Helicobacter Pylori Infection and Migraines

Is There a Link Between H. pylori and Migraines?

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Should You Get Tested for H. Pylori?. Science Photo Library/Healther Davies/Brand X Pictures/Getty Images

Migraines are not just headaches. Rather, a migraine attack is a debilitating, neurological condition that impacts one's functioning, in addition to being a painful experience. So, if migraines involve our nervous system, how can our stomach be involved? Well, there is a possibility that a bacteria found in our stomach, called H. pylori, is linked to migraines.

So, if there is a link, would killing the bacteria help alleviate your migraine?

Let's take a closer look.

What is Helicobacter pylori (H. pylori)?

H. pylori is a bacteria that is found in the stomach and is present in approximately half of the world's population. Despite its widespread prevalence, it does not usually cause symptoms. When it does though, it can cause inflammation of the stomach (gastritis) or duodenum (duodenitis), which is the first part of the small intestine. Other complications of H. pylori include ulcers in the stomach or duodenum that may cause bleeding. Stomach cancer is a rare outcome of H. pylori. Overall, we do not know why some people become develop symptoms and others do not.

How is H. Pylori Spread?

It is spread by eating food and/or drinking water that contains fecal matter.

How Is H. Pylori Diagnosed?

H.pylori can be diagnosed by any one of the following three tests:

  • Blood test: Testing an antibody in your blood to H. pylori
  • Urea Breath Test: After swallowing a capsule or liquid that contains urea “labeled” with a special carbon atom, you exhale out (releasing carbon dioxide) into a container. If the special carbon atom is found in the exhaled breath, H. pylori is present. This is because H. pylori  contains large amounts of urease, an enzyme that splits urea.
  • Stool test: Detecting H. Pylori in your stool
  • Tissue Sample: A gastroenterologist may perform an upper endoscopy to obtain tissue samples from your stomach and/or duodenum to test for the presence of H. pylori.

How Do You Get Rid of H. Pylori?

If you have a history of ulcers or currently have an ulcer(s) in the stomach or duodenum, and you test positive for H. pylori, then your doctor will want to eradicate the bacteria.

Typically, you will be given a three to four drug regimen, which includes two antibiotics and a proton pump inhibitor, for 7 to 14 days. Your doctor will re-test you after you finish the medications to ensure the bacteria is cleared.

Is There a Link Between H Pylori and Migraines?

Possibly. In one study in the Archives of Medical Science, 70 patients with migraine were compared to 70 patients without migraine. Antibody levels to H. pylori (IgG and IgM) were compared between the two groups. Antibodies to H. pylori were overall significantly higher in the migraine group than in the non-migraine group.

In another study in Pain Physician, H. pylori eradication was beneficial in migraine sufferers. In this study, there were 64 patients with migraine. One half of them blindly received treatment for migraine, as well as H. pylori. The other half received migraine treatment and a placebo. All of the participants completed a MIDAS questionnaire (Migraine Disability Assessment) before and after treatment.

The treatment control had a significant decrease in their MIDAS score, compared to the control group. This implicates that eradicating or treating H. pylori diminishes migraine severity.

The Bottom Line

Remember a link or association does not imply causation.  We are not at the point where headache specialists are testing for and treating H. pylori as a standard of medical care. It's hard to say if this will become a regular practice. More studies are needed to better understand the precise relationship between H. pylori and migraines.

Sources:

Crowe SE. Patient Information: Helicobacter infection and treatment (Beyond the Basics). In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013. Accessed July 2014.

Faraji, F., Zarinfar, N., Zanjani, A.T., & Morteza A. (2012). The effect of Helicobacter pylori eradication on migraine: a randomized, double blind, controlled trial. Pain Physician, Nov-Dec;15(6):495-8.

Morteza, H., Khosravi, A., Saki, K., & Ranjbar, R. (2011). Evaluation of Helicobacter pylori infection in patients with common migraine headache. Archives of Medical Science, Oct 7(5): 844–849.

National Digestive Diseases Information Clearinghouse (NDDIC). (October 2013).  H.Pylori and Peptic Ulcers. NIH Publication No. 10–4225.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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