Irritable Bowel Syndrome (IBS) describes a cluster of gastrointestinal symptoms that appear together, whether chronically or periodically. Other physical symptoms may accompany common digestive symptoms, such as headaches. Here’s your guide to the common causes of headaches and migraines in IBS, and how to manage them.
The Connection Between IBS & Headaches
A 2022 study conducted suggested those with IBS were more likely to develop headaches than other populations–women especially seemed to suffer from this comorbidity. Both tension headaches and migraines are seen in IBS patients, although migraines are slightly more common.
Tension headaches can be caused by stress or muscle tension, with mild to moderate pain felt on all sides of the head, and sometimes the neck. Migraines, on the other hand, are severely painful, worsen with activity, and can cause nausea or vomiting. Many with migraines become extremely sensitive to light, sound, and scents.
Causes of Headaches in IBS
While researchers are still investigating the connection between IBS and headaches, there are several theories as to why a patient suffering from gastrointestinal distress may also experience headaches.
Serotonin
The gastrointestinal tract is lined with cells containing receptors for the neurotransmitter serotonin. Dysfunctional serotonin activity in the central nervous system could lead to a headache or migraines, with some serotonin agonists able to relieve the pain.
Central Sensitization
Central Sensitization is when the central nervous system (CNS) becomes hypersensitive to pain. Patients with IBS typically experience pain in their abdomen or stomach–but this hypersensitivity uses the same pathways as headache pain. Therefore, there is a high likelihood that IBS patients who are sensitive to pain in one part of their body will experience headaches as well.
The HPA Axis
The hypothalamic-pituitary-adrenal (HPA) axis is a part of the brain that releases stress hormones. Dysregulation of the HPA axis has been reported in patients with IBS, with overproduction of cortisol levels implicated in IBS digestive symptoms, IBS-related mental health issues, and migraines.
Estrogen
Women with IBS are more likely to experience headaches than their male counterparts. There is a positive association of estrogen, a hormone responsible for regulating pain and stress, with the incidence of headaches. Since IBS is often triggered by stress, high levels of estrogen can lead to the manifestation of both IBS-like symptoms and headaches.
Managing Headaches
Managing a headache with IBS can be challenging. Unlike most patients with a headache, taking OTC pain medications like Advil can worsen IBS symptoms. Therefore, finding alternative ways to manage a headache is necessary.
First things first, run a mental checklist:
- Have you had enough to drink? Dehydration is known to cause headaches, as well as overheating. Drink plenty of water, slowly and in small sips so you don’t overwhelm your system (this can worsen headaches).
- Have you eaten enough today? While the thought of food, especially during a flare-up, can be nauseating, it is important to make sure that you are receiving enough nutrients. If not, try to eat something simple and small.
- Have you slept enough recently? If not, your body might be telling you to get some good ol’ shut-eye! Take a nap and see how you feel afterward.
If you’ve addressed the above, certain lifestyle changes are recommended:
Stress Reduction
By relieving stress, the body reduces the release of stress hormones, which can improve both IBS symptoms and headaches! There are many ways to reduce stress, whether through exercise, nature walks, yoga, talking to a licensed professional, or doing something you love.
Some herbal adaptogen supplements also help the body combat high levels of stress hormones and build resistance to the damaging effects of stress, such as ashwagandha.
Cool Down
Strange as it may seem, a quick temperature change by pressing an ice pack on your head or neck can relieve pain. There are many reasons for this; ice can relieve potential inflammation that might have caused the headache, or the quick temperature change can force the peripheral nervous system to release neurotransmitters to alleviate stress, leading to reduced headache intensity.
Pressure
Acupressure, like acupuncture, uses the natural pressure points on the body to relieve pain and stress. One example of reducing migraine and headache pain is the LI-4 method or Hegu. Apply continuous, moderate pressure to the webbing between the index finger and thumb for one to two minutes. This maneuver is often used after the headache has started to reduce its intensity.
When to Seek Medical Advice
If your headache has not subsided within a day, headaches are occurring more than usual, or your symptoms suddenly worsen, it is advised to reach out to a licensed medical professional for help. If the headache becomes severe, accompanied by fever, stiff neck, trouble seeing, hearing or speaking, or nausea, call emergency services.
Summer Pitocchelli-Schwartzman
