The association between gastro-oesophageal reflux and migraine in the paediatric population: a multicentre case-control study

Eur J Pediatr. 2022 Apr;181(4):1679-1687.doi: 10.1007/s00431-021-04368-6. Epub 2022 Jan 10.

Léa Lenglart # 1, Vincenzo Raieli # 2, Vittorio Sciruicchio 3, Caroline Caula 4, Giulia Vitali 4, Romain Guedj 5 6, Giuseppe Quatrosi 2, Daniela D'Agnano 3, Renato D'Alonzo 7, Thomas Moulding 8, Victoria Elisa Rinaldi 7, Luigi Titomanlio 4 9


Author information

1Department of Paediatric Emergency Care, DM'UP, APHP, Hôpital Robert Debré, 48 Boulevard Serrurier, Paris, 75019, France. lea.lenglart@gmail.com.

2Child Neuropsychiatry Unit, ISMEP, ARNAS Civico, Palermo, Italy.

3Children Epilepsy and EEG Centre, S. Paolo Hospital, Bari, Italy.

4Department of Paediatric Emergency Care, DM'UP, APHP, Hôpital Robert Debré, 48 Boulevard Serrurier, Paris, 75019, France.

5Department of Paediatric Emergency Care, Hôpital Armand Trousseau, APHP, Paris, 75012, France.

6Faculté de Médecine, UMR153, Sorbonne Université, Paris, Inserm, France.

7Department of Paediatrics, Ospedale S. Giovanni Battista, Foligno, 06034, Italia.

8Department of Specialty and Integrated Medicine, Leeds Teaching Hospitals Trust, Leeds, UK.

9University of Paris, HU I2D2 INSERM UMR1141, Paris, France.


Infantile regurgitation is one of the most common discomforts in the first months of life. Infantile colic and, in older children, functional dyspepsia have been linked to migraine. To date, this is the first study to investigate a possible association between infantile regurgitation and primary headaches in children. This is a case-control study of 195 children aged 6-17 years, with primary headache (migraine, or tension type headache) in 5 European paediatric hospitals. The control group is composed of 240 same-aged children attending with minor injuries during the same period - February 1st 2020 to December 1st 2020. A structured questionnaire identified a history of infantile regurgitation and other functional gastrointestinal disorders for case and control participants. The outcome was the difference in the prevalence of infantile regurgitation among children with or without a diagnosis of primary headache. The analysis showed a significant association between infantile regurgitation and migraine (OR = 1.88, CI 95 = 1.01-3.4, p = 0.04). No association was found between infantile regurgitation and tension type headache (p = 0.33). Subgroup analysis confirmed that the association was only significant for migraine without aura (OR = 2.3, CI 95 = 1.2-4.4, p = 0.01). In a further subgroup analysis, the presence of functional dyspepsia, irritable bowel syndrome and abdominal migraine was associated with migraine without aura.

Conclusion: The presence of migraine among children aged 6-17 was associated with a history of infantile regurgitation. Additional longitudinal studies are required to confirm whether infantile regurgitation could be considered as a precursor of migraine.

What is known: • Children suffering from functional gastrointestinal disorders are more likely to be suffering from migraine and tension-type headache as well. • Children suffering from primary headache are more likely to have had infantile colic in their first six month of life.

What is new: • It is the first study to find an association between migraine and infantile regurgitation in children. • These findings could have an impact on the diagnosis and therapeutics of both migraine and infantile regurgitation.

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