year, reported that people with IBS were 40 to 80 percent more likely to also have migraines, fibromyalgia, and/or depression than people without IBS.
More recently, a 2012 study published in Current Pain and Headache Reports found a further connection between migraine headaches, IBS, and celiac disease, the intolerance to gluten.
IBS and Migraines: Timing Is Everything
For some, symptoms of IBS and migraine headaches strike at the same time. “During the migraine attacks, some patients also have associated gastrointestinal disturbances, such as nausea, vomiting, abdominal pain, and diarrhea,” DeVito said.
Other migraine sufferers report IBS symptoms between headache attacks as well, added Maxwell Chait, MD, gastroenterologist at Columbia Doctors Medical Group in Hartsdale, N.Y.
Why the connection between migraine headaches and the digestion disturbances of IBS?
There are a few possible reasons. Researchers in the Current Pain and Headache Reports study traced the link to a genetically sensitive nervous system that turns overly vigilant, which can, over time, lead to chronic pain diseases like IBS and migraine headache.
Stress also factors into the connection between the head and the gut. “This mind-body connection is real and can greatly influence health,” Dr. Chait said.
One specific player is the brain chemical serotonin. “Serotonin is a major neurotransmitter of the gastrointestinal tract that plays a relevant part in IBS as well as migraine,” Chait said.
Strategies to Break the Mind-Gut Pain Connection
You can take steps to control both your migraines and IBS:
De-stress. As stress and anxiety increase, so do episodes of IBS and migraine headaches, DeVito said. To help reduce stress, try to identify and defuse its sources, such as finances, work, or relationships. Avoid unhealthy coping mechanisms like smoking, drinking alcohol, using drugs, and overeating. Instead, eat healthfully, get enough sleep, exercise regularly, and drink plenty of water. Make time for things you enjoy, such as reading a book or magazine, listening to music, taking a leisurely walk, and other stress-reducing activities like aerobic exercise, meditation, and yoga. If you feel overwhelmed, talk to a mental health professional.
Consider medication. Because serotonin plays a role in IBS and migraine headaches, medications that help maintain serotonin levels in the brain may help with both conditions. “For IBS, the drug tegaserod (Zelnorm), a serotonin receptor agonist, is used in people with constipation,” DeVito said. “And alosetron (Lotronex), a serotonin receptor antagonist, is prescribed for people with IBS-related diarrhea for which other medications have failed.”
Serotonin agonists called triptans are the most commonly prescribed drugs for migraines and include sumatriptan (Imitrex) and almotriptan (Axert); they also help maintain levels of serotonin in the brain.
Get educated. The better you understand your IBS and migraine headaches and what triggers them, the less anxiety you will experience surrounding your pain and other symptoms, and the better you will feel. If you have specific questions about your IBS or migraine headaches, ask your health care professional. Or research them at reputable sites online, including The National Headache Foundation or the National Institutes of Health’s National Digestive Diseases Information Clearinghouse.
Watch your diet. With both migraine headaches and IBS, foods and beverages can trigger symptoms. “For IBS, dietary advice includes avoiding dairy products, fatty foods, caffeine, and gas-producing foods (such as beans and cruciferous vegetables),” DeVito said. For migraines, potential triggers include chocolate, red wine, coffee, aged cheeses, and the food additive MSG. Keeping detailed records of what you eat and how you feel afterward will help you pinpoint food triggers of your headache and IBS symptoms.
When it comes to controlling migraine headaches and IBS, different treatments work for different people. As a first step in finding relief for all your IBS and migraine symptoms, talk to your health care professional.
Migraine, Tension Headaches, and Irritable Bowel Syndrome: What’s the Connection?
Migraine and tension headaches potentially share genetic links with irritable bowel syndrome (IBS).
Derya Uluduz, MD, Istanbul University, Turkey, commented in a news release, “Since headache and IBS are such common conditions, and causes for both are unknown, discovering a possible link hat could shed light on shared genetics of the conditions is encouraging.”
