■偏头痛和肠易激综合征(IBS)可能是难以治疗的合并症,可能是由潜在的肠-脑轴功能障碍引起的。本报告描述了低FODMAP(可发酵寡糖,二糖,单糖,和多元醇)饮食(LFD)在患有难治性偏头痛和并发IBS的患者中。
■经过不明显的身体和神经系统检查,一名57岁的IBS合并慢性偏头痛的女性在注册营养师的指导下开始接受LFD.在基线和初始随访时进行的心理测量验证调查评估了患者报告的与偏头痛和IBS症状相关的结果。
■在基线时,患者报告了80/90日的偏头痛,平均疼痛为8/10,偏头痛残疾评估(MIDAS)评分为33分,头痛影响测试-6(HIT-6)评分为64分,后2个评分表示严重残疾.在9/10记录基线IBS症状严重程度。在LFD的1周内,患者的IBS症状和偏头痛的发作频率和强度均得到改善。在LFD消除5周后,患者的临床继续改善,她报告偏头痛显著减少,平均疼痛为1/10,IBS严重程度为3/10。在经过验证的措施下,患者的残疾也从严重程度提高到最低程度(MIDAS,HIT-6和IBS患者对变化的整体印象)。
■这是第一例报告,详细介绍了利用营养师指导的LFD成功初步治疗偏头痛和合并IBS。这些肠-脑轴疾病的潜在改善有许多重要原因,这些原因正在审查中,以及对长期管理和食物重新引入的启示。较大,评估不同偏头痛患者和合并IBS患者LFD的随机试验有助于证实这些结果.
UNASSIGNED: Migraine and irritable bowel syndrome (IBS) can be difficult-to-treat comorbidities that may be driven by underlying gut-brain axis dysfunction. This report describes utilization of a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet (LFD) in a patient with refractory migraine and co-occurring IBS.
UNASSIGNED: After unremarkable physical and neurological examinations, a 57-year-old woman with IBS and chronic migraine was started on a LFD under the guidance of a registered dietician. Psychometrically validated surveys administered at baseline and initial follow-up assessed patient-reported outcomes related to migraine and IBS symptoms.
UNASSIGNED: At baseline, the patient reported 80/90 migraine days with average pain of 8/10, a Migraine Disability Assessment (MIDAS) score of 33, and Headache Impact Test-6 (HIT-6) score of 64, the latter 2 scores indicating severe disability. Baseline IBS symptom severity was noted at 9/10. Within 1 week on a LFD, the patient\'s IBS symptoms and migraines improved in both frequency and intensity of episodes. After 5 weeks on a LFD elimination, the patient\'s clinical improvement continued and she reported significant reduction in migraines, with average pain of 1/10 and IBS severity of 3/10. The patient also improved from severe to minimal levels of disability on validated measures (MIDAS, HIT-6, and IBS Patient Global Impression of Change).
UNASSIGNED: This is the first
case report detailing successful initial treatment of migraine and co-occurring IBS utilizing a dietician-guided LFD. There are a number of important reasons for potential improvement in these gut-brain axis disorders which are reviewed as well as an implication for long-term management and food reintroduction. Larger, randomized trials evaluating a LFD in diverse individuals with migraine and co-occurring IBS are warranted to help confirm these results.