IBS (irritable bowel syndrome) is a common digestive condition that impacts a significant proportion of the global population. The symptoms of IBS can include digestive issues such as:
- Abdominal pain
- Bloating
- Constipation
- Diarrhoea
A single cause of IBS has not been found; however, a range of factors may lead to these gut issues. The underlying causes of IBS can include:
- Food intolerances
- Gut bacteria imbalances
- SIBO
- Parasitic infection
- Low-grade inflammation
- Gut-brain axis issues [Source: Pubmed]
In addition to the gut symptoms of IBS (eg bloating), those with IBS commonly report non-digestive symptoms. These symptoms are present outside of the digestive tract and can commonly include:
- Headaches
- Migraines
- Anxiety
- Insomnia
- Depression
- Interstitial cystitis [Source: Pubmed]
IBS and Pain
Studies have found that those with IBS may experience a 200% increase in the likelihood that they’ll experience pain-related issues. This may be due to overlapping causes or pathways between what is happening in the gut and what is happing elsewhere in the body.
For example, more than 65% of those with IBS have symptoms associated with:
- Fibromyalgia
- Chronic pelvic pain
- Chronic fatigue syndrome
The same studies have also found that of those with IBS and migraines, 80% also experienced additional symptoms. In particular, anxiety, chronic pelvic pain and fibromyalgia. [Source: Pubmed]
IBS and Migraines
IBS and MigrainesOn average, those with IBS symptoms experience headaches and migraines more frequently than those without IBS.
Part of the research into this area also concluded that many of those who experienced migraines reported gut symptoms along with the onset of the migraine. As well as this, they also experience gut symptoms between migraine attacks.
Migraines attached are frequently present in those with IBS. Alongside this, it’s also common for other pain conditions to be present. These conditions include fibromyalgia and chronic pelvic pain. [Source: Pubmed]
What are Abdominal Migraines
Abdominal migraine is a condition that normally begins in childhood. Rather than a migraine headache, abdominal migraines refer to digestive symptoms. This can be thought of as a headache in the gut.
Abdominal migraines often appear as attacks that come and go with the symptoms including:
- Severe abdominal pain
- Nausea
- Vomiting [Source: Pubmed]
Abdominal migraines can be reasonably common in children with their presence being approximately 4% of the paediatric population.
While this condition does not generally continue into adulthood, it may develop into other symptoms. Those with abdominal migraines in childhood have an increased chance of developing migraine headaches and recurrent abdominal pain in adulthood. [Source: Pubmed]
The Rome diagnostic criteria for abdominal migraines involve:
Diagnostic criteria fulfilled in separate episodes twice within 12 months. Must include all of the following:
- Paroxysmal episodes of intense, acute periumbilical pain that lasts for one hour or more.
- Intervening periods of usual health lasting weeks to months
- The pain interferes with normal activities
- The pain is associated with two of the following: a. Anorexia b. Nausea c. Vomiting d. Headache e. Photophobia f. Pallor
- No evidence of an inflammatory, anatomic, metabolic, or neoplastic process considered that explains the subject’s symptoms [Source: Pubmed]
Both abdominal migraines and migraine headaches have been seen to involve similar triggers. These triggers include:
- Stress
- Tiredness
- Travel
- Foods [Source: Pubmed]
Food intolerances and Migraines
Certain foods are commonly reported to trigger migraine headaches. The common migraine triggers include:
- Cheese
- Chocolate
- Citrus fruits
- Red wine
It is also possible for other food sensitivities or food intolerances to trigger migraine headaches. The types of food reactions are known to trigger a wide range of symptoms that include:
As there may be a delay in the consumption of the food and the onset of the symptoms (in some cases days) these reactions can be a challenge to pinpoint.
IgG food intolerance testing has received criticism regarding the reliability of this type of intolerance testing. However, there are several studies indicating this type of test may help to identify food triggers. This may be most effective for identifying migraines when the patient also has IBS symptoms. [Source: Wiley]
However, other studies have found IgG food intolerance testing to be unreliable. This may be due the test itself not being reliable as well the fact that other factors may be contributing to the headache symptoms.
