Vince Martin, the director of a headache clinic in Cincinnati explained gut health in the 2024 World Migraine Summit earlier this year. As with some of the other presentations, I was out of my depth with the heavy science-side of things, so be sure to follow up my summary with your own research if you’re interested in reading a more reliable outline of the subject.
[Disclaimer – it’s also probably a good time to remind you I am not a healthcare professional – so please be sure to talk to your doctor before making any decisions about your diet, or pain treatment.]
Dr Martin spoke of how our brain and stomach are connected by the trigeminal nerve that apparently sends nausea signals back and forth.
Gastrointestinal issues include everything from loss of appetite and feeling full as soon as you eat, to abdominal pain, and hyper-functional bowels. These issues are often symptoms within a migraine attack – or – a symptom of the pre-migraine phase.
Gastroparesis is a condition when the stomach slows right down, making it harder to digest food or propel it to the small intestine. The condition is often associated with feeling full, nausea or vomiting, and the ‘slow down’ can make it harder to absorb medication. This is where nasal sprays, injections, or neuromodulation devices come in handy as they bypass the stomach.
He explained that there is a disease called abdominal migraine, where the pain normally associated with the brain is located in the abdomen. It is more common in children and adolescents than adults. He said it is often diagnosed after a process of elimination, however if the child’s parent(s) have migraines they should tell the doctor to potentially speed up the diagnosis.
Leaky gut was another condition explained. It is apparently an inflammatory condition in which the lining of the stomach allows toxins to leak from the stomach into the adjacent bloodstream and potentially up to the brain, potentially creating inflammation in the brain, and a sort of ‘leaky brain’. There is no way to scientifically prove you have a leaky gut. All you can do is try to be as otherwise healthy as possible.
Gluten intolerance was also raised as a gut inflammatory condition, and there was the suggestion that it can impact migraine patients, especially in terms of absorption of vitamins, but there was no medical research that shows a direct correlation between the two conditions, or that a gluten-free diet reduces migraine episodes.
There was one interesting aside which suggested that adults with migraine were often colicky as children and had a predisposition with different forms of gastroenteritis. [I’m pretty sure that I was a colicky baby according to family folklore… for whatever that’s worth.]
Things got pretty detailed when he started talking about all the neuro chemicals that are found in the gut and the brain, including (I think); serotonin, glutamate, CGRP, as well as cortisol and hormones.
There was a discussion about the brain-gut-axis and how the vagus nervous system and autonomic nervous system link the two. He was fascinated about the fact that migraine effects so many organs beyond the brain specifically.
Dr Martin spoke about the importance of gut microbiomes, and how there is a balance between ‘good’ and ‘bad’ bacteria there. Taking too many antibiotics ‘wreaks havoc’ on the biomes in your gut and can lead to inflammation, whilst eating a high fiber diet creates good biome environment. He implied that there WAS a difference between migraine-gut biomes and the gut health of non-migraineurs, but it would be difficult to separate all the other contributing factors out to show a direct correlation.
Probiotics were not discouraged, but he implied that they vary wildly in terms of their quality and benefits, and it is very hard as a consumer to know which is the most helpful, and there are no clear scientific tests that indicate which yeast, or bacteria, to use.
It got confusing when the discussion moved towards the Omegas that you can supplement your diet with. Apparently Omega 3 is good (so foods such as chia seeds, finned fish and berries) but Omega 6 is bad because it leads to inflammation (I think he mentioned bacon).
Overall, a healthy diet was recommend, with less sugar and carbohydrates, less processed food, and no MSG. Instead, opt for berries, high fiber, and whole grains. Equally importantly, go for a healthy lifestyle which includes exercise. A healthy gut is going to help you have a healthy brain, so do what you can to keep it happy.
The main take away was try your best; “don’t worry about being perfect all the time”.
Here here.
Unti next time, take care, Linda x
The Mindful Migraine 
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