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Migraine linked to increased risk of inflammatory bowel disease in recent study

A recent Scientific Reports study investigated the association between migraine and the event of inflammatory bowel disease (IBD).



Study: Migraine is related to the event of adult patients with inflammatory bowel disease: a nationwide, population-based study. Image Credit: Lightspring / Shutterstock

Background

Migraine is a condition related to painful headaches. It’s a neurological disorder that may significantly impact a person’s quality of every day life. Although the worldwide prevalence of migraine is high, this condition is under-recognized and undertreated. Typically, people younger than 50 years of age are affected by this recurrent neurological disorder. Migraine also results in substantial economic losses, each directly and not directly. 

Several gastrointestinal symptoms, resembling diarrhea, constipation, vomiting, nausea, and dyspepsia, are related to migraine. Moreover, this neurological condition has been linked with the event of irritable bowel syndrome and inflammatory bowel disease (IBD). These findings suggest that migraine could possibly be connected to the interplay of the gut–brain axis.

IBD comprises two chronic inflammatory gastrointestinal disorders, namely, Crohn’s disease (CD) and ulcerative colitis (UC). Many studies have identified the generic and environmental aspects that increase the chance of IBD. These studies have also determined the modifiable risk aspects that prevent the onset of IBD. As compared to most of the people, IBD patients are at the next risk of migraine. Up to now, no studies have investigated whether migraine impacts the event of IBD.

In regards to the Study 

The present study evaluated the association between migraine and IBD manifestation using a nationwide cohort. This study obtained data from the National Health Insurance Service (NHIS), the nationwide healthcare system for South Korean residents. This database includes detailed demographic and medical information on each outpatients and inpatients. 

Individuals who attended the routine health screenings organized by NHIS between January 2009 and December 2009 were recruited, and people with missing data were excluded. 

Study Findings

A complete of 10,131,193 individuals were recruited as per the eligibility. Around 2.8% of the study population were affected with IBD. In comparison with the control group, seniors, females, low-income individuals, and those that resided in rural settings were more more likely to have migraine. Moreover, migraineurs were at the next risk of developing IBD by 1.3-fold, in comparison with most of the people.

Consistent with the findings of the current study, previous studies indicated IBD to be an independent factor of migraine disorder. Nonetheless, this remark was contradicted by a cross-sectional UK Biobank study, which stated IBD was not related to migraine. 

Subgroup analysis for the risk of (A) Crohn’s disease and (B) ulcerative colitis in patents with migraine compared to control groups.Subgroup evaluation for the chance of (A) Crohn’s disease and (B) ulcerative colitis in patents with migraine compared to regulate groups.

The next variety of participants with migraine were related to diseases resembling chronic kidney disease (CKD), hypertension (HTN), and dyslipidemia. This remark was consistent with previous studies that documented an increased risk of metabolic syndrome and heart problems in IBD patients.

The sub-group evaluation indicated the next risk of developing IBD, i.e., each CD and UC, in patients with migraine, in comparison with the overall population. After migraine diagnosis, patients were found to be at the next risk of developing CD. Interestingly, a major surge in CD diagnosis was observed after five years of follow-up amongst migraineurs. The chance of CD development amongst migraineurs was not affected by sex, age, metabolic comorbidities, or health behavior. In contrast, a major association was observed in male UC patients.

Although regular screening for migraine in clinical settings just isn’t possible, IBD-related awareness could possibly be increased, which could enable early diagnosis and treatment for a similar. Previous studies have identified multiple mechanisms that connect migration with the event of IBD. For example, the event of proinflammatory cytokines, resembling tumor necrosis factor-α and interleukin (IL)-1b, were linked with migraine pain. A spike in proinflammatory cytokines levels causes migraine attacks, that are also linked with IBD pathogenesis. Gut microbial dysbiosis is one other factor related to the pathophysiology of IBD and migraines.

Dietary habits, particularly the Western weight-reduction plan, can instigate the event of migraine in episodic or chronic forms. Several studies have also shown that this weight-reduction plan type results in the event of IBD. Citrus fruit, gluten, coffee, alcoholic beverages, and chocolate are dietary risk aspects for each IBD and migraine. 

Pharmaceutical agents, resembling nonsteroidal anti-inflammatory drugs (NSAIDs), used to alleviate migraine symptoms could trigger the event of IBD. The next frequency of NSAID intervention increases the chance of CD development.

Conclusions

Attributable to the shortage of appropriate data, this study has some limitations, including its inability to find out how the severity of migraine and IBD are linked. As well as, this study didn’t consider vital covariates, resembling dietary patterns, healthcare, stress, family history of IBD, and other gastrointestinal disorders.

Despite the constraints, the present study revealed that migraine is a major risk factor for IBD development. Using a nationwide study cohort and a protracted follow-up period are two key strengths of this study. Considering the findings that stated patients with migraine are at the next risk of IBD, clinicians must explore the gut–brain axis further to raised understand how IBD development and migraine are associated.

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