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Rhew K. Association Between Migraine and Gastrointestinal Disease in Pediatric Patients: A Propensity Score Weighting Approach. Neuropsychiatr Dis Treat 2023; 19:2607-2615. [PMID: 38046830 PMCID: PMC10693275 DOI: 10.2147/ndt.s442635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/23/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose Migraine is a neurological disorder affecting pediatric patients of all age groups, with a prevalence ranging from approximately 5% to 15%. It significantly impacts the quality of life in children and adolescents, potentially hampering their learning abilities, school performance, and daily activities. This study investigated the association between migraine and several prevalent gastrointestinal (GI) diseases in pediatric patients. Patients and Methods We analyzed the Health Insurance Review and Assessment Service Pediatric Patient Sample (HIRA-PPS) dataset from South Korea. Propensity scores based on patient characteristics (age, sex, and insurance type) were employed through the inverse probability of treatment weighting (IPTW) in binary logistic regression. We included gastroesophageal disease (GERD), peptic ulcer disease (PUD), gastritis, dyspepsia, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) as GI diseases. Results A total of 683,347 patients from the HIRA dataset were included in the study. After IPTW adjustment, the prevalence of GI diseases among pediatric patients with migraine remained significantly increased (OR 4.15; 95% CI 4.12-4.18). Migraine patients showed higher prevalence rates for all six individual GI diseases, with GERD (OR 4.11; 95% CI 4.05-4.16) and IBS (OR 3.79; 95% CI 3.74-3.84) showing the highest associations. We also confirmed a progressively increasing association between the presence of diagnosed migraine and GI diseases. Conclusion This study highlights a strong association between pediatric migraine and GI diseases, even after adjusting for patient characteristics. The elevated prevalence of various GI diseases in migraine patients suggests the need for comprehensive approaches to their prevention and treatment.
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Affiliation(s)
- Kiyon Rhew
- College of Pharmacy, Dongduk Women’s University, Seoul, Republic of Korea
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2
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Kim J, Lee S, Rhew K. Association between Gastrointestinal Diseases and Migraine. Int J Environ Res Public Health 2022; 19. [PMID: 35409704 DOI: 10.3390/ijerph19074018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023]
Abstract
Migraine is a common disease worldwide, and recent studies showed that the incidence of migraine was increased in patients with gastrointestinal (GI) diseases. In addition, preclinical evidence suggested a bidirectional relationship between the GI nervous system and the central nervous system called the gut−brain axis. This study aimed to determine the association between several high-prevalence GI diseases and migraine. Patients diagnosed with migraine or GI diseases were classified as the patient group at least twice a year. We included peptic ulcer disease, dyspepsia, inflammatory bowel disease, irritable bowel syndrome, and gastroesophageal disease as GI diseases. A total of 781,115 patients from the HIRA dataset were included in the study. The prevalence of migraine was about 3.5 times higher in patients with one or more GI diseases after adjusting for age, gender, and insurance type (adjusted odds ratio (ORadj = 3.46, 95% CI: 3.30−3.63, p < 0.001). In addition, the prevalence of migraine was increased as the number of comorbid GI diseases increased. The prevalence of GI disease was also higher in patients with medication for migraine, both preventive and acute treatment, compared to patients with either acute preventive or acute treatment. There was a statistically significant association between the prevalence of GI diseases and migraine, and the higher the number of accompanying GI diseases, the higher the correlation was in patients using both preventive and acute treatment drugs for migraine.
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3
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Fila M, Chojnacki J, Pawlowska E, Szczepanska J, Chojnacki C, Blasiak J. Kynurenine Pathway of Tryptophan Metabolism in Migraine and Functional Gastrointestinal Disorders. Int J Mol Sci 2021; 22:ijms221810134. [PMID: 34576297 PMCID: PMC8469852 DOI: 10.3390/ijms221810134] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/12/2021] [Accepted: 09/18/2021] [Indexed: 12/12/2022] Open
Abstract
Migraine, the leading cause of disability in the population aged below 50, is associated with functional gastrointestinal (GI) disorders (FGIDs) such as functional nausea, cyclic vomiting syndrome, and irritable bowel syndrome (IBS). Conversely, changes in intestinal GI transit may cause diarrhea or constipation and are a component of the autonomic symptoms associated with pre- and post-dorsal phases of migraine attack. These mutual relationships provoke a question on a common trigger in migraine and FGIDs. The kynurenine (l-kyn) pathway (KP) is the major route for l-tryptophan (l-Trp) metabolism and transforms l-Trp into several neuroactive compounds. Changes in KP were reported in both migraine and FGIDs. Migraine was largely untreatable, but several drugs approved lately by the FDA, including monoclonal antibodies for calcitonin gene-related peptide (CGRP) and its receptor, create a hope for a breakthrough in migraine treatment. Derivatives of l-kyn were efficient in pain relief with a mechanism including CGRP inhibition. KP products are important ligands to the aryl hydrocarbon receptor (AhR), whose activation is implicated in the pathogenesis of GI and migraine. Toll-like receptors (TLRs) may play a role in migraine and IBS pathogeneses, and KP metabolites detected downstream of TLR activation may be an IBS marker. The TLR4 signaling was observed in initiating and maintaining migraine-like behavior through myeloid differentiation primary response gene 88 (MyD88) in the mouse. The aim of this review is to justify the view that KP modulation may provide common triggers for migraine and FGIDs with the involvement of TLR, AhR, and MyD88 activation.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland;
| | - Jan Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.); (C.C.)
