Managing Migraine with Gastroparesis

Managing Migraine with Gastroparesis

Gastroparesis and migraine

Have you ever taken an oral acute medication and thought “this just isn’t working?”  It could be that your stomach just can’t absorb your medications during a migraine attack.  

Gastroparesis is a condition that can occur during migraine attacks that impacts the way that your acute migraine medications work.  Gastroparesis also is referred to as delayed gastric emptying, meaning that your stomach isn’t contracting or digesting as quickly as usual. 

Patients who experience nausea and vomiting during their migraine attacks likely are experiencing gastroparesis, and, according to a study published by Dr. Lawrence Newman in the Headache Journal, gastrointestinal manifestations of migraine contribute to triptan and acute medication failure.  So what does this mean?  

When you experience gastroparesis during a migraine attack, your stomach does not digest oral medications (like Sumatriptan or Ubrelvy) as quickly as it would when you’re not having a migraine attack.  So something that typically would take fifteen or thirty minutes to digest would take hours when you have gastroparesis… and we all know that timing is essential when acutely treating migraine attacks.  

Symptoms of gastroparesis

Common symptoms for gastroparesis include nausea, vomiting, and feeling full when you’ve eaten just a tiny amount of food.  Other symptoms include stomach pain and cramping, bloating, constipation and/or diarrhea.  And migraine patients experiencing gastroparesis during their attacks will notice that their oral acute medications don’t work like they should.  

Migraine medications for patients with gastroparesis

This is why many migraine patients find that quick-melt, IV, injectable or intranasal medications are more effective than a traditional oral medication because they are absorbed by the body more efficiently.  This also is why Reglan (metoclopramide) often is given in migraine cocktail IVs because Reglan improves the rate of medication absorption.  

If you experience nausea during your migraine attacks and find that your oral acute medications do not work as effectively, talk to your provider about acute medications and treatments that bypass the stomach.  Options to discuss include: 

As always, Neura Health’s headache specialists are available for a video consultation if you want to explore the best treatment options for your individual case.

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Thomas Berk, MD FAHS
Thomas Berk is Medical Director at Neura Health, where he treats Neura patients via video visit. He is a former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine.
About the Author
Thomas Berk, MD FAHS is Medical Director of Neura Health and a neurologist and headache specialist based in New York City. A former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine, he has over 12 years of clinical experience. He graduated from the NYU Grossman School of Medicine and completed his neurology residency at NYU as well. He completed a headache fellowship at the Jefferson Headache Center in Philadelphia. He is a Fellow of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.

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