A preliminary study involved 107 patients with episodic migraines, 53 with tension-type headaches, 107 with IBS, and 53 healthy people. The patients with migraines and tension-headaches were examined for IBS symptoms and those with IBS were questioned about any headaches.
According to the study, those with migraines were twice as likely to suffer from IBS compare with those with tension headaches. Nearly 54% migraine patients also had IBS, compared to 28% of tension headache patients. Additionally, 38 IBS patients also suffered from migraines and 24 with tension headaches.
Assessing the serotonin transporter gene and the serotonin receptor 2A gene, researchers discovered that the IBS, migraine, and tension headache groups had at least one gene that differed from the genes in the healthy patients.
As such, “Further studies are needed to explore this possible link. Discovering shared genes may lead to more future treatment strategies for these chronic conditions,” concluded Uluduz.
Symptoms of IBS
The typical features of IBS are generally recognizable by a doctor. The most important first step in treating and managing symptoms is to see your doctor for a confident diagnosis of IBS.
Symptoms Cluster in IBS
A number of symptoms that occur together characterize irritable bowel syndrome (IBS). This may confuse you at first. Plus, symptoms will likely change over time. The changes may seem random. But there is a pattern to symptoms of IBS.
- The key sign or symptom of IBS is pain or discomfort in the abdomen. The abdomen is the area below your chest and above your hips.
Read more about pain in IBS
- The other symptoms of IBS relate to your bowel habit. You’ll notice a change in frequency or consistency of stool (diarrhea or constipation). These changes link to the pain.
- The symptoms occur over a long term and come and go over time.
- Some or all of IBS symptoms can occur at the same time. Some symptoms may be worse than others. Abdominal pain is often described as crampy, or as a generalized ache with periods of cramps. Sharp, dull, gas-like, or modest pains are common. The IBS discomfort or pain usually feels better after a bowel movement.
Symptom Patterns Add Up To IBS
Certain signs and symptoms occur with IBS. Symptom-based criteria for IBS emphasize a positive diagnosis rather than extensive tests to rule out all other diseases. No tests confirm the diagnosis of IBS.
Read more about IBS diagnosis
A detailed history, physical examination, and limited diagnostic tests help confirm the IBS diagnosis. More extensive testing is reserved for specific situations.
Other Symptoms May Accompany IBS
Persons treated for IBS commonly report upper gastrointestinal (GI) symptoms. About 25% to 50% report…
- Early feeling of fullness (satiety)
- Abdominal fullness
Other GI symptoms also reported include…
- Intermittent upper abdominal discomfort or pain (dyspepsia)
- Feelings of urgency (the need to find a restroom fast)
- Feeling of “incomplete” bowel emptying
Non-GI symptoms also occur. Sometimes, but not always, this may be due to an overlap of IBS with another condition. These symptoms include…
- Muscle pain
- Sleep disturbances
- Sexual dysfunction
- Low back pain
Symptoms sometimes seem contradictory, such as alternating diarrhea and constipation. It may help to keep a Symptom Diary so your doctor can see how your symptoms change over time and in relation to diet, stress, and other factors.
Get the Symptom Diary
Abnormal functioning of the nerves and muscles of the bowel produce the symptoms of IBS. A “dysregulation” between the brain, the gut, and the central nervous system causes the bowel to become “irritated,” or overly sensitive to stimuli. Symptoms may occur even in response to normal events.
Symptoms NOT Characteristic of IBS
- blood in the stools,
- unexplained weight loss, or
are not characteristic of IBS. You should alert your physician immediately if you are experiencing these symptoms.
Other signs or symptoms that call for special consideration before being attributed to IBS include:
- Age of 50 or older
- Nighttime symptoms that awake the individual
- Change in the symptom quality (e.g., new and different pain)
- Recent use of antibiotics
- A family history of other gastrointestinal diseases like inflammatory bowel disease or cancer.
You can Help Advance Understanding of IBS
Here are online studies you can take part in – from the comfort of your own home.
