gastroparesis and migraines

My common law spouse actually has gastroparesis by itself, not due to another condition. For years he was told his abdominal issues with IBS and it caused him a great deal of pain. Over time more pain due to constipation, bloating and heartburn. He is six foot six and lean, but then he began to lose weight even though he eats constantly. It was pretty disturbing to be honest. More disturbing was that his doctor at the time prescribed T3s for the intestinal pain... which was damn idiotic because I knew while maybe it would help with the pain it would also increase it because it would make him more constipated. Thankfully by chance that doctor was unavailable one day and he saw another one... who concurred with the fact the painkillers were a very bad idea and also sent him for more tests. One of which was for gastroparesis... to look and see if his stomach was working and digesting food properly, which it was in fact not. When they did the test he still had food in his stomach which should have been empty. IBS and constipation are very common symptoms resulting from gastroparesis.

I wasn't aware until years later that in fact it is commonly seen in people with migraines, just not commonly looked at. Basically gastroparesis means the stomach muscles are slow or even not functioning well at all so the food stays in there longer... as does medication, which can be a real issue. It is thought that some people with migraines get gastroparesis during a migraine, but their stomach works fine at other times... making this very difficult to diagnose. But also this would make triptans hard to work, since if you take triptans in pill form they would sit there during the peak time when they should be aborting the migraine. So it would be better to take a shot, nasal, or dissolving pill form of a triptan if this were an issue.

However a new study indicates gastroparesis might be an issue between attacks as well. "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!" (Headache and migraine news)

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  Headache and migraine news

How is it treated?

Treatment for gastroparesis depends on the severity of the condition and may include:
  • Eating several small meals each day rather than three larger meals.
  • Eating meals that are low in fiber and fat.
  • Medicine to help the stomach empty more quickly (motility agents), such as metoclopramide (Reglan), domperidone (available in Europe and Canada), or erythromycin. Erythromycin is an antibiotic, but it can also help the stomach empty more quickly.
  • Surgery to place a feeding tube in the small intestine, if gastroparesis is severe. WebMD

My spouse eats a lot of small meals. We aim for low fiber. And trust me fat content makes a difference. He is on Erythromycin which has worked for him the past few years. What they put him on at first also worked but then stopped.
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