IBS and migraine

Migraine and functional gastrointestinal problems frequently go hand in hand.
Migraine patients often have nausea, vomiting, abdominal pain and diarrhea that may occur before, during and after each migraine attack. The gastrointestinal systems of migraine patients are usually problematic even between attacks. Almost half of the IBS patients suffer migraine headaches. Other diseases that often accompanies both IBS and migraine are fibromyalgia, chronic fatigue syndrome, depression/anxiety disorders and hyperactive bladder syndrome.

Migraine, fibromyalgia and IBS bear many similarities:

1. All three are ‘central sensitization’ syndrome illnesses with changes in the pain perception of the central nervous system. The central nervous system (migraine), the central nervous system, muscles and connective tissue (fibromyalgia), and the enteric nervous system and gut smooth muscles (IBS) overreact or are over sensitive to many common and often harmless daily stimuli.
2. All three illnesses are three times more common in females (between ages 30-50).
3. Most migraine, fibromyalgia and IBS patients have a history of childhood adversity. The most common traumas are emotional neglect, emotional and sexual abuse. Trauma can cause HPA axis dysfunction, leading to illnesses.
4. The patients have problems coping with stress in all three groups. Chronic daily stress can increase the severity of all three illnesses, leading to frequent attacks or lack of response to treatment.
5. Depression and anxiety often coexist with migraine, fibromyalgia and IBS.
6. Most patients have sleep problems; and insomnia or sleeping disorders can aggravate the findings.
7. Weight gain and consuming too much caffeine worsens the symptoms in all.
8. Antidepressants acting on serotonin have been shown to be beneficial in all.
9. Gluten and cow milk and products can cause worsening in all three diseases.

Patients with IBS should see a neurologist if they have migraines, tension type headaches and fibromyalgia. Vice versa migraine patients with IBS finding should see a gastroenterologist. Both groups of patients should be see a psychiatrist if they suffer from depression and anxiety.

Lifestyle recommendations for patients with migraine and IBS:

1. Watch your sleep. Try to sleep at the same time every day and wake up at the same time. Be careful not to sleep late at night, especially staying up until the morning
2. Quit smoking
3. Reduce your alcohol consumption
4. Reduce caffeine consumption
5. Go gluten and casein free
6. Do not consume saturated fat products
7. Do not consume processed / refined / packaged products
8. Do not consume carbonated drinks
9. Drink at least 1,5 liters of water per day
10. Do not consume artificial sweeteners – especially aspartame
11. Learn how cope with stress
12. Exercise; walk at least 30 minutes every day; take at least 5000 steps
13. Practice yoga
14. Meditate for at least 2 minutes every day (more if possible)
15. Keep a food diary
16. When eating:
    • Eat slowly
    • Chew your food
    • Eat while sitting
    • Do not watch TV or look at your phone while eating
    • Have good feelings about eating and your meals, don’t hate or fight with your food
    • Be grateful for the process and people leading up to having your meal in front of you
    • Get up from the table without getting very full
    • Try to eat at the same time each day