Association between gastrointestinal disorders and migraine: an integrative review

Authors

  • Carla Cristina Kanazawa
  • Juliane Soldi Malgarin Faculdades Pequeno Príncipe
  • Bruno Bertoli Esmanhotto

DOI:

https://doi.org/10.48208/HeadacheMed.2024.13

Keywords:

Migraine, Brain-gut axis, Inflammatory enteropathies

Abstract

Introduction

Migraine is a highly incapacitating type of primary headache, characterized by high prevalence and symptoms lasting from 4 to 72 hours. It is typically unilateral and pulsatile, often accompanied by nausea, hypersensitivity to sensory stimuli, vomiting and intense fatigue, and it may or may not be preceded by an aura. Although the pathophysiology of migraine is not completely understood, several mechanisms involving the gut-brain  axis may explain the association between migraine and gastrointestinal disorders.

Objective

This review aims to analyze the influence of gastrointestinal disorders on migraine.

Methods

An integrative review was conducted by surveying articles in the LILACS, PubMed, and Scielo databases using relevant descriptors related to migraine and gastrointestinal disorders.

Results

The research identified 31 articles, of which only 11 met the previously established criteria. All eligible articles demonstrated a correlation between migraine and gastrointestinal disorders, with Irritable Bowel Syndrome (IBS) being the most frequently mentioned condition.

Conclusion

Gastrointestinal disorders influence migraine, possibly through tryptophan metabolism and its associated pathways. Understanding these mechanisms may lead to new treatments. IBS stands out among the disorders associated with migraine, suggesting an integrative approach. Changes in diet and lifestyle, along with medications, are recommended. Early  identification of comorbidities can facilitate more effective migraine management. However, further research is needed to develop more effective treatments.

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References

Goadsby PJ, Holland PR. An update: pathophysiology of migraine. Neurol Clin. 2019 Nov;37(4):651–71. doi: 10.1016/j.ncl.2019.07.008. DOI: https://doi.org/10.1016/j.ncl.2019.07.008

Thomaz TG, Paula AEA de, Alves DM de, Alves LL, Fonseca PGM da. Migraine and sleep deprivation: integrative review: BrJP [Internet]. 2021 Out;4(4):379-87. doi: 10.5935/2595-0118.20210068. DOI: https://doi.org/10.5935/2595-0118.20210068

Welander NZ, Olivo G, Pisanu C, Rukh G, Schiöth HB, Mwinyi J. Migraine and gastrointestinal disorders in middle and old age: a UK Biobank study. Brain Behav. 2021 Jul 21;11(8):e2291. doi: 10.1002/brb3.2291. DOI: https://doi.org/10.1002/brb3.2291

OMS. Organização Mundial de Saúde. Distúrbios de dor de cabeça. Genebra: OMS; 2016.

De Tommaso M, Libro G, Guido M, Difruscolo O, Losito L, Sardaro M, et al. Nitroglycerin induces migraine headache and central sensitization phenomena in patients with migraine without aura: a study of laser evoked potentials. Neurosci Lett. 2004 Jun 17;363(3):272–75. doi: 10.1016/j.neulet.2004.04.029. DOI: https://doi.org/10.1016/j.neulet.2004.04.029

Knapp L, Szita B, Kocsis K, Vécsei L, Toldi J. Nitroglycerin enhances the propagation of cortical spreading depression: comparative studies with sumatriptan and novel kynurenic acid analogues. Drug Des Devel Ther. 2016 Dez 20;11:27–34. doi: 10.2147/DDDT.S117166. DOI: https://doi.org/10.2147/DDDT.S117166

Martami F, Togha M, Seifishahpar M, Ghorbani Z, Ansari H, Karimi T, et al. The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: a randomized double-blind controlled trial. Cephalalgia. 2019 Jun;39(7):841–853. doi: 10.1177/0333102418820102. DOI: https://doi.org/10.1177/0333102418820102

Wen Z, He M, Peng C, Rao Y, Li J, Li Z, et al. Metabolomics and 16S rRNA gene sequencing analyses of changes in the intestinal flora and biomarkers induced by gastrodia-uncaria treatment in a rat model of chronic migraine. Front Pharmacol. 2019 Dez;10:1425. doi: 10.3389/fphar.2019.01425. DOI: https://doi.org/10.3389/fphar.2019.01425

