Many people with migraine also live with comorbid gastrointestinal (GI) disorders. These include inflammatory bowel disease, irritable bowel syndrome, gastroparesis, celiac disease, GERD, and cyclical vomiting syndrome among others. Recent studies have found that GI disorders appear to be more frequent in patients with migraine than in the general population.
GI issues can often be migraine symptoms. Many will experience nausea, vomiting, reflux, diarrhea, and/or constipation before, during and after a migraine attack (read more about that here). The severity of these symptoms can make a migraine attack even more disabling. In addition, the presence of these symptoms can make the attack more difficult to treat, as oral medications may not be tolerated or absorbed, especially if vomiting is experienced.
It’s important to understand that the relationship between migraine and GI disorders is bidirectional. What that means is that while GI issues can be symptoms of attacks, migraine can also be a symptom of GI disorders. For example, migraine headaches are a common symptom of celiac disease. According to one study, the prevalence of migraine in people with GI diseases is almost 3.5 times higher than in patients without GI disease.
More research is needed, but scientific evidence shows an overlap in pathophysiology between GI disorders and migraine; often known as the “gut-brain connection.”  This gut-brain connection is believed to occur through an interaction of numerous factors including inflammatory mediators, gut microbiota, neuropeptides, and the serotonin pathway. 
The gut-brain connection also means that, like migraine, GI disorders are often comorbid with mental health disorders, creating a trifecta of conditions that can be difficult to pinpoint, diagnose and treat.
The Impact on Treatment
Treating GI disorders has shown to improve the frequency and severity of migraine attacks, but finding a well-tolerated treatment can be difficult. In people who have both migraine and GI disorders, the absorption of migraine medications may be decreased and GI symptoms may become more severe in patients taking migraine medications. 
The good news is that there is some overlap when it comes to treatment. Migraine and GI disorders such as IBS may improve with healthy lifestyle habits, such as:
- Maintaining a well-balanced diet
- Staying hydrated
- Managing stress
- Getting regular exercise
In addition, some medications like beta blockers and anti-depressants have been shown to help both migraine and GI disorders. The downside is that these medications also have the potential to increase GI side effects like nausea and/or constipation.
As always, it’s important to discuss ALL of your symptoms with your doctor, even if they seem unrelated. If you think your GI symptoms may be more than just migraine, trust your gut—literally! It’s so crucial to be an empowered patient—educate yourself, and do not be afraid to speak up if something doesn’t feel right.
Tell us! Do you have comorbid GI disorders and migraine? Have you found an overlapping treatment that works? What is the most challenging part of living with a GI disease and migraine?