Go Deeper…There’s a Lot More to Discover About IBS
IFFGD’s publications are written by noted doctors and therapists from around the world. Here are some suggestions: Gynecological Aspects of IBS looks at IBS features in women. IBS in Men: A Different Disease? looks at IBS features in men. We have many publications about IBS available as PDFs in our library.
The Rome IV Diagnostic Criteria*
(a system for diagnosing functional gastrointestinal disorders based on symptoms) for IBS is as follows:
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria:
- Related to defecation
- Associated with a change in frequency of stool
- Associated with a change in form (appearance) of stool
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
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Can Constipation Cause a Headache?
If you experience a headache when you’re constipated, you may think your sluggish bowel is the culprit. It’s unclear, though, if headaches are a direct result of constipation. Instead, headaches and constipation may be side effects of an underlying condition.
Constipation occurs when you have less than three bowel movements a week. Your stools may be hard and difficult to pass. You may have a sensation of not finishing bowel movements. You may also have a feeling of fullness in your rectum.
Headache is pain anywhere in your head. It may be all over or on one side. It may feel sharp, throbbing, or dull. Headaches may last a few minutes or for days at a time. There are several types of headaches, including:
- sinus headache
- tension headache
- migraine headache
- cluster headaches
- chronic headache
When headaches and constipation occur on their own, it may be nothing to worry about. Everyone experiences them now and then. You may simply need to have more fiber and water, or find ways to better cope with stress. If headaches and constipation happen at the same time on a regular basis, you may have an underlying chronic condition. Keep reading to learn more about the possible conditions.
Classic symptoms of fibromyalgia include:
- muscle aches and pain
- joint aches and pain
- sleep problems
- memory and mood problems
Other symptoms may also occur, such as constipation and headaches, which may vary in severity.
Many people with fibromyalgia also have irritable bowel syndrome (IBS). In fact, up to 70 percent of people with fibromyalgia have IBS. IBS causes periods of constipation and diarrhea. Your symptoms may alternate between the two.
A 2005 study showed headaches, including migraines, are present in up to half of people with fibromyalgia. Over 80 percent of study participants reported headaches that severely affected their lives.
Constipation and headache may be symptoms of mood disorders such as anxiety and depression. Research shows people with constipation have higher psychological distress than those without the condition.
Stress, anxiety, and depression are common headache triggers. Migraines, tension headaches, and chronic headaches may be experienced daily.
In some cases, constipation and headaches trigger a vicious cycle. You may be more stressed because of constipation, which in turn causes more stress-related headaches.
Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) is characterized by unrelenting fatigue and lethargy. The fatigue you feel with CFS is not the same as being tired after a restless night. It’s a debilitating exhaustion that doesn’t improve after sleeping. Headaches are a common symptom of CFS.
Research indicates a possible link between CFS and IBS symptoms such as constipation. Some people with CFS are also diagnosed with IBS. It’s unclear if they actually have IBS, or if CFS causes gut inflammation and IBS-like symptoms.
Celiac disease is an autoimmune disorder triggered by gluten intolerance. Gluten is a protein found in wheat, barley, and rye. Symptoms occur when you consume foods or beverages containing gluten. Gluten may also be found in less-obvious places, such as:
- instant coffee
There are many possible symptoms of celiac disease, including headache and constipation.
Try these gluten-free recipes today: 25 gluten-free breakfast recipes “
Some medications may cause constipation and headaches. For example, opioids are well-known for causing severe constipation. Using them long-term may cause rebound headaches. Rebound headaches are also known as medication-overuse headaches. They’re triggered by extended use of certain medications.
Constipation and headaches are potential side effects of statins such as Zocor. If you regularly take prescription medications, check with your pharmacist to see if the drugs may be responsible for your symptoms.
The pathophysiology of migraine headache remains poorly understood; however, various theories have been proposed, including a “migraine center” in the brainstem that increases in activity and blood flow during migraine attacks,3 a neurogenic process with secondary changes in cerebral perfusion,4 modulation of dopaminergic neurotransmission,5 magnesium deficiency in the brain,6 and neurogenic inflammation, with the release of potent vasoactive pain-associated neuropeptides, including calcitonin gene-related peptide, substance P, and neurokinin A.8 Although these theories have evolved over the years, none has unequivocally provided robust evidence to fully explain the clinical spectrum of migraine.
