Some patients with irritable bowel syndrome (IBS) also have migraine headaches. In the Rome IV classification abdominal migraine is only defined in pediatric patients. For adults migraine is a "non-GI symptom" that supports the diagnosis, with both conditions sharing a central sensitization that affects the brain-gut axis.
Features:
(1) The patient meets criteria for irritable bowel syndrome (IBS).
(2) The patient has signs and symptoms of migraine.
Criteria for irritable bowel syndrome includes:
(1) recurrent abdominal pain that occurs >= 1 day per week (on average) for >= 3 months
(2) at least 2 of the following:
(2a) related to defecation
(2b) change in frequency of defecation
(2c) change in stool appearance
(3) exclusion of an underlying pathology
The presence of both conditions tends to be more common in young women, who usually have the diarrheal variant of IBS. For some women symptoms become worse during the menstrual cycle.
According to Li et al a patient with migraines is more likely to have IBS if:
(1) there is a long history of headaches
(2) the patient experiences recurrent, episodic headache attacks (>= 7 days per month)
(3) the patient is experiencing anxiety
In some patients medications taken for migraine (such as triptans) reduce the occurrence of IBS. The symptoms of IBS may be worse under conditions that worsen migraine (lack of sleep, stress).