[00:00]
What if the uncomfortable swelling in your belly is not separate from your migraine,
[00:05]
but part of the same conversation happening inside your body?
[00:11]
Welcome to Migraine Heroes, a podcast for people living with chronic migraines with years of pain,
[00:17]
misunderstanding and lack of answers. I'm Diane Ducarme. I've helped more than a thousand people
[00:23]
reduce the burden of migraines and feel more in control. My mission in life? To help a
[00:29]
million people. Each episode brings you grounded insight into what your body might be asking for
[00:36]
and what can truly help. Just to keep you fully supported, this podcast is educational. For
[00:43]
diagnosis or medication, always work with your doctor. Now, take a breath and let's dive in.
[00:52]
In this episode, you will learn why bloating and migraine may appear together and why the
[00:58]
connection involves much more than simply eating the wrong food. How your nervous system, digestive
[01:05]
movement, gut sensitivity, hormones and migraine pathways can create symptoms in both your head
[01:10]
and your abdomen. And you will leave with a simple way to identify whether your bloating is a random
[01:15]
event, a treatment side effect or a meaningful clue about the pattern of your migraine attacks.
[01:22]
Stay with me till the end because at the end of this episode, you will understand the nuances
[01:26]
of your gut-brain axis. So before we talk about mechanics, I want to acknowledge how frustrating,
[01:33]
yet quite common in my experience, the combination can be. So perhaps your jeans feel suddenly tight
[01:40]
even though you have barely eaten. Your stomach feels heavy, swollen or painfully full. Then the
[01:47]
pressure begins behind your eye, on your temple, across your forehead, at the base of your skull.
[01:52]
You may wonder whether you ate something wrong. You may blame gluten, dairy, sugar, yesterday's
[01:59]
leftovers or yourself. And because these symptoms are often treated separately, you may visit one
[02:05]
person for your digestion and another for your migraines, while nobody steps back and asks whether
[02:11]
the two could be connected. So let us begin with the central question. Is bloating simply a coincidence
[02:19]
or can it be a clue? And the scientific answer is it can be a clue. A repeating relationship
[02:26]
between bloating and migraine may point toward shared changes in digestion, nerve signaling, gut
[02:32]
sensitivities, stress physiology, hormones or medication effects. But one episode of bloating
[02:37]
does not automatically mean that a migraine is coming and bloating does not necessarily cause a
[02:42]
migraine. What matters is the pattern. Now what do I mean by bloating? So bloating is sort of the
[02:49]
sensation that your abdomen feels full. It feels pressurized, swollen or stretched. It's not exactly
[02:57]
the same as abdominal distension. Bloating is what you feel and distension is what can be seen
[03:04]
or measured. So you can feel extremely bloated without your abdomen becoming visibly larger and
[03:10]
you can sometimes have visible distension without experiencing much discomfort. This is important
[03:15]
because bloating is not always caused by an enormous quantity of trapped gas. It can also
[03:20]
involve constipation. It can involve delayed movement of food or fermentation. It can involve
[03:26]
increased sensitivity of the intestinal nerves or an altered coordination between the diaphragm
[03:32]
and the abdominal wall. And in 2023, an expert review published in the Journal of Gastroenterology
[03:40]
explains that bloating and distension can have several overlapping causes and these include food
[03:45]
intolerance, constipation, disorders of the gut-brain interaction, altered pelvic floor function
[03:52]
and abnormal muscular responses to normal digestive contents. And so that means the
[03:58]
sensitivity of your bloating does not always tell us how much gas is physically present. Sometimes
[04:04]
the digestive system is reaching strongly to an amount of pressure or stretching that another
[04:09]
person might barely notice. Now, I do vividly remember this woman in New Zealand. I had done a talk
[04:16]
at her employer and she came to me and we started to work together. And really early on, she said to
[04:22]
me, wow, my colleagues told me I had lost weight. And she said, I haven't, or at least not yet, but
[04:29]
my belly is just not bloated anymore. There's not so much gas inside. You know, it was physically
[04:35]
voluminous because there was so much gas trapped. And my husband and I had to laugh a little about
[04:41]
my gas because it was so omnipresent. And now it's, you know, mostly gone and I feel so much better.