Additionally, the the unreliability of IgG test may be due to how it measures foods. For example, most commercially available IgG food intolerance tests asses for the raw form of the food which is different to the cooked version that would more commonly be consumed. [Source: Springer]
Why does IBS cause headaches?
Why does IBS cause headaches?There isn’t a clear understanding that links IBS and migraine headaches. However, there are several theories that include increased pain sensitivity, food intolerances and microbial imbalances in the gut.
The gut microbes help to regulate digestive function and nutrient absorption as well as immune balance and brain development.
Migraines are associated with a wide range of gut issues that include:
- Diarrhoea
- Constipation
- Dyspepsia
- Reflux
- IBS
- Celiac disease
- IBD [Source: Pubmed]
It’s been repeatedly found that gut imbalances have been linked to a wide range of digestive and non-digestive conditions. Part of this is understood to be due to alterations in the gut-brain axis, the communication pathway between the gut and the brain. [Source: Pubmed]
While the link isn’t clear, the factors understood to play a role include:
- Inflammation (IL-1β, IL-6, IL-8, and TNFα)
- Gut microbiota balance
- Neuropeptides and serotonin pathway
- Stress hormones
- Food intolerances [Source: Pubmed]
Probiotics for migraine headaches
Probiotic supplements have been studied in regard to reducing migraine attacks.
While the exact mechanisms are unknown researchers have linked the benefit of probiotics to:
- An increase in SCFA production (important for the gut lining)
- Reducing inflammation
- Support gastric emptying
A 2019 study found that the administration of a multi-strain probiotic over a 10-week period lead to improvements in migraines. In particular, there was a significantly reduced frequency and reduced severity of migraines in those taking the probiotic. [Source: Pubmed]
Best Foods for IBS
When symptoms of IBS increase, this can be referred to as a flare-up. Once this happens, food reactions can become unpredictable.
It’s very common for a range of foods that were tolerated before symptoms flared to now be an issue. This means, that while certain foods (for example, garlic and onion) were well tolerated when the gut is happy, during a flare-up these may increase IBS symptoms further.
It’s also not uncommon for someone to feel as though they’re reacting to everything with even water causing more bloating. This can be where everything that is being eaten or drank causes an increase in symptoms due to the heightened sensitivity in the gut.
One dietary approach to calming down IBS symptoms is the low FODMAP diet.
This diet limited specific carbohydrates found in many fruits and vegetables. While these foods are healthy, when there are imbalances in the gut, this can lead to sensitivity to high FODMAP foods. This is largely due to alterations in the absorption or fermentation of FODMAPs in the gut of someone with IBS.
Low FODMAP Diet for IBS
A low FODMAP diet may not work for everyone, but several studies have shown improvements in overall IBS symptoms in the range of 68-86% when following this diet. [Source: Pubmed]
Foods that are low in FODMAPs include:
- Protein – beef, lamb, chicken, eggs.
- Certain vegetables – tomato, rocket, celery, aubergine, carrots, potato, courgette
- Certain fruits – berries, kiwi, pomegranates, oranges, pineapple.
- Starches – rice, oats, quinoa
High FODMAP foods include:
- Protein – lentils, beans, chickpeas
- Certain vegetables – garlic, onion, leeks, artichokes, asparagus
- Certain fruits – apples, pears, and cherries
Also Read: Low FODMAP Foods – Everything You Need To Know
It’s also been shown that even a normal amount of gas produced in the gut can be extremely painful. This is often due to increased sensitivity in the nerves along the gut lining. [Source: Pubmed]
The low FODMAP diet essentially takes a strain off a sensitive gut and can be a helpful short-term approach. However, the long-term use of a low FODMAP diet has been indicated to have negative consequences. These include nutritional deficiencies and a negative impact on the gut microbiome.
Therefore the Low FODMAP diet is an approach that should be used to manage symptoms rather than something that’s seen as a treatment in and of itself. [Source: Pubmed]
Conclusion
With any condition, be it IBS or migraines, there are 2 main strategies to calm symptoms. One can be pharmaceutical medications to suppress or reduce symptoms.
The other is working to address the root cause to address the underlying issue. With both IBS and migraines there are common factors that can trigger symptoms which included both food sensitivities, gut imbalances and alterations in the gut-brain connection.
Working with a registered practitioner can help to guide you through this process to identify and address the underlying issue.