| | - Elzbieta Pawlowska
- Department of Orthodontics, Medical University of Lodz, 92-217 Lodz, Poland;
| | - Joanna Szczepanska
- Department of Pediatric Dentistry, Medical University of Lodz, 92-216 Lodz, Poland;
| | - Cezary Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.); (C.C.)
| | - Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland
- Correspondence:
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Altamura C, Corbelli I, de Tommaso M, Di Lorenzo C, Di Lorenzo G, Di Renzo A, Filippi M, Jannini TB, Messina R, Parisi P, Parisi V, Pierelli F, Rainero I, Raucci U, Rubino E, Sarchielli P, Li L, Vernieri F, Vollono C, Coppola G. Pathophysiological Bases of Comorbidity in Migraine. Front Hum Neurosci 2021; 15:640574. [PMID: 33958992 PMCID: PMC8093831 DOI: 10.3389/fnhum.2021.640574] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Despite that it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bidirectional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involves a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.
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Affiliation(s)
- Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Ilenia Corbelli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Bari, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso B Jannini
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberta Messina
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,Headache Clinic, IRCCS-Neuromed, Pozzilli, Italy
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Linxin Li
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Catello Vollono
- Department of Neurology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
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Arzani M, Jahromi SR, Ghorbani Z, Vahabizad F, Martelletti P, Ghaemi A, Sacco S, Togha M. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain 2020; 21:15. [PMID: 32054443 PMCID: PMC7020496 DOI: 10.1186/s10194-020-1078-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/23/2020] [Indexed: 02/08/2023] Open
Abstract
The terminology "gut-brain axis "points out a bidirectional relationship between the GI system and the central nervous system (CNS). To date, several researches have shown that migraine is associated with some gastrointestinal (GI) disorders such as Helicobacter pylori (HP) infection, irritable bowel syndrome (IBS), and celiac disease (CD). The present review article aims to discuss the direct and indirect evidence suggesting relationships between migraine and the gut-brain axis. However, the mechanisms explaining how the gut and the brain may interact in patients with migraine are not entirely clear. Studies suggest that this interaction seems to be influenced by multiple factors such as inflammatory mediators (IL-1β, IL-6, IL-8, and TNF-α), gut microbiota profile, neuropeptides and serotonin pathway, stress hormones and nutritional substances. Neuropeptides including CGRP, SP, VIP, NPY are thought to have antimicrobial impact on a variety of the gut bacterial strains and thus speculated to be involved in the bidirectional relationship between the gut and the brain. According to the current knowledge, migraine headache in patients harboring HP might be improved following the bacteria eradication. Migraineurs with long headache history and high headache frequency have a higher chance of being diagnosed with IBS. IBS and migraine share some similarities and can alter gut microflora composition and thereby may affect the gut-brain axis and inflammatory status. Migraine has been also associated with CD and the condition should be searched particularly in patients with migraine with occipital and parieto-occipital calcification at brain neuroimaging. In those patients, gluten-free diet can also be effective in reducing migraine frequency. It has also been proposed that migraine may be improved by dietary approaches with beneficial effects on gut microbiota and gut-brain axis including appropriate consumption of fiber per day, adhering to a low glycemic index diet, supplementation with vitamin D, omega-3 and probiotics as well as weight loss dietary plans for overweight and obese patients.
