Migraine of gastrointestinal origin

A consecutive series of 31 children (median age 12 years) suffering from migraine with (n = 21) or without (n = 10) aura underwent endoscopic oesophageal, gastric and duodenal biopsy in order to determine whether the complaints were of gastro-intestinal origin. Of these 31 children, 13 (41.9%) showed oesophagitis, 16 (51.6%) gastritis of corpus, 12 (38.7%) antral gastritis and 27 (87.1%) duodenitis. Thus, 29 of the 31 children studied had an underlying inflammatory lesion explaining their complaints. Helicobacter pylori colonization was found in 7 of the children: one had H. pylori associated antral and corporal gastritis and 6 H. pylori associated antral gastritis only. Gastritis of corpus without H. pylori was present in all these 6 children. Our data do not support that H. pylori is a primary pathogen of inflammatory changes seen in children studied, neither do they establish an association between H. pylori, antral gastritis and migraine. However, our data strongly suggest that there is a gastro-intestinal origin of these patients' complaints.

Our findings provide further evidence that recurrent abdominal pain is an early expression of migraine and strongly support a causal link between recurrent abdominal pain and migraine.