THURSDAY, May 3 (HealthDay News) -- Migraine headaches are more
likely to plague people with celiac disease than those without it,
according to new research.
The connection between the digestive tract and the brain has
been studied in Europe, but this is the first time American
researchers have linked celiac disease and other bowel problems
with migraines, said study co-author Dr. Alexandra Dimitrova.
"We found significantly higher prevalence of headaches in patients with celiac disease compared to those without it," said Dimitrova, a neurology resident at the Neurological Institute at Columbia University Medical Center in New York City.
Celiac disease is an autoimmune disease that affects one out of
every 133 people in the United States, according to the Celiac
Disease Foundation. People with the condition can't eat pizza,
pastries and other foods that contain wheat gluten. Symptoms
include stomach problems, joint pain and headaches.
Neurologic manifestations of celiac disease have been described
since the 1960s, and poor coordination and subtle sensory loss are
among the symptoms commonly reported, Dimitrova said.
The researchers also looked at two other related conditions.
More than 1.5 million Americans have Crohn's disease or ulcerative
colitis, the most common forms of inflammatory bowel disease,
according to the Mayo Clinic. Both conditions inflame the lining of
the intestines and can cause bouts of diarrhea, rectal bleeding and
abdominal cramps, as well as pain, fever and weight loss.
For the study, Dimitrova and her colleagues surveyed more than
700 people using a four-page questionnaire. A detailed medical
history was logged, which included whether a participant had been
diagnosed with celiac disease or inflammatory bowel disease, or had
problems eating foods containing wheat. Researchers also asked
about headache history. Lifestyle details -- such as smoking,
alcohol and coffee habits -- also were documented.
"We ended up analyzing 502 people," Dimitrova said. "We eliminated those who had head trauma or brain tumors, everybody who drank more than two alcoholic beverages a day and people who drank four or more cups of coffee a day -- anything that could be headache contributors."
The yearlong study found that 188 people had celiac disease, 111
had inflammatory bowel disease and 25 were gluten-sensitive --
meaning they had not tested positive for celiac disease but
reported symptoms when they ate foods with wheat. The other 178
healthy individuals served as the control group.
Chronic headaches of any kind were reported by 56 percent of
gluten-sensitive participants, 30 percent of those with celiac
disease and 23 percent of those with inflammatory bowel disease,
while only 14 percent of the control group reported headaches.
Dimitrova said that when the researchers screened specifically
for migraines, 21 percent of those in the celiac group and 14
percent of the inflammatory bowel disease group met the criteria
for the sometimes disabling headaches, compared with only 6 percent
of the control group.
"Our findings suggest that migraine is a common neurologic manifestation in celiac disease, gluten sensitivity and [inflammatory bowel disease]," said Dimitrova, who also said they don't know what the mechanism is.
"It's possible the patients with [inflammatory bowel disease] have a generalized inflammatory response, and this may be similar in celiac disease patients, where the whole body, including the brain, is affected by inflammation," she said. "The other possibility is that there are antibodies in celiac disease that may ... attack the brain cells and membranes covering the nervous system and somehow cause headaches. What we know for sure is that there is a higher prevalence of headache of any kind, including migraine headaches, compared to healthy controls."
Dr. Alessio Fasano, medical director of the University of
Maryland Center for Celiac Research in Baltimore, said it is not
unusual to hear his patients with celiac disease complain of
headaches.
"Roughly one-third of celiac disease or gluten-sensitive patients we see have some form of migraine," Fasano said. "That link with gluten-related disorders is very well known to us. We don't know why. What is the connection?"
Dimitrova said many patients reported major improvements in the
frequency and severity of headaches once they adopted a gluten-free
diet.
Fasano said he has seen it work the other way around, too, in
that people with migraines often also complain of belly woes and
some experience less digestive trouble when they go on gluten-free
diets.
"One thing is for sure: Many people with migraines, when they go on a gluten-free diet, the migraines improve or go away," he said.
Migraine sufferers who don't get relief from treatments should
ask their doctors about a celiac disease screening, Dimitrova
said.
The researchers presented their findings last week at the
American Academy of Neurology annual meeting in New Orleans. The
data and conclusions should be viewed as preliminary until
published in a peer-reviewed journal.
More information
The U.S. National Library of Medicine has more about
celiac disease.