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Affiliation(s)
- Mahsa Arzani
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fahimeh Vahabizad
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Neurology Ward, Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Amir Ghaemi
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Simona Sacco
- Neuroscience section - Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
| | - Mansoureh Togha
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Headache Department, Neurology Ward, Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Affaitati G, Costantini R, Tana C, Cipollone F, Giamberardino MA. Co-occurrence of pain syndromes. J Neural Transm (Vienna) 2020; 127:625-46. [DOI: 10.1007/s00702-019-02107-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/17/2019] [Indexed: 12/17/2022]
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7
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Hormati A, Akbari N, Sharifipour E, Hejazi SA, Jafari F, Alemi F, Mohammadbeigi A. Migraine and gastric disorders: Are they associated? J Res Med Sci 2019; 24:60. [PMID: 31523246 PMCID: PMC6669996 DOI: 10.4103/jrms.jrms_464_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/10/2018] [Accepted: 03/25/2019] [Indexed: 12/29/2022]
Abstract
Background: Migraine is a common disorder which affects quality of life. There has been an increasing interest for discovering the association of gastrointestinal (GI) disorders with migraine during past years. This study aims to evaluate the association of Helicobacter pylori contamination, gastroesophageal reflux disease (GERD), gastric ulcer (GU), and duodenal ulcer (DU) with migraine in patients who underwent upper GI endoscopy due to refractory dyspepsia. Materials and Methods: In this observational cross-sectional study, 341 dyspeptic patients who underwent upper GI endoscopy in Shahid Beheshti Hospital, Qom, Iran, included during 2016–2018. A checklist was used for collecting demographics, symptoms, and results from endoscopy and H. pylori testing. Diagnosis of migraine was made according to the International Headache Society criteria in patients who had headache. Data were analyzed using Chi-square and independent samples t-tests in SPSS 16 (SPSS Inc., Chicago, IL, USA) with P < 0.05 as significance level. Results: Among 341 patients, 141 (% 41.3) were male and 200 (58.7%) were female. 149 (43.7%) patients were diagnosed with migraine, from which 48 (32.2%) were male and 101 (67.8%) were female. The observed difference in migraine prevalence among male and female was statistically significant (P = 0.003). 198 (58.06%) patients were H. pylori contaminated, among these 138 (69.7%) suffered from migraine. Among 143 H. pylori-negative patients, there were 11 (7.7%) migraineurs. The difference in the prevalence of migraine among H. pylori positive and negative patients was significant. H. pylori and GERD were associated with migraine with P < 0.001. Patients with DU were more commonly suffering from migraine (P = 0.001). The association in patients with GU was not statistically significant (P = 0.863). Conclusion: Migraine might be associated with GERD, H. pylori infection, and DU, and the treatment of the underlying GI disorder may control headaches.
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Affiliation(s)
- Ahmad Hormati
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran.,Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nayyereh Akbari
- Neuroscience Research Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Ehsan Sharifipour
- Neuroscience Research Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Seyyed Amir Hejazi
- Neuroscience Research Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Fatemeh Jafari
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Faezeh Alemi
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Abolfaz Mohammadbeigi
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
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Martami F, Ghorbani Z, Abolhasani M, Togha M, Meysamie A, Sharifi A, Razeghi Jahromi S. Comorbidity of gastrointestinal disorders, migraine, and tension-type headache: a cross-sectional study in Iran. Neurol Sci 2018; 39:63-70. [PMID: 29022143 DOI: 10.1007/s10072-017-3141-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/03/2017] [Indexed: 12/17/2022]
Abstract
Migraine can be accompanied by some gastrointestinal (GI) disorders. In this study, we aimed to investigate the relationship between migraine and tension-type headache (TTH) and different lower and upper GI disorders as well as non-alcoholic fatty liver (NAFLD) and cholelithiasis. This cross-sectional study included 1574 overweight and obese participants who were referred to the Obesity Research Center of Sina Hospital, Tehran, Iran. The diagnosis of migraine and TTH was made by an expert neurologist based on the international classification of headache disorders-III β (ICHD III β). GI disorders, including irritable bowel syndrome (IBS), constipation, heartburn, dyspepsia, non-alcoholic fatty liver (NAFLD), and cholelithiasis, were diagnosed by a gastroenterology specialist. The overall mean age of participants was 37.44 ± 12.62. A total of 181 (11.5%) migraine sufferers (with and without aura) and 78 (5%) TTH subjects were diagnosed. After adjusting for potential confounders by multivariable regression models, migraine had significant association with IBS (OR = 5.16, 95% CI = 2.07-12.85, P = 0.000), constipation (OR = 3.96, 95% CI = 2.25-6.99, P = 0.000), dyspepsia (OR = 4.12, 95% CI = 2.63-6.45, P = 0.000), and heartburn (OR = 5.03, 95% CI 2.45-10.33, P = 0.000), while the association between migraine and NAFLD was marginally significant (OR = 2.03, 95% CI = 0.98-4.21, P = 0.055). Furthermore, the prevalence of NAFLD (OR = 2.93, 95% CI 1.29-6.65, P = 0.010) and dyspepsia (OR = 4.06, 95% CI = 2.24-7.34, P = 0.000) was significantly higher in TTH patients than the headache-free group. These findings show an association between GI disorders and primary headaches especially migraine and are, therefore, of value to the management of migraine and TTH. Further studies should investigate the etiology of the relationship between all subtypes of primary headaches and GI disorders.
