Prevalence of Migraine in Patients With Celiac Disease and Inflammatory Bowel Disease

Objective:
To assess the prevalence of headache in clinic and support group patients with celiac disease and inflammatory bowel disease (IBD) compared with a sample of healthy controls.

Background:
European studies have demonstrated increased prevalence of headache of patients with celiac disease compared with controls.

Methods:
Subjects took a self-administered survey containing clinical, demographic, and dietary data, as well as questions about headache type and frequency. The ID-Migraine screening tool and the Headache Impact Test (HIT-6) were also used.

Results:
Five hundred and two subjects who met exclusion criteria were analyzed – 188 with celiac disease, 111 with IBD, 25 with gluten sensitivity (GS), and 178 controls (C). Chronic headaches were reported by 30% of celiac disease, 56% of GS, 23% of IBD, and 14% of control subjects (P < .0001). On multivariate logistic regression, celiac disease (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.78-8.10), GS (OR 9.53, 95%CI 3.24-28.09), and IBD (OR 2.66, 95%CI 1.08-6.54) subjects all had significantly higher prevalence of migraine headaches compared with controls. Female sex (P = .01), depression, and anxiety (P = .0059) were independent predictors of migraine headaches, whereas age >65 was protective (P = .0345). Seventy-two percent of celiac disease subjects graded their migraine as severe in impact, compared with 30% of IBD, 60% of GS, and 50% of C subjects (P = .0919). There was no correlation between years on gluten-free diet and migraine severity.

Conclusions:
Migraine was more prevalent in celiac disease and IBD subjects than in controls. Future studies should include screening migraine patients for celiac disease and assessing the effects of gluten-free diet on migraines in celiac disease.

Authors: Alexandra K. Dimitrova MD, Ryan C. Ungaro MD, Benjamin Lebwohl MD, Suzanne K. Lewis MD, Christina A. Tennyson MD, Mark W. Green MD, Mark W. Babyatsky MD, Peter H. Green MD

Source: Headache: The Journal of Head and Face Pain – November 2012