ISLAMABAD, Jan 23 (Online): More than 1 billion peopleTrusted Source globally have at least one migraine attack each year.
Previous studies show that migraine can potentially increase a person’s risk for other conditions, including strokeTrusted Source, heart diseaseTrusted Source, epilepsyTrusted Source, sleeping issuesTrusted Source, and anxiety and depressionTrusted Source.
Migraine has also been linked to some gastrointestinal conditionsTrusted Source, including irritable bowel syndrome (IBS)Trusted Source.
Now, researchers from Seoul National University College of Medicine in South Korea say there may also be a link between migraine and an increased risk for irritable bowel disease (IBD), which is an umbrella term that includes Crohn’s disease and ulcerative colitis.
The study was recently published in the journal Scientific ReportsTrusted Source.
Migraine and IBD: An unsurprising connection
According to Dr. Brooks D. Cash, professor and chief of the division of Gastroenterology, Hepatology, and Nutrition at UTHealth Houston in Texas, who was not involved in this study, the field of gastroenterology has recognized for many years that migraine has been associated with many chronic gastrointestinal syndromes and diseases.
“The data in this report supports previous reports of an association between migraine headaches and IBD,” Dr. Cash told Medical News Today.
Dr. Rudolph Bedford, a board-certified gastroenterologist at Providence Saint John’s Health Center in Santa Monica, CA, who was also not involved in this study, told MNT that the research results were not surprising.
“[With] inflammatory bowel disease we do see some extra-intestinal manifestations including things involving the eye or ocular findings, which may be neurogenic in nature, so it wasn’t surprising,” Dr. Bedford added.
This is not the first study to look at a connection between migraine and IBD.
A study published in March 2021 of people in the United States found a higher prevalenceTrusted Source of migraine or severe headaches among adults with IBD than in those without.
Research published in March 2023 reported an increased prevalence of IBD in people with migraine with and without aura.
Could migraine increase risk of inflammatory bowel disease?
For the current study, researchers analyzed data from more than 10 million people through the nationwide healthcare system for South Korean citizens. About 3% of the study population had IBD.
Through the data, scientists found the incidence of IBD was significantly higher in people who had migraine compared to those who did not.
Scientists also reviewed the data through subgroups of Crohn’s disease and ulcerative colitis incidences. People with migraine in both subgroups had a higher risk of developing either condition when compared to people without migraine.
After a migraine diagnosis, researchers found people were at a higher risk of developing Crohn’s disease, with a significant rise after a 5-year follow-up.
Additionally, within the subgroups, scientists reported that the impact of migraine on the risk of developing ulcerative colitis was more prominent in men than women.
Study results not definitive
Based on these findings, the research team suggests that people with migraine be monitored carefully for the development of IBD.
However, Dr. Cash stated that the data presented do not convincingly support that approach or recommendation.
“The odds ratios that were reported in this study, which can be thought of as the increased odds of an outcome (e.g., developing IBD) with a given exposure (e.g., migraine headaches), were consistently between one to two, which is not far from definitive and can be easily misinterpreted or misrepresented,” he explained.
“The results are, at best, suggestive of an association between migraines and IBD, which we were already aware of based on previous research and deserve to be further evaluated. However, the minimal increase in the odds of developing IBD reported in this study is not sufficient to recommend increased monitoring of patients with migraines for the development of Crohn’s disease or ulcerative colitis.”
– Dr. Brooks D. Cash
Importance of identifying potential IBD triggers
Dr. Bedford said it is important to identify potential health issues that may trigger IBD, as a doctor may be able to mitigate the symptoms of IBD if they know what may be associated with it.
“Migraines can be very debilitating and you may want to identify those people with migraines,” he continued. “We don’t normally question patients with inflammatory bowel disease whether or not they have migraine headaches, so it probably rates as something that should be done more frequently.”
“These results add to an already relatively robust body of research suggesting that chronic pain syndromes are statistically more common in patients with chronic GI syndromes or diseases,” Dr. Cash said.
“We do not have enough information or proof yet to establish a causal relationship either way. But this data can be used to explain some therapeutic approaches that may benefit both GI and neurologic symptoms in patients with migraines,” he added.
Research next steps
Regarding the next steps for this research, Dr. Cash said that mechanistic data evaluating the possible reasons for these consistent observations of association is needed.
“Right now, all we have are hypotheses,” he continued. “Are there changes in the gut-brain communication pathways or sensory perceptions in the enteric and central nervous systems? Is the gut microbiome involved? Are there psychological and stress-mediated factors at play?”
“Once clinical relationships such as these have been identified, we need to move toward trying to explain why those relationships may exist,” Dr. Cash added. “That, in turn, may lead us to develop more targeted and effective therapies that can address multiple symptoms/syndromes.”
Dr. Bedford suggested researchers look for an association between IBD flares and migraine occurring at the same time. As migraine is associated with serotonin release, he encouraged researchers to examine how the serotonin transporters within the GI tract, small bowel, and colon might play a role.
“I think just questioning our patients in terms of quality of life issues — is there any way that we can mitigate their migraine headaches, potentially preventing their inflammatory bowel disease flare, or vice versa, is certainly something to look into,” Dr. Bedford said.
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