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Lee SH, Lee JJ, Kwon Y, Kim JH, Sohn JH. Clinical Implications of Associations between Headache and Gastrointestinal Disorders: A Study Using the Hallym Smart Clinical Data Warehouse. Front Neurol 2017; 8:526. [PMID: 29042857 PMCID: PMC5632350 DOI: 10.3389/fneur.2017.00526] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 09/21/2017] [Indexed: 01/01/2023] Open
Abstract
Background The brain and gastrointestinal (GI) tract are strongly connected via neural, endocrine, and immune pathways. Previous studies suggest that headaches, especially migraines, may be associated with various GI disorders. However, upper GI endoscopy in migraineurs has shown a low prevalence of abnormal findings. Also, the majority of studies have not demonstrated an association between Helicobacter pylori (HP) infection and migraine, although a pathogenic role for HP infection in migraines has been suggested. Further knowledge concerning the relation between headaches and GI disorders is important as it may have therapeutic consequences. Thus, we sought to investigate possible associations between GI disorders and common primary headaches, such as migraines and tension-type headaches (TTH), using the Smart Clinical Data Warehouse (CDW) over a period of 10 years. Methods We retrospectively investigated clinical data using a clinical data analytic solution called the Smart CDW from 2006 to 2016. In patients with migraines and TTH who visited a gastroenterology center, GI disorder diagnosis, upper GI endoscopy findings, and results of HP infection were collected and compared to clinical data from controls, who had health checkups without headache. The time interval between headache diagnosis and an examination at a gastroenterology center did not exceed 1 year. Results Patients were age- and sex-matched and eligible cases were included in the migraine (n = 168), the TTH (n = 168), and the control group (n = 336). Among the GI disorders diagnosed by gastroenterologists, gastroesophageal reflux disorder was more prevalent in the migraine group, whereas gastric ulcers were more common in the migraine and TTH groups compared with controls (p < 0.0001). With regard to endoscopic findings, there were high numbers of erosive gastritis and chronic superficial gastritis cases in the migraine and TTH groups, respectively, and the severity of gastritis was significantly higher in patients with TTH compared with controls (p < 0.001). However, no differences were observed in the prevalence of HP infection between the groups. Conclusion The observed association in this study may suggest that primary headache sufferers who experience migraines or TTH are more prone to GI disorders, which may have various clinical implications. Further research concerning the etiology of the association between headaches and GI disorders is warranted.
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Affiliation(s)
- Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea
| | - Jae-June Lee
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea
| | - Youngsuk Kwon
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea
| | - Jong-Ho Kim
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea
| | - Jong-Hee Sohn
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, South Korea
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11
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Peşkersoy C, Peker Ş, Kaya A, Ünalp A, Gökay N. Evaluation of the relationship between migraine disorder andoral comorbidities: multicenter randomized clinical trial. Turk J Med Sci 2016; 46:712-8. [PMID: 27513246 DOI: 10.3906/sag-1412-71] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 07/27/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Although migraine is a common disorder, there is a lack of research investigating the possible relationship between migraine and oral health. The aim of the present study was to explore the relationship between temporomandibular disorders, bruxism, dental caries, periodontal status, and migraine disorder in a multicenter, parallel, case-controlled clinical study. MATERIALS AND METHODS A total of 2001 participants were divided into two groups: migraineurs (nm = 998) and nonmigraineurs (nh = 1003). International Headache Society's Second Edition of International Classification of Headache Disorders and modified Migraine Disability Assessment surveys were administered to evaluate the level of migraine; a pretreatment questionnaire and the World Health Organization oral health assessment form were used to determine the oral comorbidities and their possible effects on DMFT index, gingival plaque index, existence of temporomandibular disorders, bruxism, and consistency of daily oral hygiene habits. RESULTS The mean age was 39.6 ± 10.5 years. Female patients seemed to experience migraine attacks more than male patients (64%). The frequency of gastroesophageal reflux was higher in migraineurs in comparison with nonmigraineurs (47%) and tooth wear and abrasion also seemed more frequent (76%). DMFT and plaque index scores showed significant differences for both groups. CONCLUSION There is a strong relationship between migraine and oral health status. The existence of reflux in addition to migraine leads to higher dental problems.
