Season 4 Episode 9: Are IBS and Migraines Connected?
I get asked this all the time! “Are my migraines connected to my IBS or other digestive disorders?” The short answer is not directly, but possibly indirectly, which I know is confusing, but don’t worry, I explain what I mean in this episode.
During the episode, I share the definition of migraines, how having a migraine may trigger a GI symptom and how to deal with migraines next time you’re inflicted with one.
In this episode, we cover:
What are migraines and how do they relate to IBS?
The triggers of migraines
The feeling of nausea and other GI symptoms
How to deal with migraines
Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.
Today’s episode is sponsored by Sunfiber. Sunfiber is a prebiotic fiber supplement that is gut-friendly as a soluble, low FODMAP fiber. Sunfiber-containing products typically contain between 5-7 grams of fiber, and it mixes into water or food without adding color, texture, or flavor. That means you can easily add this to your routine to increase your intake and benefit the balance of your gut without the symptoms. Sunfiber can be found in hundreds of different products. Find your favorites at Sunfiber.com
Are migraines connected to IBS and other digestive disorders? The short answer is not directly, but possibly indirectly. So let's get into it!
IBS symptoms are localized to the lower GI tract, specifically the colon or the large intestine. This means that upper GI symptoms like reflux, heartburn, burping and nausea are not considered IBS symptoms. However, they may be indicative of upper GI disorders, like gastroparesis, GERD and things like that. Typically, these are going to be considered more overlapping symptoms if they're present for someone who's dealing with IBS or other lower GI conditions.
Now headaches and migraines are really difficult to define. They don't fit into this GI symptom, grouping, if you will. So they're considered non GI or non gastrointestinal. However, what's happening in the GI tract from the mouth all the way to the anus, as well as contributors to GI symptoms, and even symptoms of IBS, these can be causes and triggers of headaches and migraines as well. There might be some overlapping kind of causes that are going on here.
So before we get into what those are, how is a migraine actually defined? What do we think about when we say migraine? Well, the International Classification of Headache Disorders defines it as a common disabling primary headache disorder, so it is considered a disorder of headaches. And this typically shows up as moderate to severe headaches that can last anywhere from four to 72 hours, which can vary by person, and they're usually accompanied by nausea and sensitivity to sounds in light. This is thought to affect about a billion individuals worldwide and does primarily impact women more than men, which is also very true of IBS.
Now, the more common digestive disorders that are seen as overlapping with migraines include the upper GI disorders like gastroparesis, Gerd and functional dyspepsia. Surveys also show that there might be an overlap with IBS, and that those with IBS do present or say that they do have recurrent headaches that fit within this category to be classified as a migraine, but the pathologies of these conditions do not overlap with migraines and what we know about migraines right now.
Now, like IBS and some of our digestive disorders, the pathophysiology of migraines is kind of unclear and a bit of a mystery, but it's likely the result of abnormal brain activity that affects nerve signals, chemicals and blood vessels in the brain. So it is something that's considered to be kind of neural and it's happening typically in the brain, but involves the entire nervous system.
Now, because of the role of the gut brain access in IBS and digestive disorders, which is along the vagus nerve and involves nerves and even brain signals, this might explain why there is an overlap between gut symptoms and migraines or headaches for some. Now when we think about the triggers of migraine, so just like IBS, the pathophysiology of the cause of IBS and different causes aren't necessarily the same as the triggers of symptoms. We know that it can be caused by something, but the symptoms themselves are triggered by these other factors that we have to address when we deal with management of the condition.
With migraines this can include hormonal changes, and this can come down to significant like long term hormonal changes, like we see the different stages of life, but also hormonal changes throughout a menstrual cycle, which menstruating individuals are going to experience. Stress and anxiety, those are two huge ones especially prolonged levels of increased stress and poor our nervous system regulation for stress management. Poor sleep is huge, and muscle tension, especially in the shoulders and the neck, which is going to create tension, that's going to lead to migraines. Low blood sugar and some blood sugar dysregulation, so kind of ups and downs and blood sugar levels. Inconsistent and meal patterns, especially around skipping meals. Dehydration, which is a big one, typically it's going to lead to more acute migraines, but could trigger the onset of a migraine, excessive alcohol or caffeine consumption, changes in climate, especially kind of drastic changes if you're flying somewhere or you're somewhere new or the weather has changed significantly. And then drastic changes in environment overall, including lights and sounds and of course medications, especially birth control and different hormone therapies, which goes back to the hormonal changes.
For some, there may be some dietary triggers as well outside of even caffeine and alcohol that may make migraines either present or make them worse. That can include tyramine containing foods, chocolate and citrus fruits, so that's something that might be modified based on how you're presenting and what you're working on with your healthcare team.
So when a migraine hits, there is a vascular activation that can lead to nausea and vomiting, which is why nausea is kind of a hallmark symptom of migraines. This can create a migraine GI symptoms cycle, because the the migraine might contribute to more nausea, maybe even contribute to vomiting, and that's gonna lead to other GI symptoms, which might lead to feelings of reflux and discomfort, maybe that leads to something like constipation, especially if you are skipping meals, and then that can worsen the symptoms you're having. It can lead to this little cycle that we see with even IBS and triggers and things that are going on there as well. Not only would you know migraines, and IBS, or migraines and digestive symptoms can be overlapping in different ways, but this cycle itself may kind of develop a deeper connection between the symptoms you're experiencing.
