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World J Gastroenterol. Sep 28, 2016; 22(36): 8149-8160
Published online Sep 28, 2016. doi: 10.3748/wjg.v22.i36.8149
Gastrointestinal disorders associated with migraine: A comprehensive review
Carlos R Cámara-Lemarroy, Rene Rodriguez-Gutierrez, Roberto Monreal-Robles, Alejandro Marfil-Rivera
Carlos R Cámara-Lemarroy, Alejandro Marfil-Rivera, Servicio de Neurología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey 64460, México
Rene Rodriguez-Gutierrez, Servicio de Endocrinología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey 64460, México
Roberto Monreal-Robles, Servicio de Gastroenterología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey 64460, México
Author contributions: Cámara-Lemarroy CR led the conception and review of the literature, and drafted the manuscript; Rodriguez-Gutierrez R and Monreal-Robles R helped gather the literature for review and in preparing tables and figures; Marfil-Rivera A helped draft the manuscript and approved the final version; all authors reviewed the manuscript for important intellectual content and participated in the final approval of the version to be published.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlos R Cámara Lemarroy, MD, Servicio de Neurología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León. Monterrey, México. Ave. Madero y Gonzalitos s/n, Monterrey 64460, México. crcamara83@hotmail.com
Telephone: +52-81-83337798 Fax: +52-81-83337798
Received: May 30, 2016
Peer-review started: May 30, 2016
First decision: July 12, 2016
Revised: August 3, 2016
Accepted: August 23, 2016
Article in press: August 23, 2016
Published online: September 28, 2016
Processing time: 119 Days and 4.5 Hours
Abstract

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.

Keywords: Migraine; Headache; Microbiota; Review; Gastrointestinal diseases

Core tip: Migraine is a recurrent and disabling primary headache disorder that commonly affects a significant proportion of the global population. Recent reports demonstrate an increased frequency of gastrointestinal (GI) disorders in patients with migraine compared with the general population. We review the available literature linking migraine with GI complications and comorbidities.