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Affiliation(s)
- Cem Peşkersoy
- Department of Restorative Dentistry, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Şule Peker
- Department of Neurology, Faculty of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
| | - Ayşegül Kaya
- Department of Restorative Dentistry, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Aycan Ünalp
- Department of Pediatric Neurology, İzmir Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Necmi Gökay
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Tai ML, Norhatta N, Goh KJ, Moy FM, Sujarita R, Asraff AA, Lee QZ, Ng JH, Tan EC, Mahadeva S. The impact of dyspepsia on symptom severity and quality of life in adults with headache. PLoS One 2015; 10:e0115838. [PMID: 25629323 DOI: 10.1371/journal.pone.0115838] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/18/2014] [Indexed: 11/24/2022] Open
Abstract
Background Dyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache. Methods A cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL) data were compared between subjects with headache and controls (non-headache subjects). The impact of dyspepsia was analysed further in subjects with headache alone. Results 280 subjects (93 cases with headache and 187 matched controls) were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0±17.3 years, 57.0% females and ethnic distribution—Malaysian = 45 (48.4%), Chinese n = 24 (25.8%) and Indians n = 24 (25.8%). Headache sub-types among cases with headache were as follows: tension-type headache (TTH) n = 53 (57.0%) and migraine n = 40 (43.0%). Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%, p = 0.011), and headache was independently associated with dyspepsia (OR 2.75, 95% CI 1.39–5.43). Among cases with headache, there was a trend towards a higher prevalence of dyspepsia in those with migraine (27.5%) compared to TTH (24.5%). Subjects with headache and dyspepsia, compared to those with headache alone, had a greater severity of headache symptoms (63.67±22.85 mm vs 51.20 ±24.0 mm VAS, p = 0.029). Overall HRQOL scores were lower in headache subjects with dyspepsia (EQ-5D summary score 0.82±0.18 vs 0.90 ±0.16, p = 0.037 and EQ-5D VAS 62.08±17.50 mm vs 72.62 ±18.85 mm, p = 0.018), compared to those without dyspepsia. Conclusion Dyspepsia is associated with more severe headache symptoms and results in a lower HRQOL in patients with headache.
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Kurth T. Is the way to headache through the stomach? Cephalalgia 2014; 35:201-2. [PMID: 24847168 DOI: 10.1177/0333102414535112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tobias Kurth
- Inserm Research Center for Epidemiology and Biostatistics (U897) - Team Neuroepidemiology, Bordeaux, France University of Bordeaux, College of Health Sciences, Bordeaux, France
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Min YW, Lee JH, Min BH, Lee JH, Kim JJ, Chung CS, Rhee PL. Clinical Predictors for Migraine in Patients Presenting With Nausea and/or Vomiting. J Neurogastroenterol Motil 2013; 19:516-20. [PMID: 24199013 PMCID: PMC3816187 DOI: 10.5056/jnm.2013.19.4.516] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/27/2013] [Accepted: 07/30/2013] [Indexed: 11/20/2022] Open
Abstract
Background/Aims Many migraine patients develop nausea and/or vomiting (N/V) and are referred to gastroenterologists. This can lead to an inappropriate treatment and a delay of the correct diagnosis. We therefore aimed to identify predictors for migraine in patients presenting with N/V as well as headache. Methods A total of 407 patients who were first diagnosed with migraine at Samsung Medical Center, Seoul, Korea, in 2009 were analyzed. Among them, 261 patients had N/V (migraine with N/V group) and 146 did not (migraine without N/V group). Each patient was evaluated using a structured questionnaire. Results Migraine with N/V group was younger, comprised of more females, had more abnormal body mass index, less alcohol intake, more family history of migraine, higher attack severity, more stress association, more aggravation by physical activity, more abdominal pain, and more photophobia/phonophobia than migraine without N/V group. Multivariate analysis revealed that young age (age < 40 years vs. ≥ 40 years, odds ratio (OR), 2.128; 95% confidence interval (CI), 1.206-3.756; P = 0.009), female (OR, 2.703; 95% CI, 1.492-4.896; P = 0.001), family history of migraine (OR, 2.080; 95% CI, 1.169-3.700; P = 0.013), abdominal pain (OR, 4.452; 95% CI, 1.263-15.693; P = 0.020), and photophobia/phonophobia (OR, 2.296; 95% CI, 1.308-4.030; P = 0.004) were independent predictive factors associated with migraine in patients with N/V. Conclusions Because young age, female, family history of migraine, abdominal pain, and photophobia/phonophobia are associated with migraine in patients presenting with N/V as well as headache, physicians should have a high index of suspicion for migraine in N/V patients who belong to these categories.
