Migren Hastalarında Gastroözofageal Reflü Hastalığı (GÖRH) Sıklığı ve GÖRH Tedavisinin Migren Atakları Üzerindeki Etkisi

Abstract

Amaç: Migren hastalarında gastroözofageal reflü hastalığı (GÖRH) sıklığını belirlemek ve GÖRH tedavisine uyumun migren atak sıklığı üzerindeki etkisini araştırmak. Yöntem: Dokuz Eylül Üniversitesi (DEÜ) Nöroloji-Baş Ağrısı Kliniği ve DEÜ Aile Sağlığı Merkezlerine başvuran ve dahil etme kriterlerini karşılayan 18-45 yaş arası toplam 757 kişi çalışmaya dahil edildi. Dışlama kriterleri gebelik, kanser, alarm bulguları ve anketin anlaşılmasını engelleyecek herhangi bir zihinsel engeldi. Migreni teşhis etmek için Uluslararası Baş Ağrısı Derneği (IHS) kriterlerini içeren Migren Tanı Anketi, GÖRH' yi teşhis etmek için Gastroözofageal Reflü Hastalığı Anketi (GERDQ) ve ilaç uyumunu değerlendirmek için Modifiye Morisky Ölçeği kullanıldı. İstatistiksel analiz için SPSS 22 paketi kullanıldı. Verilerin istatistiksel değerlendirilmesinde ki-kare, t-testi ve ANOVA kullanıldı ve p<0,05 anlamlı kabul edildi. Bulgular: Çalışmaya katılan 757 kişiden 428'i migren tanısı almış ve nöroloji polikliniğinde takip ediliyordu. Aile sağlığı merkezlerine başvuran 329 hastadan 122'si migren tanısı almış ve 108'i migren dışı baş ağrısı tanısı almıştı. 99'unun baş ağrısı şikâyeti yoktu. Çalışmaya katılan hastaların GERDQ skorları değerlendirildiğinde migrenlilerde GERDQ skoru 8 ve üzeri olan 183 kişi (%33,3), migren dışı baş ağrısı olan 19 kişi (%17,6) ve baş ağrısı olmayan 8 kişi (%8,1) vardı. Migrenlilerin GERDQ reflü skorunun diğer gruplara göre yüksek olduğu ve bu düzeyin istatistiksel olarak anlamlı olduğu bulundu (p<0,001). GÖRH tedavisi alan migren hastalarında tedaviye uyumun migren atak sıklığı ile anlamlı bir ilişkisinin olmadığı görüldü. Sonuç: Migrenli hastalarda GÖRH insidansı migreni olmayan hastalara göre daha yüksek bulunmuş ve bu hastaların tedaviye uyumunun daha düşük olduğu görülmüştür. Migrenli hastalara poliklinik başvurularında GÖRH varlığı araştırılması ve tedavi motivasyonlarının desteklenmesi faydalı olabilir.

Keywords

• GÖRH
• migren
• ilaç uyumu

The Frequency of Gastroesophageal Reflux Disease (GERD) in Migraineurs and the Impact of GERD Treatment on Migraine Attacks

Abstract

Objective: To determine the frequency of gastroesophageal reflux disease (GERD) in migraine patients and investigate the impact of adherence to gastroesophageal reflux treatment on migraine attack frequency. Method: A total of 757 people aged 18-45 years who applied to the Dokuz Eylul University (DEU) Neurology-Headache Clinic and the DEU Family Health Centers and met the inclusion criteria were included in the study. Exclusion criteria were pregnancy, cancer or alarming findings, and any mental disability that would prevent understanding of the questionnaire. The Migraine Diagnostic Questionnaire, including International Headache Society (IHS) criteria, was used to diagnose migraine, the Gastroesophageal Reflux Disease Questionnaire (GERDQ) to diagnose GERD, and the Modified Morisky Scale to assess medication compliance. SPSS 22 package was used for statistical analysis. Chi-square, t-test and ANOVA were used for statistical evaluation of the data, and p<0.05 was considered significant. Results: Of the 757 people who participated in the study, 428 patients were diagnosed with migraine and followed up in the neurology outpatient clinic. Of the 329 patients who applied for family health centers, 122 were diagnosed with migraine and 108 with non-migraine headaches. 99 did not complain of headache. When the GERDQ scores of the patients participating in the study were evaluated, there were 183 people (33.3%) with a GERDQ score of 8 and above among the migraineurs, 19 people (17.6%) with non-migraine headaches and 8 people (8.1%) without headaches. The GERDQ reflux score of migraineurs was found to be higher than in the other groups and this level was statistically significant (p<0.001). When the migraine attack frequency of migraine patients treated for GERD was evaluated, no significant relationship was found between treatment adherence and migraine attack frequency. Conclusion: The incidence of GERD in patients with migraine was found to be higher than in patients without migraine, and the compliance of these patients with treatment was found to be lower. It may be useful to ask patients with migraine about GERD when they come to the outpatient clinic and to support their motivation for treatment.

Keywords

• migraine
• medication adherence
• GERD

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