We also think that serotonin may play a major role in this, which is known to impact digestive disorders and serotonin activity can lead to changes in gut motility, which is fascinating, so there might be a piece of that as well. Now there is a recent literature review that breaks this down in more detail, especially the science behind it all, if you are interested in the nitty gritty like science of all of these different mechanisms and things that might be going on in the body, so you're welcome to check it out. I will say it's a little bit more advanced and they're polling for these different connections, but it is an interesting review to get a better understanding of what's actually activating and how serotonin may play a role. So that is a fascinating review, if you want to read it.
The big takeaway, though, is that you know, migraines night not be due to IBS, IBS may not be due to migraines, but there may be this connection. And so if you are experiencing migraines, this is not something that you want to ignore and you also don't want to just chalk it up to being IBS, it may be due to something else that's also playing a role in these different parts of your body. So it can be helpful to make sure that you're keeping up with when migraines are occurring, and what correlations may be present and then how your gut is also responding to that.
As you start to develop plans for either your migraines or your IBS, notice how the other one may change so that you can kind of personalize your plan to yourself more. If you do have a provider, let's say your GI doctor who is not necessarily listening or taking your migraine seriously, and vice versa, it may be helpful to create a team with different specialists that can help you work on these different pieces that may be presenting together as well, they may be connected in some ways, it doesn't mean that just working on your gut is going to make the migraine problem go away, and if the migraine problems leading to other gut symptoms, then that may be something that does need to be addressed kind of in its own bucket and with its own specialists in order for the GI symptoms to get better too.
So it's not in your head, metaphorically and physically, it's not just in your head if you're experiencing these, it can be very real, you're not alone in it and it is something that you do want to keep up with and communicate to all of your providers to see what's going on.
Now those different triggers I mentioned earlier are things that you can assess in yourself and see if maybe eliminating some of those different pieces or working on them may help, but to break it down to action steps of what you can actually do about it, here are a few things that you can really start to work on that's going to help both your GI symptoms and potentially help your migraines. It's a place to start while you are getting answers.
The first one is eating consistent meals, being adequately nourished and staying nourished consistently is key. Especially, I see this a lot with even headaches. So if you are dealing with recurrent headaches and nausea related to that, it is very important to have a very consistent meal schedule. Now will you always feel like eating if you're dealing with headaches and nausea when you wake up? Absolutely not. And so it may help to have even smaller meals, but really focus on getting some nutrition in, because eating consistently can help like bring those symptoms down and also help prevent a migraine from coming on, which is important.
With your meals, you also want to think about blood sugar regulation and this really comes down to how we balance out meals. This is something I teach a lot in my Foundations Course where I talk about kind of the macro nutrients and what that used to look like on a plate, that the goal here is making sure you have carbs, fats and proteins together, and you're regulating the blood sugar curve in your body so that you're not having these spikes and dips. Consistent meals is going to help with that, but also how you balance and what you choose is going to help with that as well.
The third thing is to focus on sleep. Not only do you want to make sure that you're getting some sleep, you want to make sure you're getting enough and you're getting it consistently. So seven to nine hours is the recommendation and then going to sleep around the same time and waking up around the same time each day, kind of keeping to that schedule can be really helpful. It helps the circadian rhythm support and can also help with how your body responds to your sleep and the quality of sleep that you're able to get. Your body loves to work like clock, work like a machine, so whenever you're able to provide some stability, that does help the body get the most out of these different activities like sleep.
Fourth is nervous system regulation. So not only do we want to think about stress management, we want to think about regulating the nervous system. So getting the body out of a stress state into this kind of rest and digest state, and moving between the two well. This includes stress management, so you have to be aware of your stressors, how you respond to stress in how you handle emotions, and regulate emotions, that is really important. And so that's something that you may do with a healthcare professional, like a mental health professional, but you also need to understand how to regulate your own nervous system and that includes like completing nerve stress cycles, which you can do through exercise and things like that. Taking breaks is huge, your sleep kind of fits into there, as well as bringing down your body's stress response with your breath and with the power of kind of mindfulness and connection to yourself, that all can be really beneficial for preventing migraines that are caused by stress, but also helping to get out of those cycles that you may be easily pulled into.
And then the last thing is hydration. This is really important, because it's something that can easily get missed and usually if you get behind and you get dehydrated, if your body's really sensitive to that, that can lead to a GI flare, it can lead to a migraine flare, without you even realizing it and then it's really hard to just catch up on it. It's not just about drinking more water one day and it all goes away, usually have to kind of, you know, be really consistent and get out of that flare that was caused by even a day of dehydration.
Finding ways to get enough water, maybe adding in minerals, depending on where you're at and how your body is doing, which you would discuss with your own healthcare team, that can help you with proper hydration. And just like eating consistent meals and staying nourished daily and sleeping daily and the consistency there, you do need to be consistent with your hydration and making sure that you are adequately hydrated every day so that your body does not kind of fall back and respond to a state of dehydration.
If you're dealing with migraines, that is a place that you can start, it may not be the whole answer or there may be more to it and there may be even a chain of events and a chain of things that are going on, but this is at least a place where you can start taking action, see if you see any results from that and then get your healthcare team to work together and see what all may be going on. Keep a detailed log so that you can track what's happening and how your body's responding and then look for those correlations that may be going on and try to take it back a step to you know what is leading to this and that will help you put together a plan that does work for you.
If you do have anything that you want to add, any questions or anything that you want to share, please come on over to Instagram @erinjudge.rd or find us on Facebook at The Gut Community so that you can share your story and what you've experienced. We'd be happy for the whole community to find value in that as well!