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gastric stasis

Is Your Medication Being Absorbed? Gastroparesis and Headaches

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It’s unpopular, but it’s true. Many migraine and headache patients may need to stop taking pills and go to an injection or skin patch or other type of delivery that bypasses the stomach.

We’re frequently told that these other delivery methods, such as injection or IV, get the medication to us “faster”, and that, especially in migraine, faster is better.

The human digestive systemAnd that may be true. But for some people, the pills they take may be sitting in the stomach for hours, while their migraine pain continues.

This is a condition called gastric stasis (delayed gastric emptying), or, in severe cases, gastroparesis.

Gastroparesis and headaches can go together for a number of reasons, not just because your body doesn’t receive the medication you’re trying to give it. When food isn’t properly absorbed, patients can experience bloating, malnutrition, nausea, and problems with blood sugar levels.

In other words, gastric stasis and gastroparesis can cause problems with the body that can trigger headaches – and then the medication you take doesn’t help at all.

That’s why migraine patients can take the exact same medication, the exact same dosage, but if it goes through the stomach it doesn’t help, and if it bypasses the stomach it does.

So what can be done to solve the problem? Your doctor will help diagnose the problem and recommend treatments, such as:

  • Treating an underlying condition (for example, gastroparesis can be linked to diabetes)
  • Changes in diet – eating smaller amounts more frequently, cooking and chewing foods well, and drinking plenty of water with meals
  • Other lifestyle changes, such as gentle exercise after eating and avoiding carbonated beverages and alcohol
  • Certain medications such as metoclopramide (Reglan), domperidone (Motilium) and onabotulinumtoxinA (Botox).
  • Changing the delivery method of your medications

In very severe cases, surgery may be required to make sure you’re getting nourishment. (More on treating gastroparesis)

Gastric stasis can be a problem for migraine patients even when they’re not having a migraine attack, which can cause problems with regular nutrition and preventative medications. If you’ve found that migraine medication isn’t doing much, this may explain it. Gastroparesis and headaches can both be treated, but they can certainly complicate each other if they are not properly diagnosed.

Gastric stasis can be diagnosed using a gastric emptying study. If you suspect this may be a problem for you, this is something you can discuss with your doctor.

6 Key Stomach/Gut Terms related to Migraine

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6 Key Stomach / Gut Terms related to Migraine

  1. Abdominal Migraine  Common in children, but also seen in adults.  A type of migraine that could include stomach pain and nausea, and may not include headache.
  2. Cyclic Vomiting Syndrome (CVS)  Particularly in children, this could be related to migraine or could actually be a type of migraine.
  3. Gastric Stasis  A common condition in migraine patients – a delayed emptying of the stomach – which can keep medications from working properly.
  4. Gut-Brain Connection  The enteric nervous system or “second brain” in the gut may explain why diet and treatment of stomach issues are closely connected to migraine.
  5. Irritable Bowel Syndrome (IBS)  A common disorder comorbid with migraine.
  6. Nausea  One of the most common symptoms of migraine (including vomiting).

Stomach problems?

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When we talk about migraine, we frequently end up talking about the stomach.  Whether a migraine causes abdominal pain, nausea, or other problems, it’s well known that there’s a link, although we’re still learning how that link works.

One problem that is believed to be common in migraine patients is something called gastric stasis, or gastroparesis (which can refer to more serious forms of gastric stasis).  Gastric stasis basically means that things stay in your stomach longer.  This can be a problem when you’re taking pills, because they don’t do much good when they’re sitting in your stomach.  This is one reason why researchers are looking for better ways to get the migraine drugs into your system (and why drug companies using such technologies are funding studies on gastric stasis!).

Though it’s believed that gastric stasis is a problem during a migraine attack, a new study adds a new wrinkle to the theory.  This study was published in Headache and reported in a news release at GlaxoSmithKline last Tuesday.  This small study focused on patients with migraine with aura.  Here’s the bottom line.  The study seems to indicate that indeed migraineurs have problems with gastric stasis – but not just during an attack.  In fact, the problem seems to be worse when they don’t have a migraine attack!

Why is this important?  1) It further demonstrates that migraine is a disease impacting all of life, it’s not just a bad headache  2) It calls for further research into links between migraine and the digestive system, and the neurological connection  3) As Dr Sheena Aurora of the Swedish Headache Center in Seattle, WA USA points out, it "affirms the importance of considering gastric stasis in treating these patients"  4) It’s another reason to consider alternatives to medicine you are now taking, especially if you have symptoms such as bloating, nausea and heartburn.  Why?  Because some drugs can actually cause gastric stasis, including narcotics, tricyclic antidepressants and calcium channel blockers (see WebMD on gastroparesis).

If I’m able I hope to further develop the topic about migraine and stomach issues.  It’s a big topic, and it may hold a lot of keys to relief.  And that’s why we’re here, right?  ðŸ™‚

Gastroparesis is particularly a problem with diabetes patients.  Learn more about gastroparesis at the Mayo Clinic.

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