Migrenli Bireylerdeki Gastrointestinal Semptomların Ağrı Karakteristiği ve Özür Durumu İle İlişkisi

Year 2020, Volume: 25 Issue: 2, 88 - 94, 13.06.2020

Nesrin Karahan Özge Çoban Oğuzhan Mete Şeyda Toprak Çelenay

https://doi.org/10.21673/anadoluklin.679430

Abstract

Amaç: Bu çalışmanın amacı, migrenli bireylerde gastrointestinal sistem (GİS) semptomları ile ağrı karakteristiği ve özür durumu arasındaki ilişkisinin incelenmesidir.

Gereç ve Yöntemler: Çalışmamız kırk beş migren hastası ile gerçekleştirildi. Migrenli bireylerin GİS semptomları Gastrointestinal Semptom Derecelendirme Ölçeği (GSDÖ) ile, ağrı karakteristiği Görsel Analog Skalası ile belirlenen son üç aydaki ortalama ağrı şiddeti ve ağrılı atak sıklığı ile, migrene bağlı özür durumu Migren Özür Değerlendirme Skalası (MÖDS) ile değerlendirildi.

Bulgular: Çalışmanın sonucunda, migrenli bireylerin atak sıklığı ile GSDÖ-total skor ile pozitif yönde orta derecede ilişki (p<0,001; rho:0,449), GSDÖ-reflü skoru ile pozitif yönde orta derecede ilişki (p:0,004; rho:0,424), GSDÖ-hazımsızlık skoru ile pozitif yönde düşük-orta derecede ilişki (p:0,007; 0,394) ve GSDÖ-kontipasyon skoru ile pozitif yönde düşük-orta derecede ilişki (p:0,007; 0,399) gösterdi. Migrenli bireylerin MÖDS skoru, GSDÖ-total skor ile pozitif yönde orta derecede ilişki (p:0,005; rho:0,410), GSDÖ-kontipasyon skoru ile pozitif yönde orta derecede ilişki (p<0,001; rho:0,541) gösterdi. MÖDS skoru, GSDÖ-karın ağrısı, GSDÖ-reflü, GSDÖ-diyare ve GSDÖ-hazımsızlık skorları ile ilişki göstermedi (p>0,05). Migrenli bireylerin ağrı şiddeti ile GSDÖ skorunun herhangi bir parametresinde ilişki bulunamadı. (p>0,05).

Sonuç: Çalışmamızda migrenli bireylerde GİS semptomları ile atak sıklığı ve özür durumu arasındaki pozitif ilişki ortaya konmuştur. GİS semptomları ile migrenin arasındaki ilişkinin göz önünde bulundurulması migren tanı sürecini kolaylaştırıp kısaltabilir ve aynı zamanda migren tedavisine katkıda bulunabilir.

Keywords

başağrısı, gastrointestinal semptomlar, migren

Supporting Institution

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Project Number

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Thanks

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The Relationship between Gastrointestinal Symptoms and Pain Characteristic and Disability in Individuals with Migraine

Abstract

Objective: The aim of this study was to investigate the relationship between gastrointestinal system (GIS) symptoms and pain characteristics, disability in patients with migraine.

Material and Methods: Forty-five migraine patients were included in the study. GIS symptoms with Gastrointestinal Symptom Rating Scale (GSRS), pain characteristic with pain intensity in the last 3 months determined by Visual Analogue Scale and frequency of attacks with pain, migraine-related disability status with Migraine Disability Assessment Scale (MIDAS) were evaluated in patients with migraine.

Results: As a result of this study, a moderate positive correlation with the frequency of attacks of migraine subjects and GSRS-total score (p <0.001; rho: 0.449), a positive moderate correlation with GSDS-reflux score (p: 0.004; rho: 0.424), a positive and low to moderate correlation between the indigestion score (p: 0.007; 0.394), a positive low to moderate correlation with the GSRS-constipation score (p: 0.007; 0.399) The MIDAS score of the individuals with migraine showed a positive correlation with GSRS-total score (p: 0.005; rho: 0.410), and a positive relationship with GSRS-constipation score (p<0.001; rho: 0.541). MIDAS score did not correlate with GSRS-abdominal pain, GSRS-reflux, GSRS-diarrhea, and SRS-indigestion scores (p>0.05). There was no correlation between pain severity of migraine subjects and any parameter of GSRS score. (p>0.05).

Conclusion: In our study, a positive correlation was found between GIS symptoms and frequency of attacks and disability in patients with migraine. Considering the relationship between gastrointestinal symptoms and migraine may facilitate and shorten the diagnosis of migraine and may also contribute to migraine treatment.

