Gastrointestinal symptoms commonly accompany migraine attacks. Although they do not necessarily come along with every attack, these symptoms can be quite debilitating and difficult to treat when they do. They can also add to the already intense pain of an attack and leave you feeling drained for days.
What do migraine-related GI symptoms feel like?
Nausea and vomiting are the most prevalent migraine-related GI symptoms. It is estimated that more than two-thirds of patients with migraine experience vomiting during their migraine attacks. Some also experience diarrhea, though it is less common.
In many cases nausea and vomiting can be even more incapacitating than the head pain itself. Coupled with intense head pain, nausea and vomiting are extremely challenging. They can make it incredibly hard to get comfortable and cope with the pain, and sometimes the vomiting can even escalate the pain level experienced. Not only that, but vomiting and nausea make a migraine attack very difficult to treat, as it is nearly impossible for a pill to work when you can’t keep anything down or your GI system won’t absorb any oral medication.
In addition to acute symptoms of an actual attack, many people experience ongoing GI side effects from the migraine medications they take. These include reflux, nausea, diarrhea, constipation, and even GI pain. Some even experience cyclical vomiting syndrome and abdominal migraine, either with or without head pain.
How long do GI symptoms last?
Nausea and vomiting typically present during the attack phase and last until the attack resolves, although some have ongoing nausea during the interictal period between attacks. Diarrhea is a less common symptom, but can occur before, during, or after an attack. Interestingly, people who regularly experience GI issues such as reflux, diarrhea, constipation or nausea may be more likely to experience migraine as these are comorbid conditions.
When and how should you treat GI issues?
Medications
If GI symptoms are routinely part of your migraine attacks, your doctor may recommend an anti-nausea or anti-diarrheal medication. You should also consider a non-oral abortive or rescue medication that bypasses the gut to treat your migraine. These can come in the form of nasal sprays, injections and patches.
Hydration
Though it can be difficult, it is important to stay hydrated during an attack. Try chewing on ice chips, or sipping small amounts of clear liquids such as water, Gatorade or ginger ale. Or you can make your own electrolyte drink with fresh ginger, seltzer, fresh orange juice and salt.
When to seek help
If your symptoms are severe and last for an extended period of time, you may need to visit an urgent care or emergency room for a stronger medication and/or IV fluids.
woman holding nasal spray
When should you talk to your doctor?
There are many comorbid conditions that have overlapping symptoms with migraine, so if you’re having any sort of GI symptoms it’s important to discuss them with your doctor. This helps your doctor better understand your specific situation and personalize treatment to best suit your needs. It’s important to know that sometimes underlying conditions such as celiac disease, irritable bowel syndrome or thyroid issues can contribute to migraine attacks, so make sure to tell you doctor everything that is going on. Treating these other conditions may be able to help reduce the frequency and/or severity of your migraine attacks.
We want to know!
Do you experience GI issues along with your migraine attacks? Is there anything that brings you relief or comfort?