[04:48]
But also my colleagues commented on it, but my weight on the scale hasn't changed necessarily.
[04:54]
Just my volume has changed. Gorgeous woman. She had a full-blown IBS, got pregnant. It was just a gorgeous,
[05:00]
gorgeous story. Now I want to talk about the gut and the brain and how they're in constant
[05:05]
conversation. We now know, in the West, that your gut and your brain are not separate systems
[05:11]
operating in isolation. We've believed that for a long time. In the East, for a long time, we've
[05:16]
known they were together. Now everyone does know it. Just the West has proven it scientifically.
[05:21]
Okay. So they communicate continuously through what is called the autonomic nervous system,
[05:27]
the enteric nervous system, the vagus nerve, immune messengers, hormones, and microbial metabolites.
[05:34]
So the enteric nervous system is sometimes called the nervous system of the gut. It helps coordinate
[05:39]
digestion, movement, secretion, and sensation. And meanwhile, your brain is constantly receiving
[05:45]
information about what's happening inside your digestive tract, if you think it's quite logical.
[05:50]
So the communication travels both directions. Your gut can influence your brain,
[05:56]
but your brain can also change how quickly your stomach empties, how strongly your intestines
[06:01]
contract, how sensitive you are to abdominal pressure, and how comfortably you digest a meal.
[06:07]
A disturbed digestive system may influence the threshold at which your nervous system
[06:13]
becomes reactive. So at the same time, the neurological changes surrounding a migraine
[06:17]
may alter your digestion. So it's not necessarily gut first or brain first. And sometimes both
[06:25]
systems are responding to the same underlying change. And I really want to insist here that
[06:31]
the science is completely observable in the clinical work that we do every day at Migraine
[06:36]
Heroes. Now I want to add and go deeper. Migraine and irritable bowel symptoms often overlap as well.
[06:44]
So one of the strongest pieces of evidence for a gut-migraine relationship comes from research on
[06:50]
irritable bowel syndrome. So irritable bowel syndrome is a disorder of gut-brain interaction
[06:56]
involving abdominal pain and changes in bowel habits, just like the one I was referring to
[07:01]
earlier. Many people also experience bloating, urgency, constipation, diarrhea, or uncomfortable
[07:07]
feeling of incomplete emptying. So there was a systemic review and analysis, which was published
[07:13]
in the European Journal of Gastroenterology and Hepatology, and that was in 2022. And the
[07:19]
researchers combined 11 studies involving more than 28,000 people with migraine and more than
[07:26]
one and a half million people without migraine. And they found that people with migraine had
[07:33]
approximately two and a half times the odds of also having irritable bowel syndrome compared
[07:39]
with people without migraine. And so the authors also noted variation between studies and possible
[07:45]
publication bias, where the exact number should be interpreted cautiously. Still, the overall
[07:51]
association was significant. This does not mean that every person with migraine has irritable
[07:56]
bowel syndrome. It means that the overlap is too consistent to dismiss as pure coincidence.
[08:01]
Now researchers are obviously fascinated. They're investigating several possible explanations,
[08:06]
altered pain processing, autonomic nervous system changes, serotonin signaling,
[08:11]
immune activity, stress responses, intestinal sensitivity, and differences in the gut microbiome.
[08:18]
Now, does your bloating come before, during, or after the migraine? And the timing can offer
[08:25]
valuable clues. So first, when bloating comes before the headache. So bloating before the pain
[08:32]
may be part of the early migraine process, especially when it appears with fatigue,
[08:37]
with uncontrollable yawning, with food cravings, neck stiffness, mood changes, or difficulty
[08:44]
concentrating. In that case, the nervous system may already be shifting before you recognize the
[08:49]
migraine itself. The bloating is not necessarily the cause. It may be an early companion symptom.