Recently, evidence has accumulated to support a complex neurobiologic basis for migraine, with origins beyond the brain. The prevailing theory involves the gut-brain axis, which postulates a complex interplay between the brain and the gastrointestinal tract. However, the precise mechanism that links the brain and the gut and triggers a migraine event remains unclear. It has been suggested that undigested food particles and gut-associated bacterial components that act as endotoxins entering the bloodstream may play a role.9-11 In fact, it has been reported that gut permeability is increased and its barrier function compromised during various disease states such as gastrointestinal disorders, depression, and multiple sclerosis.11 The logical assumption is that restoring the intestinal barrier function may be a strategy to treat migraine attacks.
Although circumstantial evidence links gastrointestinal disorders with migraine headaches — including the similarity of their association with nausea, vomiting, and gastroparesis — a recent study by Doulberis and colleagues provides a comprehensive summary of the relevant published studies linking migraine and gastrointestinal or related disorders.12 The investigators found a clear association between migraine and various gastrointestinal diseases, including irritable bowel syndrome, inflammatory bowel disease, celiac disease, Helicobacter pylori infection, and cyclic vomiting syndrome, as well as food allergy and infantile colic.12 Philip Rosenthal, MD, professor of pediatrics at the University of California, San Francisco, confirmed: “In young children, several syndromes that cause gastrointestinal symptoms are associated with migraines. These syndromes can cause episodes of cyclic vomiting, abdominal pain (abdominal migraine), and dizziness (benign paroxysmal vertigo) and are often referred to as childhood periodic syndromes. In older children, irritable bowel syndrome, inflammatory bowel disease, and celiac disease may be associated.”
Both a population-based study involving 1038 subjects 15 years and older and a case-control study involving 424 children and adolescents 6 to 17 years old found similar associations between migraines and gastrointestinal functional disorders.13,14 In the case-control study, among the children with migraine, 32% were diagnosed with functional gastrointestinal disorders compared with 18% in the control group (P <.0001).14 Further, there was a significant association between migraine and dyspepsia (P <.0001), irritable bowel syndrome (P =.0002), and abdominal migraine (P =.002).14 The challenge, however, is that a meaningful comparison among these various studies cannot be made because of the heterogeneity of the study design, data collection, and analyses, and therefore a definitive conclusion linking specific gastrointestinal disorders and migraine cannot be made. In addition, the evidence of cause and effect between the gastrointestinal tract and migraine has not been established, although according to Dr Rosenthal, “a mechanism possibly related to permeable gut or intestinal inflammation . There are more nerves in the GI tract than in the brain.”
Gastrointestinal microbiota, and particularly an imbalance of the gut flora, has been implicated in the development of migraine,15 potentially associated with the increased permeability of the gut. Dai and colleagues concluded from their review of the literature that an improvement in gut microbiota and a reduction in inflammation can have positive effects on strengthening gut and brain function, inferring that probiotics may have a beneficial effect on the frequency and severity of migraine attacks.16 This inference was subsequently explored by Roos and colleagues in a randomized double-blind placebo-controlled trial to investigate whether probiotics could reduce migraine through their effect on intestinal permeability and inflammation.11 In the study, patients with migraine were randomly allocated to receive a multispecies probiotic (n =31) or placebo (n =32). Migraine events were assessed with the Migraine Disability Assessment Scale, the Headache Disability Inventory, and headache diaries. Intestinal permeability was assessed with the urinary lactose/mannitol test and fecal and serum zonulin, while inflammation was measured from interleukin-6, interleukin-10, tumor necrosis factor-α, and serum C-reactive protein.11 The investigators found no significant effect of multispecies probiotic on migraine frequency and intensity or on the markers of intestinal permeability and inflammation. Thus, the hypothesis that probiotics can relieve migraine through their effect on the intestinal epithelial barrier could not be corroborated.11 In discussing the results, Roos and colleagues explained that study limitations may explain the failure to demonstrate benefit of multispecies probiotic for migraine. Limitations of the study included a study population that had a selection bias and may not be truly representative of the migraine population, the small sample size of 63 patients may not be sufficiently powered to show a statistically significant benefit of multispecies probiotic, and variations in dosage and duration of treatment protocols among the studies. Further, the study could not account for confounding variables introduced by differences in patient susceptibility to probiotics and lack of control regarding additional medications and over-the-counter products that might interfere with inflammation and intestinal permeability.