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Affiliation(s)
- Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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15
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Soares RLS, Moreira-Filho PF, Maneschy CP, Breijão JF, Schmidte NM. The prevalence and clinical characteristics of primary headache in irritable bowel syndrome: a subgroup of the functional somatic syndromes. Arq Gastroenterol 2013; 50:281-4. [PMID: 24474230 DOI: 10.1590/s0004-28032013000400008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/13/2013] [Indexed: 02/06/2023]
Abstract
CONTEXT The irritable bowel syndrome and primary headache are two chronic diseases characterized by symptoms of recurring pain and affect approximately 10%-20% of the general population. OBJECTIVES To study the prevalence of primary headache in volunteers with irritable bowel syndrome in a Brazilian urban community. METHODS It was evaluated the prevalence of primary headache associated with irritable bowel syndrome in adult volunteers 330 no patients.The protocol included the Rome III criteria, international classification of Headaches, later divided into four groups: I- Irritable bowel syndrome (n = 52), II- Primary headache (n = 45), III-Irritable bowel syndrome (n = 26) and headache, and IV- Controls (207). RESULTS We not found significant difference in the average age of the four groups and the diagnosis of irritable bowel syndrome, primary headache and their association was more frequent in females. The frequent use of analgesics was greater in groups II and III. CONCLUSION Our results suggest that irritable bowel syndrome and primary headache are also common in third world countries. The frequency in use of analgesics in association between the two entities was relevant. The identification of irritable bowel syndrome patients with different clinical sub-types could improve the therapeutics options and the prevention strategies.
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Affiliation(s)
- Rosa L S Soares
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal Fluminense (UFF), NiteróiRJ, Brasil
| | - Pedro Ferreira Moreira-Filho
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal Fluminense (UFF), NiteróiRJ, Brasil
| | | | - Julia Fumian Breijão
- Hospital Antonio Pedro, Faculdade de Medicina, Universidade Federal Fluminense (UFF), NiteróiRJ, Brasil
| | - Nathan Mielke Schmidte
- Hospital Antonio Pedro, Faculdade de Medicina, Universidade Federal Fluminense (UFF), NiteróiRJ, Brasil
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16
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Park JW, Cho YS, Lee SY, Kim ES, Cho H, Shin HE, Suh GI, Choi MG. Concomitant functional gastrointestinal symptoms influence psychological status in Korean migraine patients. Gut Liver 2013; 7:668-74. [PMID: 24312707 PMCID: PMC3848535 DOI: 10.5009/gnl.2013.7.6.668] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/22/2013] [Accepted: 02/08/2013] [Indexed: 12/15/2022] Open
Abstract
Background/Aims Migraine is frequently accompanied by symptoms consistent with functional gastrointestinal disorders (FGIDs). This study evaluated the prevalence of functional gastrointestinal symptoms and assessed the symptoms' relationship with the concomitant functional symptoms of anxiety, depression, and headache-related disability. Methods This prospective study included 109 patients with migraine who were recruited from a headache clinic at a teaching hospital. The participants completed a self-administered survey that collected information on headache characteristics, functional gastrointestinal symptoms (using Rome III criteria to classify FGID), anxiety, depression, and headache-related disability. Results In total, 71% of patients met the Rome III criteria for at least one FGID. In patients with FGID, irritable bowel syndrome was the most common symptom (40.4%), followed by nausea and vomiting syndrome (24.8%) and functional dyspepsia (23.9%). Depression and anxiety scores were significantly higher in patients meeting the criteria for any FGID. The number of the symptoms consistent with FGID in individual patients correlated positively with depression and anxiety. Conclusions FGID symptoms defined by the Rome III criteria are highly prevalent in migraine. These symptoms correlate with psychological comorbidities, such as depression and anxiety.
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Affiliation(s)
- Jeong Wook Park
- Department of Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
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Yu YH, Jo Y, Jung JY, Kim BK, Seok JW. Gastric emptying in migraine: a comparison with functional dyspepsia. J Neurogastroenterol Motil 2012; 18:412-8. [PMID: 23106002 PMCID: PMC3479255 DOI: 10.5056/jnm.2012.18.4.412] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 09/13/2012] [Accepted: 09/17/2012] [Indexed: 12/12/2022] Open
Abstract
Background/Aims Gastric stasis in migraineurs remains controversial. The aim of this study is to investigate gastric emptying (GE) time, and any associations between GE parameters and dyspeptic symptoms among patients with functional dyspepsia (FD) and migraine without any gastrointestinal symptoms during the interictal period. Methods We enrolled 27 migraine patients, 32 FD patients and 12 healthy people as controls, and performed GE scintigraphy as gastric function test. Gastrointestinal symptoms were evaluated in the FD and migraine. Results The age-adjusted mean gastric half-emptying time in FD (125.51 ± 52.55 minutes) patients was longer than in migraineurs (100.82 ± 23.94 minutes, P = 0.035) and controls (95.25 ± 23.29 minutes, P = 0.021). The percentage of gastric retention was higher in FD than in migraine. However, migraineurs did not show an obvious delayed gastric emptying or an increase of gastric retention when compared to the normal controls. The association between each dyspeptic symptom and GE parameters was not significant, but postprandial fullness and early satiety showed a tendency of delayed GE. In migraineurs, GE time did not show significant association with nausea and vomiting during interictal periods. Conclusions Delayed GE does not appear to be a mechanism that patients with FD and migraine have in common. Migraineurs without dyspepsia during interictal period had normal GE, and further study for association with FD should be investigated.
