IBS and migraine may share genes, mechanism of action

Reuters Health Information: IBS and migraine may share genes, mechanism of action

IBS and migraine may share genes, mechanism of action

Last Updated: 2016-04-18

By Rob Goodier

NEW YORK (Reuters Health) - Irritable bowel syndrome (IBS) and migraine frequently occur together and that might not be a coincidence, new research suggests.

Patients with migraines were more than twice as likely to have IBS compared with controls and patients with tension-type headaches, according to a new study scheduled for presentation April 19 at the American Academy of Neurology annual meeting in Vancouver, Canada. The work also shows patients with both migraine and IBS may share differences in serotonin transporter and receptor genes.

"This study revealed the importance of treatments that target the brain-gut axis and also selective use of 5-hydroxytryptamine (5HT) receptor antagonist drugs in IBS particularly with comorbid primary headaches," lead researcher Dr. Derya Uluduz from Istanbul University Cerrahpasa School of Medicine in Turkey told Reuters Health by email.

"Patients with IBS have decreased serotonin transport . . . causing serotonin to stay around longer and triggering problems," Dr. Uluduz said.

5-HT3 antagonists may be able to reduce the pain brought on by that extra 5-HT, Dr. Uluduz added, and can also reduce inflammation of the cranial trigeminal nerve which may help prevent migraine.

The study included 107 patients with episodic migraine, 53 patients with episodic tension-type headache, 107 patients with IBS and 53 healthy controls.

More than half of the patients with migraine (54.2%) also had IBS, compared to 28.3% of the tension-headache patients (p<0.05). IBS patients were more likely to have migraine than tension headache (35.5% vs. 22.4%), but the difference was not statistically significant.

The researchers also looked for polymorphisms in the serotonin transporter and receptor 2A genes. They found that IBS, migraine and tension-headache patients each had at least one gene that differed from those of the healthy controls.

Patients with both migraine and IBS had significantly different serotonin genes (5HTTLPR-LL genotype, 5HTTVNTR 10/12 genotype and 5HT2A-1438 GG genotype) compared to the other participants, "suggesting a clear shared link between IBS and migraine apart from overlapping somatic and psychiatric comorbidities," Dr. Uluduz said.

"Defect in serotonin signaling occurs in patients with IBS. There has been impairment in serotonin metabolism in the pathogenesis of migraine as well. In this respect, IBS may be defined as the migraine of the bowels," Dr. Uluduz added.

The possibility of a shared pathophysiology between the two disorders is plausible, given that they often occur together, says Dr. Teshamae Monteith, a neurologist at the University of Miami, Florida, who was not involved in the research.

"Future studies should focus on targeted therapy for the migraine-IBS phenotype, which includes not only pharmacology, but also drug delivery, food sensitivities, and even behavioral techniques," Dr. Monteith says.

SOURCE: http://bit.ly/1S5y49R

American Academy of Neurology 2016.

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