Despite the limitations of the current studies, the general consensus from the various evidence to date suggests that it is reasonable for clinicians to have a heightened awareness of the potential relationship between gastrointestinal functional disorders and migraine. This awareness can trigger clinical suspicion that may influence approach to diagnosis and therapeutic management of migraine. Larger, multicenter, placebo-controlled clinical trials are needed to better define the link between gastrointestinal disorders and migraine and perhaps establish a cause and effect relationship.
- National Institute of Neurological Disorders and Stroke. Headache: Hope Through Research. April 2016. Accessed September 15, 2017.
- Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache. 2015;55:21-34.
- Diener H-C. Positron emission tomography studies in headache. Headache. 1997;37:622-625.
- Cutrer FM, Charles A. The neurogenic basis of migraine. Headache. 2008; 48:1411-1414.
- Akerman S, Goadsby PJ. Dopamine and migraine: biology and clinical implications. Cephalalgia. 2007;27:1308-1314.
- Sun-Edelstein C, Mauskop. Role of magnesium in the pathogenesis and treatment of migraine. Expert Rev Neurother. 2009;9:369-379.
- van Hemert S, Breedveld AC, Rovers JM, et al. Migraine associated with gastrointestinal disorders: review of the literature and clinical implications. Front Neurol. 2014;5:1-7.
- Malhotra R. Understanding migraine: potential role of neurogenic inflammation. Ann Indian Acad Neurol. 2016;19:175-182.
- Covelli V, Pellegrino NM, Jirillo E. A point of view: the need to identify an antigen in psyconeuroimmunological disorders. Curr Pharm Des. 2003;9:1951-1955.
- Mennigen R, Bruewer M. Effect of probiotics on intestinal barrier function. Ann N Y Acad Sci. 2009;1165:183-189.
- de Roos NM, van Hemert S, Rovers JMP, Smits MG, Witteman BJM. The effects of a multispecies probiotic on migraine and markers of intestinal permeability-results of a randomized placebo-controlled study . Eur J Clin Nutr. doi: 10.1038/ejcn.2017.57
- Doulberis M, Saleh C, Beyenburg S. Is there an association between migraine and gastrointestinal disorders? J Clin Neurol. 2017;13:215-226.
- Lankarani KB, Akbari M, Tabrizi R. Association of gastrointestinal functional disorders and migraine headache: a population base study. Middle East J Dig Dis. 2017;9:139-145.
- Le Gal J, Michel J-F, Rinaldi VE, et al. Association between functional gastrointestinal disorders and migraine in children and adolescents: a case-control study. Lancet Gastroenterol Hepatol. 2016;1:114-121.
- Hindiyeh N, Aurora SK. What the gut can teach us about migraine. Curr Pain Headache Rep. 2015;19:33.
- Dai YJ, Wang HY, Wang XJ, Kaye AD, Sun YH. Potential beneficial effects of probiotics on human migraine headache: a literature review. Pain Physician. 2017;20:E251-E255.
Constipation and headaches at the same time
Dehydration, which occurs when someone loses more fluid than they take in, can result in both constipation and headaches.
Constipation can also occur due to eating foods that contain little or no fiber. Many of these foods, such as fast foods and processed foods, are high in sugar. This may cause headaches.
In these instances, taking in more fluid and eating more nutritious high fiber foods could help resolve both symptoms.
There are also several underlying conditions that may cause both constipation and headaches. A person with one of these conditions may experience the two symptoms at the same time. These conditions include:
Celiac disease is a type of autoimmune condition. People who have celiac disease experience intestinal inflammation and damage as a result of eating gluten. Gluten is a protein present in wheat and wheat products.