Keywords

gastrointestinal symptoms, headache, migraine

Project Number

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References

• 1. Arnold M. Headache classification committee of the international headache society (IHS) the international classification of headache disorders. Cephalalgia. 2018;38(1):1-211.
• 2. Silberstein S. Migraine pathophysiology and its clinical implications. Cephalalgia. 2004;24(2_suppl):2-7.
• 3. Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton RB, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193-210.
• 4. Steiner TJ, Stovner LJ, Vos T. GBD 2015: migraine is the third cause of disability in under 50s. J Headache Pain. 2016;17(1):104.
• 5. Ertas M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13(2):147.
• 6. Chen P-K, Wang S-J. Non-headache symptoms in migraine patients. F1000Research. 2018;7:118.
• 7. Martami F, Ghorbani Z, Abolhasani M, Togha M, Meysamie A, Sharifi A, et al. Comorbidity of gastrointestinal disorders, migraine, and tension-type headache: a cross-sectional study in Iran. J Neurol Sci. 2018;39(1):63-70.
• 8. Lankarani KB, Akbari M, Tabrizi R. Association of gastrointestinal functional disorders and migraine headache: a population base study. Middle East J Dig Dis. 2017;9(3):139.
• 9. Le Gal J, Michel J-F, Rinaldi VE, Spiri D, Moretti R, Bettati D, et al. Association between functional gastrointestinal disorders and migraine in children and adolescents: a case-control study. Lancet Gastroenterol Hepatol. 2016;1(2):114-21.
• 10. Cámara-Lemarroy CR, Rodriguez-Gutierrez R, Monreal-Robles R, Marfil-Rivera A. Gastrointestinal disorders associated with migraine: A comprehensive review. World J Gastroenterol. 2016;22(36):8149.
• 11. Martinez V, Taché Y. Calcitonin gene-related peptide and gastrointestinal function. Handbook of biologically active peptides: Elsevier; 2006. p. 1005-11.
• 12. Edvinsson L. The Trigeminovascular P athway: Role of CGRP and CGRP Receptors in M igraine. Headache: The Journal of Head and Face Pain. 2017;57:47-55.
• 13. Noghani MT, Namdar H. Migraine associated with gastrointestinal disorders: A pathophysiological explanation. Med hypotheses. 2019;125:90-3.
• 14. Park JW, Cho Y-S, Lee SY, Kim E-S, Cho H, Shin HE, et al. Concomitant functional gastrointestinal symptoms influence psychological status in Korean migraine patients. Gut and liver. 2013;7(6):668.
• 15. Aamodt A, Stovner L, Hagen K, Zwart J. Comorbidity of headache and gastrointestinal complaints. The Head-HUNT Study. Cephalalgia. 2008;28(2):144-51.
• 16. Association GAotWM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81(3):14.
• 17. Turan N, Asti TA, Kaya N. Reliability and validity of the Turkish version of the Gastrointestinal Symptom Rating Scale. Gastroenterol Nurs. 2017;40(1):47-55.
• 18. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87-101.
• 19. Ertaş M, Siva A, Dalkara T, Uzuner N, Dora B, Inan L, et al. Validity and reliability of the Turkish Migraine Disability Assessment (MIDAS) questionnaire. Headache: The Journal of Head and Face Pain. 2004;44(8):786-93.
• 20. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60.
• 21. Aamodt AH, Stovner LJ, Hagen K, Zwart JA. Comorbidity of headache and gastrointestinal complaints. The Head-HUNT Study. Cephalalgia. 2008;28(2):144-51.
• 22. Doulberis M, Saleh C, Beyenburg S. Is there an Association between Migraine and Gastrointestinal Disorders? J Clin Neurol. 2017;13(3):215-26.
• 23. Napthali K, Koloski N, Talley NJ. Abdominal migraine. Cephalalgia. 2016;36(10):980-6.
• 24. van Hemert S, Breedveld AC, Rovers JMP, Vermeiden JPW, Witteman BJM, Smits MG, et al. Migraine associated with gastrointestinal disorders: review of the literature and clinical implications. Front Neurol. 2014;5:241-.
• 25. Park M-N, Choi M-G, You SJ. The relationship between primary headache and constipation in children and adolescents. Korean j Pediatr. 2015;58(2):60-3.
• 26. Keszthelyi D, Troost FJ, Masclee AA. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. Methods to assess visceral hypersensitivity in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2012;303(2):G141-54.
• 27. Noseda R, Burstein R. Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain. Pain. 2013;154 Suppl 1:S44-53.
• 28. Aggarwal M, Puri V, Puri S. Serotonin and CGRP in migraine. Ann Neurosci. 2012;19(2):88-94.
• 29. Costedio MM, Coates MD, Brooks EM, Glass LM, Ganguly EK, Blaszyk H, et al. Mucosal serotonin signaling is altered in chronic constipation but not in opiate-induced constipation. Am J Gastroenterol. 2010;105(5):1173-80.
• 30. Tai M-LS, Norhatta N, Goh KJ, Moy FM, Sujarita R, Asraff AA, et al. The impact of dyspepsia on symptom severity and quality of life in adults with headache. PloS one. 2015;10(1):e0115838-e.
• 31. Akbari N, Hormati A, Sharifipour E, Hejazi SA, Jafari F, Mousavi-Aghdas SA, et al. Migraine, dyspepsia, and Helicobacter pylori: Zeroing in on the culprit. Iran J Neurol. 2019;18(1):19-24.