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Affiliation(s)
- Yeon Hwa Yu
- Department of Internal Medicine, Hanyang University College of Medicine, Guri, Gyeonggi-do, Korea
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Hosseinzadeh M, Khosravi A, Saki K, Ranjbar R. Evaluation of Helicobacter pylori infection in patients with common migraine headache. Arch Med Sci 2011; 7:844-9. [PMID: 22291830 PMCID: PMC3258796 DOI: 10.5114/aoms.2011.25560] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 03/10/2011] [Accepted: 04/16/2011] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Migraine can cause headache in different communities so that 12-15% are suffering worldwide. Recently the relationship between infectious diseases such as Helicobacter pylori infection and migraine headache has been the focus of many studies. The current study was designed to evaluate IgG and IgM antibodies to H. pylori in patients suffering from migraine headaches. MATERIAL AND METHODS Patients who had diagnostic criteria for migraine were chosen as cases compared to some healthy individuals as the control group amongst which immunoglobulin G (IgG), immunoglobulin M (IgM), age, job, gastro-intestinal (GI) disorders, history of migraine, special meals, medications, sleeping disorders, stress, environmental factors etc were analysed. RESULTS The prevalence of disease was 38.6%. Household women had the highest prevalence (40%). Among them menstruation was related to high prevalence of migraine. 75.6% of patients had gastrointestinal disorders of which the gastric reflux was the most important sign (47.1%). The mean optical density (OD) value of IgG and IgM antibody to H. pylori was 60.08 ±7.7 and 32.1 ±8.7 for the case group, 21.82 ±6.2 and 17.6 ±9.4 for the control group, respectively. CONCLUSIONS There was a significant difference in mean OD value of both antibodies to H. pylori amongst the case and control groups. As a result, active H. pylori infection is strongly related to the outbreak and severity of migraine headaches, and H. pylori treatment reduces migraine headaches significantly. Hopefully, the definite treatment and eradication of this infection can cure or reduce the severity and course of migraine headaches significantly if not totally.
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Affiliation(s)
- Morteza Hosseinzadeh
- Department of Immunology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Afra Khosravi
- Department of Immunology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Saki
- Department of Psychology, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Ranjbar
- Molecular Biology Research Center, Baqhiatallah University of Medical Sciences, Tehran, Iran
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Guariso G, Meneghel A, Dalla Pozza LV, Romano C, Dall'Oglio L, Lombardi G, Conte S, Calacoci M, Campanozzi A, Nichetti C, Piovan S, Zancan L, Facchin P. Indications to upper gastrointestinal endoscopy in children with dyspepsia. J Pediatr Gastroenterol Nutr 2010; 50:493-9. [PMID: 20639706 DOI: 10.1097/mpg.0b013e3181bb3362] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The objective of the study was to ascertain the appropriateness of indications for upper gastrointestinal (UGI) endoscopy in children with dyspepsia. METHODS We used the RAND/University of California at Los Angeles method to investigate the appropriateness of the opinions of a panel of experts. The panel judged 2304 theoretical patient scenarios defined by a combination of demographic and clinical variables. Descriptive and multivariate logistic regression analyses were performed. RESULTS The panel rated UGI endoscopy as appropriate in 27.2% of cases, inappropriate in 14.3%, and dubious in 58.5%. Disagreement emerged for 21% of cases. UGI endoscopy was considered increasingly appropriate in cases with a positive family history of peptic ulcer and/or Helicobacter pylori infection (odds ratio [OR] 8.518, P < 0.0001), when dyspepsia interfered with activities of daily living ("sleep" OR 7.540, P < 0.0001; "normal activities" OR 5.725, P < 0.0001), and when patients were older than 10 years ("<or=10 years" OR 0.310, P < 0.0001) the longer the duration ("0-2 months" OR 0.002, P < 0.0001; "3-5 months" OR 0.059, P < 0.0001; "6-11 months" OR 0.516, P = 0.0005) and the greater the severity ("mild" OR 0.002, P < 0.0001; "moderate" OR 0.013, P < 0.0001) of their dyspeptic symptoms. CONCLUSIONS UGI endoscopy is not appropriate for all children with dyspeptic symptoms, but only for cases with a family history of peptic ulcer and/or Helicobacter pylori infection, older than 10 years of age, with symptoms persisting for more than 6 months and severe enough to affect activities of daily living.
