BackgroundThe brain and gastrointestinal (GI) tract are strongly connected via neural, endocrine, and immune pathways. Previous studies suggest that headaches, especially migraines, may be associated with various GI disorders. However, upper GI endoscopy in migraineurs has shown a low prevalence of abnormal findings. Also, the majority of studies have not demonstrated an association between Helicobacter pylori (HP) infection and migraine, although a pathogenic role for HP infection in migraines has been suggested. Further knowledge concerning the relation between headaches and GI disorders is important as it may have therapeutic consequences. Thus, we sought to investigate possible associations between GI disorders and common primary headaches, such as migraines and tension-type headaches (TTH), using the Smart Clinical Data Warehouse (CDW) over a period of 10 years.MethodsWe retrospectively investigated clinical data using a clinical data analytic solution called the Smart CDW from 2006 to 2016. In patients with migraines and TTH who visited a gastroenterology center, GI disorder diagnosis, upper GI endoscopy findings, and results of HP infection were collected and compared to clinical data from controls, who had health checkups without headache. The time interval between headache diagnosis and an examination at a gastroenterology center did not exceed 1 year.ResultsPatients were age- and sex-matched and eligible cases were included in the migraine (n = 168), the TTH (n = 168), and the control group (n = 336). Among the GI disorders diagnosed by gastroenterologists, gastroesophageal reflux disorder was more prevalent in the migraine group, whereas gastric ulcers were more common in the migraine and TTH groups compared with controls (p < 0.0001). With regard to endoscopic findings, there were high numbers of erosive gastritis and chronic superficial gastritis cases in the migraine and TTH groups, respectively, and the severity of gastritis was significantly higher in patients with TTH compared with controls (p < 0.001). However, no differences were observed in the prevalence of HP infection between the groups.ConclusionThe observed association in this study may suggest that primary headache sufferers who experience migraines or TTH are more prone to GI disorders, which may have various clinical implications. Further research concerning the etiology of the association between headaches and GI disorders is warranted.
Headaches, especially migraines, have been associated with various vestibular symptoms and syndromes. Tinnitus and hearing loss have also been reported to be more prevalent among migraineurs. However, whether headaches, including migraine or non-migraine headaches (nMH), are associated with vestibular and cochlear disorders remains unclear. Thus, we sought to investigate possible associations between headache and vestibulocochlear disorders. We analyzed 10 years of data from the Smart Clinical Data Warehouse. In patients with migraines and nMH, meniere’s disease (MD), BPPV, vestibular neuronitis (VN) and cochlear disorders, such as sensorineural hearing loss (SNHL) and tinnitus, were collected and compared to clinical data from controls who had health check-ups without headache. Participants included 15,128 with migraines, 76,773 patients with nMH and controls were identified based on propensity score matching (PSM). After PSM, the odds ratios (OR) in subjects with migraine versus controls were 2.59 for MD, 2.05 for BPPV, 2.98 for VN, 1.74 for SNHL, and 1.97 for tinnitus, respectively (p < 0.001). The OR for MD (1.77), BPPV (1.73), VN (2.05), SNHL (1.40), and tinnitus (1.70) in patients with nMH was also high after matching (p < 0.001). Our findings suggest that migraines and nMH are associated with an increased risk of cochlear disorders in addition to vestibular disorders.
Background Headache, especially migraine, has been associated with various vestibular symptoms and several vestibular syndromes. In addition, cochlear disorders, such as tinnitus and hearing loss, have recently been reported to be more prevalent among migraine patients. However, whether headaches, including migraine or non-migraine headaches, are associated with vestibular and cochlear disorders remains unclear. Thus, the possible associations between headaches, including migraine and non-migraine headaches, and vestibulocochlear disorders were investigated in the present study. Methods Clinical data were analyzed from the Smart Clinical Data Warehouse of Hallym University Medical Center from 2011–2021. In patients with migraine and non-migraine headaches, data on Meniere`s disease (MD), benign paroxysmal positional vertigo (BPPV), vestibular neuronitis (VN), and cochlear disorders such as sensorineural hearing loss (SNHL) and tinnitus, were collected and compared with clinical data from controls without headache who had health check-ups. In addition, the presence of comorbidities were defined according to the International Classification of Diseases, tenth revision codes in the database and analyzed. Results The study included 15,128 participants with migraines and 76,773 with non-migraine headaches. Controls were identified based on propensity score matching (PSM). After PSM, the adjusted odds ratios (ORs) in subjects with migraine versus controls were 2.597 for MD (95% CI, 2.047–3.295; p < 0.001), 2.045 for BPPV (95% CI, 1.816–2.302; p < 0.001), 2.976 for VN (95% CI, 2.636–3.360; p < 0.001), 1.739 for SNHL (95% CI, 1.404–2.156; p < 0.001), and 1.970 for tinnitus (95% CI, 1.658–2.341; p < 0.001). The adjusted ORs for MD (1.771; 95% CI, 1.560–2.011; p < 0.001)), BPPV (1.731; 95% CI, 1.637–1.831; p < 0.001), VN (2.048; 95% CI, 1.935–2.168; p < 0.001), SNHL (1.396; 95% CI, 1.273–1.531; p < 0.001), and tinnitus (1.693; 95% CI, 1.569–1.826; p < 0.001) in patients with non-migraine headache versus controls were also high after PSM. Conclusion The present study findings indicated that migraine and non-migraine headaches are associated with an increased risk of cochlear disorders, such as SNHL and tinnitus, in addition to vestibular disorders.
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