Can IBS trigger migraines?

In most people, IBS is often accompanied by other pain-related disorders such as joint pain, muscle ache, regular headaches and, in some instances, migraines.  But what exactly is a migraine and is it an inevitable aspect of IBS?

What is IBS?

Irritable Bowel Syndrome or IBS is a common gastrointestinal disorder that affects the functioning of your bowel. The main symptoms include abdominal pain, bloating and alternating constipation or diarrhoea or both.  The exact cause of IBS is unknown, but it can be triggered by various environmental factors such as infection, emotional stress, changes of routine, food intolerance, diet and hormonal factors.

What is a migraine?

A migraine is a neurological disorder characterised by throbbing or pulsating headache in one particular area. A migraine headache is often more intense than a regular headache and can last up to several days after the attack. It is often accompanied by nausea, vomiting as well as extreme sensitivity to light and sound.  The common triggers of a migraine include hormonal changes, emotional distress and dietary factors. Migraines are reported to be more prevalent in females and often coincide with the menstrual cycle!

So, how are they linked exactly?

If you have IBS, then there is a high chance that you have also experienced a migraine at one point. Experts believe that both conditions share a possible common origin – your central nervous system, which is made up of the brain and spinal cord.

In people with either IBS or migraine, the pain sensitivity is heightened. This means that they feel a higher level of pain than most people when exposed to triggers such as light, sound, smell or touch. This also includes having particularly sensitive stretch sensors in intestinal organs, which translates to bloating and cramps in those with IBS.

One of the mechanisms that could explain the link between gastrointestinal disorders such as IBS and migraines is increased permeability in the gut. IBS may lead to leakage of harmful bacteria into the bloodstream. This can trigger inflammation and potentially migraine attacks.

It also appears that similar pathways are activated in response to both IBS flare ups and migraine attacks.  Your body responds by producing similar molecules or neurotransmitters (brain chemicals). This suggests a direct link between the two conditions.

Can IBS trigger migraines? Or vice versa?

There is an established link between migraine and IBS, although the underlying mechanisms are not entirely clear.

While IBS is not always associated with migraines, people with IBS tend to have migraines more often than general population. In fact, they have a 40 to 80% higher chance of migraines. And this effect is vice versa – people with migraines often report having gastrointestinal symptoms, such as reflux, nausea, diarrhoea and constipation.

Like the chicken and the egg, it’s unclear whether IBS or migraines contribute first.  Both conditions often occur together and generally benefit from similar treatment strategies.

Why is it more prevalent in females?

IBS and migraines both are more common in women compared to men, particularly during reproductive years. This suggests that female sexual hormones may be playing a role – a powerful one!

Serotonin is the ‘happy hormone’ that men and women have. It is believed that estrogen, the main female sex hormone, can influence pain sensitivity by increasing these serotonin levels in women.

Estrogen levels fluctuate throughout a woman’s cycle. These changes in estrogen levels can also affect blood vessels and blood pressure, which play a role in migraines. Progesterone, another important female sex hormone, also contributes to this.

There are estrogen and progesterone receptors all throughout a woman’s gastrointestinal tract – this means the levels of these hormones can directly influence IBS. During menstruation, estrogen and progesterone levels drop to the lowest and bowel symptoms tend to increase. This often leads to stomach pain, diarrhoea, constipation, nausea and bloating.

For this reason, the IBS symptoms in women can worsen during menstruation. And so does the prevalence of migraine attacks.

Strategies that can help relieve migraines

Navigating the world with IBS is challenging enough, but once you throw migraines into the equation, it’s a whole different story.
The good news is – there are simple strategies that can help you manage migraine headaches effectively.

Create a calm environment:
Because people with migraines have heightened sensitivity, it’s helpful to manage your environmental triggers. This means switching off the lights, using noise cancelling headphones, playing soft and calming tunes (if that relaxes you), lighting a candle and stepping away from activities that are mentally demanding.

Prioritise sleep:
Sleep plays an important role in regulating your hormone levels, and poor sleep can be a possible trigger for migraine attacks. So, it’s important to establish regular sleep hours and unwind at the end of each day.

Eat the right foods (for you):
Certain foods and preservatives can trigger migraine headaches, and this may be different everyone. Caffeine, alcohol, excess oil and refined sugar are common dietary triggers, so it’s important that you identify your triggers and minimise/avoid these foods.

On the flip side, certain foods have been shown to help relieve and even minimise migraines. These include orange and yellow vegetables like carrots, sweet potato and squash; leafy greens such as collard greens and kale; whole grains such as brown rice, oats and quinoa, nuts and seeds, dark chocolate; and, water.

The role of probiotics

The latest and perhaps the most fascinating strategy appears to be the use of probiotics. Probiotics are a population of friendly gut bacteria that reside in your gut, particularly your colon. They help break down food particles, including FODMAPs, and provide beneficial molecules in return.

A recent study demonstrated that probiotics can significantly reduce both the frequency and severity of migraine attacks in adults.  However, more research is needed to determine the strains of bacteria that are specifically responsible for this benefit.

Researchers believe probiotics are beneficial as gut bacteria play a key role in the gut-brain connection and disturbances to the gut bacteria may be associated with neurological disorders like migraines.

FODMAP Friendly Certified Probiotics: Blackmores Probiotics + IBS Support; Casa de Santé Colon Cleanse & Probiotic; Stellar Labs Probiotic 40 Immune and Digestive Support Formula
For a combination of Prebiotics and Probiotics: The Gut Co FEED and REPAIR; Casa de Santé Advanced Probiotic & Prebiotics

In summary

There is an established connection between IBS and migraines, and the prevalence appears to be higher in women. It is believed that both conditions are influenced by disturbances in gut bacteria and is likely to improve with the use of probiotics. Other strategies that can help relieve migraines include creating a calm environment, establishing a healthy sleep routine and paying attention to your dietary habits.

Written by Thimpika Sachdej (Registered Nutritionist)
Reviewed by Kiarra Martindale (Accredited Practising Dietitian)