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Affiliation(s)
- G Guariso
- Gastroenterology and Endoscopy Unit, Department of Pediatrics, University of Padua, Padua, Italy.
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Mostaghni A, Mehrabani D, Khademolhosseini F, Masoumi SJ, Moradi F, Zare N, Saberi-Firoozi M. Prevalence and risk factors of gastroesophageal reflux disease in Qashqai migrating nomads, southern Iran. World J Gastroenterol 2009; 15:961-5. [PMID: 19248195 PMCID: PMC2653400 DOI: 10.3748/wjg.15.961] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM: To investigate the prevalence and risk factors of gastroesophageal reflux disease (GERD) symptoms in Qashqai migrating nomads with a different life style in Fars province, southern Iran.
METHODS: In summer 2006, 748 Qashqai migrating nomads aged 25 years or more were enrolled using a multiple-stage stratified cluster random sampling method. A questionnaire consisting of demographic characteristics, lifestyle and GERD symptoms (heartburn, regurgitation, chest pain, dysphagia, hoarseness and cough) as completed for each subject.
RESULTS: The questionnaire was completed in 717 subjects. The prevalence rate of GERD, defined as reflux occurring at least one time per week in the preceding year, was 33% (237 subjects). The prevalence was higher in older individuals (36.0% vs 28.9%, P < 0.05) and in those with other gastrointestinal complaints (51.0% vs 27.8%, P < 0.001), but not different in obese and non-obese subjects. It was also higher in those consuming fruits and vegetables more than once a week (36.2% vs 17.3%, P < 0.001). GERD had a positive correlation with smoking (42.1% vs 27.8%, P < 0.001), but a negative relation with non-alcoholic beverages. The association between GERD and non-steroidal anti-inflammatory drugs (NSAIDs) consumption was also significant (40.2% vs 25.4%, P < 0.001).
CONCLUSION: The prevalence of GERD (33%) is very high in Qashqai migrating nomads which may be due to a lower socioeconomic and educational level of these people and difference in the life style. Older age, frequent consumption of fruits and vegetables, smoking and NSAIDs are risk factors for GERD in this population.
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Katić BJ, Golden W, Cady RK, Hu XH. GERD prevalence in migraine patients and the implication for acute migraine treatment. J Headache Pain 2008; 10:35-43. [PMID: 19009231 PMCID: PMC3451764 DOI: 10.1007/s10194-008-0083-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 10/27/2008] [Indexed: 01/08/2023] Open
Abstract
The objective of this study is to estimate the prevalence of gastroesophageal reflux disease (GERD) and heartburn in migraine patients and examine their use of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin-containing medications when treating acute migraine attacks. Responses from a web-based survey of migraine patients were matched to the same patient’s responses on a general health survey. A total of 1,832 migraineurs (92.0%) were successfully matched. A total of 403 migraineurs (22.0%) reported having diagnosed GERD, 212 (11.6%) reported diagnosed heartburn, and 290 (15.8%) reported reflux symptoms but were undiagnosed. The most common prescription drugs used to treat migraines were triptans. First-line NSAID/aspirin medication use was 10.0% among diagnosed GERD and heartburn patients, 17.8% among undiagnosed patients, and 11.8% among GERD/heartburn-free migraineurs. In conclusion, almost half of migraineurs reported physician-diagnosed GERD and heartburn or symptoms of these conditions. Use of NSAID medications for migraine is fairly common among diagnosed GERD patients and more so for those with undiagnosed GERD symptoms. Physicians should minimize prescribing NSAIDs or NSAID-containing acute migraine medications in this population.
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Affiliation(s)
- Bozena J Katić
- Center for Pharmaceutical Health Services Research, Temple University School of Pharmacy, Philadelphia, PA, USA.
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Abstract
This review reports important co-morbid conditions of migraine and resulting consequences for the choice of acute and preventive treatments of migraine. Comorbidity in this context means the occurrence of two diseases in an individual beyond chance. The basis of comorbidity can be genetic and/or based on common environmental factors. In some cases, the temporal relationship is unclear and one disease can cause another disease. In order to prove a real comorbidity, large-scale and well-performed epidemiological studies are required.
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Affiliation(s)
- H C Diener
- Dept. of Neurology and Headache Center, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
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