Long T, He W, Pan Q, Zhang S, Zhang D, Qin G, et al. Microglia P2X4R-BDNF signalling contributes to central sensitization in a recurrent nitroglycerin-induced chronic migraine model. J Headache Pain. 2020 Jan 14;21(1):4. doi: 10.1186/s10194-019-1070-4. DOI: https://doi.org/10.1186/s10194-019-1070-4

Tang Y, Liu S, Shu H, Yanagisawa L, Tao F. Gut microbiota dysbiosis enhances migraine-like pain via TNFα upregulation. Mol Neurobiol. 2020 Jan;57(1):461–68. doi: 10.1007/s12035-019-01721-7. DOI: https://doi.org/10.1007/s12035-019-01721-7

Bhandari S, Venkatesan T. Clinical characteristics, comorbidities and hospital outcomes in hospitalizations with cyclic vomiting syndrome: a nationwide analysis. Dig Dis Sci. 2017 Ago;62(8):2035-2044. doi: 10.1007/s10620-016-4432-7. DOI: https://doi.org/10.1007/s10620-016-4432-7

Fila M, Chojnacki C, Chojnacki J, Blasiak J. The kynurenine pathway of tryptophan metabolism in abdominal migraine in children - a therapeutic potential? Eur J Paediatr Neurol. 2024 Jan 1;48:1–12. doi: 10.1016/j.ejpn.2023.11.001. DOI: https://doi.org/10.1016/j.ejpn.2023.11.001

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 Nov 15;20(10):1195–1203. Doi: 10.1111/j.1365-2036.2004.02250.x. DOI: https://doi.org/10.1111/j.1365-2036.2004.02250.x

Cámara-Lemarroy CR, Rodriguez-Gutierrez R, Monreal-Robles R, Marfil-Rivera A. Gastrointestinal disorders associated with migraine: a comprehensive review. World J Gastroenterol. 2016 Set 28.;22(36):8149–8160. doi: 10.3748/wjg.v22.i36.8149. DOI: https://doi.org/10.3748/wjg.v22.i36.8149

Noghani MT, Namdar H. Migraine associated with gastrointestinal disorders: a pathophysiological explanation. Med Hypotheses. 2019 Abr;125:90–3. doi: 10.1016/j.mehy.2019.02.041. DOI: https://doi.org/10.1016/j.mehy.2019.02.041

Parohan M, Djalali M, Sarraf P, Yaghoubi S, Seraj A, Foroushani AR, et al. Effect of probiotic supplementation on migraine prophylaxis: a systematic review and meta-analysis of randomized controlled trials. Nutr Neurosci. 2020 Mar;25(3):511-18. doi: 10.1080/1028415X.2020.1764292. DOI: https://doi.org/10.1080/1028415X.2020.1764292

Griauzdaitė K, Maselis K, Žvirblienė A, Vaitkus A, Jančiauskas D, Banaitytė-Baleišienė I, et al. Associations between migraine, celiac disease, non-celiac gluten sensitivity and activity of diamine oxidase. Med Hypotheses. 2020 Set;142:109738. doi: 10.1016/j.mehy.2020.109738. DOI: https://doi.org/10.1016/j.mehy.2020.109738

Boutrid N, Rahmoune H. “3M”: migraine, microbiota and melatonin. Med Hypotheses. 2019 Jun;127:90. doi: 10.1016/j.mehy.2019.04.001. DOI: https://doi.org/10.1016/j.mehy.2019.04.001

Chen J, Wang Qi, Wang A, Lin Z. Structural and functional characterization of the gut microbiota in elderly women with migraine. Front Cell Infect Microbiol. 2020 Jan 29;9:470. doi: 10.3389/fcimb.2019.00470. DOI: https://doi.org/10.3389/fcimb.2019.00470

Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clin North Am. 2001 Jul;85(4):911–941. doi: 10.1016/s0025-7125(05)70351-5. DOI: https://doi.org/10.1016/S0025-7125(05)70351-5

Giamberardino MA, Martelletti P, editors. Comorbidities in headache disorders. Roma: Springer; 2017. doi: 10.1007/978-3-319-41454-6. DOI: https://doi.org/10.1007/978-3-319-41454-6

Aamodt AH, Stovner LJ, Zwart J-A. Comorbidity of headache and gastrointestinal complaints: the head-hunt study. Cephalalgia. 2008 Fev;28(2):144-152. doi: 10.1111/j.1468-2982.2007.01486.x.

