Migraines Linked to IBS, Peptic Ulcers

Migraine patients are at an enhanced risks for at least 2 gastrointestinal disorders in irritable bowel syndrome (IBS) and peptic ulcers, but not others, according to new research.

A team, led by Nike Zoe Welander, Department of Neuroscience, Uppsala University, Uppsala, identified the associations between migraines and different gastrointestinal disorders to determine the relative strengths of the different associations.

The pathophysiological mechanisms of migraines are not entirely understood and gastrointestinal disorders often co-occur without a direction of a causal link between the 2 conditions.

The Link

In the cross-sectional study, the researchers examined whether migraines are linked to irritable bowel syndrome, peptic ulcers, Helicobacter pylori (HP) infections, celiac disease, Crohn's disease, and ulcerative colitis using baseline data of 489,753 participants in the UK Biobank, a large prospective cohort containing health-related information from more than 500,000 individuals. This included 14,180 migraine patients.

The investigators used Pearson chi-square tests and adjusted binary logistic regression models.

Migraines were significantly associated with IBS (OR, 2.24; 95% CI, 2.08-2.40l P <0.001), as well as peptic ulcers (OR, 1.55; 95% CI, 1.35-1.77; P <0.001).

On the other hand, there was no association with HP infection (OR, 1.34; 95% CI, 1.04–1.73; P = 0.024), celiac disease (OR, 1.29; 95% CI, 1.04–1.60; P = 0.023), Crohn's disease (OR, 1.08; 95% CI, 0.80–1.45; P = 0.617), or ulcerative colitis (OR, 1.00; 95% CI, 0.79–1.27; P = 0.979) after adjusting for multiple testing.

“Migraine was associated with IBS and peptic ulcers in this large population-based cohort,” the authors wrote. “The associations with HP infection, celiac disease, Crohn's disease, and ulcerative colitis did not reach significance, suggesting a weaker link between migraine and autoimmune gastrointestinal conditions or HP infection.”

The Problem

Migraines currently affect 14% of women and 6% of men, making it 1 of the world’s most common neurological disorders. Some of the associations between migraines and gastrointestinal disorders suggest the disorder may be related to a disruption in the gut-brain axis that causes a decrease in serotonin levels, which shows there are bidirectional relationships between neurological and gastrointestinal symptoms.

Another mechanism that could explain this include is increased gut permeability and inflammatory processes.

“The fact that IBS and peptic ulcers were significantly associated with migraine, while celiac disease, Crohn's disease, and ulcerative colitis were not, could be related to differences in pathophysiology,” the authors wrote. “Specifically, migraine was not significantly associated with any of the three autoimmune conditions included in the analyses.”

Limitations

However, there were some limitations of the study that warrant further examination for future studies.For example, the prevalence rates of GI disorders in the study population were generally low and the data was derived from self-reported illnesses.

The researchers were also concerned that the large sample size of UK Biobank may have resulted in statistically significant associations that are not necessarily clinically relevant.

The study, “Migraine and gastrointestinal disorders in middle and old age: A UK Biobank study,” was published online in Brain and Behavior.