There are three types of celiac disease: classical, nonclassical, and silent.
Classical celiac disease is characterized by intestinal malabsorption. This refers to when the intestines become so damaged that they are unable to absorb enough nutrients from the diet. Some signs of intestinal malabsorption include:
- pale, foul-smelling, fatty stools
- unexpected weight loss
- stunted growth (in children)
A person with nonclassical celiac disease may experience mild gastrointestinal (GI) symptoms such as abdominal pain and bloating. They may also experience:
- a deficiency in folic acid and vitamin B-12
- elevated liver enzymes
- chronic migraine
- chronic fatigue
- tingling, numbness, or pain in the hands and feet
- reduced bone mass
- bone fractures
- dental enamel defects
- an itchy skin rash
- difficulty losing weight
- delayed onset of menstruation
- early menopause
Silent celiac disease is so-called because those who have it are unlikely to experience any symptoms. They may, however, experience improved health after adopting a gluten-free diet.
The only treatment for celiac disease is to follow a strict gluten-free diet. This will allow the small intestine to heal, which should lead to a reduction in GI symptoms.
Mood disorders such as depression and anxiety can trigger tension headaches and GI issues.
Some additional symptoms of depression include:
- low mood
- feelings of sadness, worthlessness, or guilt
- loss of interest or pleasure in activities
- difficulty sleeping, or sleeping too much
- difficulty thinking, concentrating, or making decisions
- slowed movements and speech
- changes in appetite
- suicidal thoughts
There are also several types of anxiety disorder. Generalized anxiety disorder (GAD) is one of the most common. People with GAD experience persistent and excessive worry that interferes with their daily life.
They may also experience symptoms such as:
- increased heart rate
- rapid breathing
- difficulty concentrating
- muscle tension
- difficulty sleeping
- weakness or fatigue
- GI issues
A doctor may prescribe medications for people with depression or anxiety. However, these medications can take some time to work. People may also need to try several medications before finding a drug that works well for them.
People with either mood disorder may also benefit from talking therapies, such as cognitive behavioral therapy (CBT).
Fibromyalgia is a condition characterized by chronic widespread musculoskeletal pain. Common symptoms of fibromyalgia include:
- tenderness to touch or pressure
- severe fatigue
- sleep problems
- memory problems
Some people with fibromyalgia may experience migraine or tension headaches. They may also experience digestive issues, such as irritable bowel syndrome or gastroesophageal reflux disease.
The most effective treatment for fibromyalgia is physical exercise. Aerobic exercise may be particularly effective.
People with fibromyalgia may also benefit from taking certain medications. The Food and Drug Administration (FDA) have approved the following three drugs for the treatment of fibromyalgia:
- duloxetine (Cymbalta)
- milnacipran (Savella)
- pregabalin (Lyrica)
People with fibromyalgia may also benefit from the following treatments:
- massage therapy
Chronic fatigue syndrome
Chronic fatigue syndrome (CFS) is a condition that causes a person to feel overwhelmingly tired or fatigued. As a result, a person may have great difficulty carrying out normal daily activities.
CFS can cause headaches and, in some instances, constipation. Other symptoms may include:
- feeling tired even after sleep
- problems with memory or concentration
- muscle and joint pain
There is currently no cure for CFS. However, there are things a person can do to alleviate their symptoms. This may include spreading out activities that they know will drain them of energy. Certain supplements and relaxation therapies may also help.
The symptoms of CFS differ from one person to another. For this reason, a person should talk to their doctor about their specific symptoms and the possible treatment options.
Headaches and constipation can both be side effects of certain medications. Two medications that may cause these symptoms are opioids and statins.
A person should talk to their doctor if they develop constipation or headaches after starting a new medication.
If medication is the cause of both constipation and headaches, a doctor may lower the dosage. When possible, they may even prescribe an alternative medication.
If these options are not feasible, a doctor may prescribe medications to help alleviate the side effects.