Chang F-Y, Lu CL. Irritable bowel syndrome and migraine: bystanders or partners? J Neurogastroenterol Motil. 2013 Jul;19(3):301–311. doi: 10.5056/jnm.2013.19.3.301. DOI: https://doi.org/10.5056/jnm.2013.19.3.301

Ozan ZT, Tanik N, Inan LE. Constipation is associated with tension type headache in women. Arq Neuropsiquiatr. 2019 Mar;77(3):161–5. doi: 10.1590/0004-282X20190015. DOI: https://doi.org/10.1590/0004-282x20190015

Di Stefano M, Pucci E, Miceli E, Pagani E, Brondino N, Nappi G, et al. Prevalence and pathophysiology of post-prandial migraine in patients with functional dyspepsia. Cephalalgia. 2019 Out;39(12):1560¬-8. doi: 10.1177/0333102419857596. DOI: https://doi.org/10.1177/0333102419857596

Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic vomitin syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005 Dez 21;3:20. doi: 10.1186/1741-7015-3-20. DOI: https://doi.org/10.1186/1741-7015-3-20

Aurora SK, Shrewsbury SB, Ray S, Hindiyeh N, Nguyen L. A link between gastrointestinal disorders and migraine: insights into the gut–brain connection. Headache. 2021 Abr;61(4):576–89. doi: 10.1111/head.14099. DOI: https://doi.org/10.1111/head.14099

Hemarajata P, Versalovic J. Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013 Jan;6(1):39–51. doi: 10.1177/1756283X12459294. DOI: https://doi.org/10.1177/1756283X12459294

Souza LLB, Leite L de O, Nepomuceno CMM. Association between migraine, constipation and lactose intolerance in adults patients. Br J Pain. 2020;3(2):118-122. doi: 10.5935/2595-0118.20200020. DOI: https://doi.org/10.5935/2595-0118.20200020

David LA, Materna AC, Friedman J, Campos-Baptista MI, Blackburn MC, Perrotta A, et al. Host lifestyle affects human microbiota on daily timescales. Genome Biol. 2014;15(7):R89. doi: 10.1186/gb-2014-15-7-r89. DOI: https://doi.org/10.1186/gb-2014-15-7-r89

Singh RK, Chang H-W, Yan D, Lee KM, Ucmak D, Wong K, et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017 Abr 8;15(1):73. doi: 10.1186/s12967-017-1175-y. DOI: https://doi.org/10.1186/s12967-017-1175-y

Wu GD, Chen J, Hoffmann C, Bittinger K, Chen Y-Y, Keilbaugh AS, et al. Linking long-term dietary patterns with gut microbial enterotypes. Science. 2011 Out 7;334(6052):105–8. doi: 10.1126/science.1208344. DOI: https://doi.org/10.1126/science.1208344

Zhang C, Zhang M, Wang S, Han R, Cao Y, Hua W, et al. Interactions between gut microbiota, host genetics and diet relevant to development of metabolic syndromes in mice. ISME J. 2010 Fev;4(2):232–41. doi: 10.1038/ismej.2009.112. DOI: https://doi.org/10.1038/ismej.2009.112

Peatfield RC, Glover V, Littlewood JT, Sandler M, Rose FC. The prevalence of diet-induced migraine. Cephalalgia. 1984 Set;4(3):179–183. doi: 10.1046/j.1468-2982.1984.0403179.x. DOI: https://doi.org/10.1046/j.1468-2982.1984.0403179.x

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Published

2024-06-29

How to Cite

1.
Cristina Kanazawa C, Malgarin JS, Esmanhotto BB. Association between gastrointestinal disorders and migraine: an integrative review. Headache Med [Internet]. 2024 Jun. 29 [cited 2024 Jul. 14];15(2):47-53. Available from: https://headachemedicine.com.br/index.php/hm/article/view/1072

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Review

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