| Summary: | Migraine is a recurrent and commonly disabling primary
headache disorder that affects over 17% of women and
5%-8% of men. Migraine susceptibility is multifactorial
with genetic, hormonal and environmental factors all
playing an important role. The physiopathology of
migraine is complex and still not fully understood. Many
different neuropeptides, neurotransmitters and brain
pathways have been implicated. In connection with
the myriad mechanisms and pathways implicated in
migraine, a variety of multisystemic comorbidities
(e.g., cardiovascular, psychiatric and other neurological
conditions) have been found to be closely associated
with migraine. Recent reports demonstrate an increased
frequency of gastrointestinal (GI) disorders in patients
with migraine compared with the general population.
Helicobacter pylori infection, irritable bowel syndrome,
gastroparesis, hepatobiliary disorders, celiac disease and alterations in the microbiota have been linked to the
occurrence of migraine. Several mechanisms involving
the gut-brain axis, such as a chronic inflammatory
response with inflammatory and vasoactive mediators
passing to the circulatory system, intestinal microbiota
modulation of the enteric immunological milieu and
dysfunction of the autonomic and enteric nervous system,
have been postulated to explain these associations.
However, the precise mechanisms and pathways related to the gut-brain axis in migraine need to be fully elucidated. In this review, we survey the available
literature linking migraine with GI disorders. We discuss
the possible physiopathological mechanisms, and clinical
implications as well as several future areas of interest
for research.
|
|---|
