The Impact of Dyspepsia on Symptom Severity and Quality of Life in Adults with Headache

Abstract

BackgroundDyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache.MethodsA cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL) data were compared between subjects with headache and controls (non-headache subjects). The impact of dyspepsia was analysed further in subjects with headache alone.Results280 subjects (93 cases with headache and 187 matched controls) were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0±17.3 years, 57.0% females and ethnic distribution—Malaysian = 45 (48.4%), Chinese n = 24 (25.8%) and Indians n = 24 (25.8%). Headache sub-types among cases with headache were as follows: tension-type headache (TTH) n = 53 (57.0%) and migraine n = 40 (43.0%). Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%, p = 0.011), and headache was independently associated with dyspepsia (OR 2.75, 95% CI 1.39–5.43). Among cases with headache, there was a trend towards a higher prevalence of dyspepsia in those with migraine (27.5%) compared to TTH (24.5%). Subjects with headache and dyspepsia, compared to those with headache alone, had a greater severity of headache symptoms (63.67±22.85 mm vs 51.20 ±24.0 mm VAS, p = 0.029). Overall HRQOL scores were lower in headache subjects with dyspepsia (EQ-5D summary score 0.82±0.18 vs 0.90 ±0.16, p = 0.037 and EQ-5D VAS 62.08±17.50 mm vs 72.62 ±18.85 mm, p = 0.018), compared to those without dyspepsia.ConclusionDyspepsia is associated with more severe headache symptoms and results in a lower HRQOL in patients with headache.

Clinical Implications of Associations between Headache and Gastrointestinal Disorders: A Study Using the Hallym Smart Clinical Data Warehouse

“…Abnormal visceral mechanosensory and vagal function has been found to be involved in dyspeptic patients, and disturbances in visceral nerves have also been implicated in migraines ( 7 , 24 ). In addition, individuals with headaches and GI symptoms had more severe and frequent symptoms compared to those subjects without GI symptoms ( 8 , 25 , 26 ). A possible explanation for this effect may be a heightened common pathophysiological mechanism, which may lead to more severe symptoms in individuals with dual pathology compared to just headaches alone ( 25 ).…”

“…In addition, individuals with headaches and GI symptoms had more severe and frequent symptoms compared to those subjects without GI symptoms ( 8 , 25 , 26 ). A possible explanation for this effect may be a heightened common pathophysiological mechanism, which may lead to more severe symptoms in individuals with dual pathology compared to just headaches alone ( 25 ).…”

Quality of life in dyspepsia and its subgroups using EQ-5D (EuroQol) questionnaire

“…A previous study using EQ-5D in a secondary care hospital setting, patients with dyspepsia and headache had greater severity of the latter symptom resulting in lower scores for HRQOL compared to those without dyspepsia. [11]…”

Functional dyspepsia and irritable bowel syndrome in teenagers: Internet survey

“…Sullivan et al have reported that pediatric patients with chronic upper GI symptoms may have underlying OD, and that for patients with upper GI symptoms and OD, treatment of OD might help to resolve GI symptoms . With regard to headache, recent studies have shown that dyspepsia is strongly associated with headache …”