[08:55]
Now, when bloating and migraine begin together, when both systems start at approximately the same
[09:02]
time, a shared autonomic or hormonal change may be involved. Your stomach may slow,
[09:07]
your sensitivity may increase, and your migraine pathways may activate within the same biological
[09:13]
window. And when bloating appears after the headache or treatment, bloating after the attack
[09:18]
may result from the medication, or the constipation, or the dehydration, or the reduced movement,
[09:23]
or disrupted meals, or several hours spent lying down. So this pattern, unlike the previous one,
[09:28]
is going to direct your attention toward recovery habits and treatment side effects, rather than
[09:33]
toward the food you ate before the attack. Now, none of these patterns prove a cause.
[09:38]
They create a better question. Now, I want to stress something. If your bloating is persistent
[09:46]
and progressively worsening, and is accompanied by unexplained weight loss, or blood in the stool,
[09:52]
repeated vomiting, fever, severe abdominal pain, anemia, difficulty swallowing, a major change in
[09:59]
bowel habits, or a family of serious history of digestive disease, really, you should seek a
[10:04]
medical assessment. So, coincidence or clue? Here's the clearest answer. Occasional bloating may be a
[10:11]
coincidence, but repeating bloating may be a clue. It becomes more meaningful when it follows a
[10:17]
consistent timeline, such as bloating beginning several hours before most attacks, or constipation
[10:22]
worsening during high-frequency migraine weeks, or early fullness and nausea making oral medicine
[10:28]
less effective, or digestive changes beginning after a new treatment. Bloating and migraine
[10:33]
appearing together around the same points in the menstrual cycle, or both symptoms improving when
[10:38]
sleep, meals, and bowel regularity becomes more stable. Clue is not simply that both symptoms
[10:44]
exist. The clue is the relationship between them. Now, I want to take an Eastern perspective.
[10:51]
Traditional Chinese medicine often distinguishes between the roots of a pattern and its branches.
[10:56]
So, the branch is the symptom demanding attention today. The swollen abdomen, the nausea, the headache,
[11:03]
or the sensitivity to light. The root is the deeper pattern that makes those systems easier to trigger.
[11:10]
The exhaustion, the irregular nourishment, the poor sleep, the chronic tension, the weak digestion,
[11:15]
or a long period of pushing beyond the body's capacity. And, of course, all of the underlying
[11:21]
patterns that are root causes of those. Now, the distinction matters because many people spend
[11:25]
years chasing branches. They remove one food, then another, then they change supplements.
[11:31]
They search for the ingredient responsible for yesterday's symptoms. Sometimes it's helpful,
[11:37]
but sometimes the body's not reacting to one ingredient. It's reacting to the overall conditions
[11:42]
in which the ingredient arrived. Were you rested? Were you calm enough to digest? Had you skipped two
[11:47]
meals? Did you eat quickly? Were you already constipated? Was your nervous system already
[11:52]
approaching its migraine threshold? The same meal can feel nourishing on one day and overwhelming
[11:58]
on another because the person receiving the meal is not in the same state. So, traditional Chinese
[12:04]
medicine approaches this relationship from a different angle. It does not begin by isolating
[12:10]
the brain from the stomach or by asking which single molecule is responsible. Instead, it's
[12:14]
going to ask, how is the energy moving through the whole system? What is failing to transform?
[12:19]
What is becoming stuck? And where is the body losing its natural rhythm? Now, I'm going to go
[12:25]
to Ayurveda, to India, for a minute. Ayurveda has a concept, which is really interesting, called
[12:31]
acne. And it often translates to digestive fire. And when digestive fire is steady, food and
[12:37]
experience are believed to be processed clearly. When it becomes weak or irregular, the person may
[12:43]
experience heaviness, gas, bloating, or incomplete digestion. Ayurveda may also associate variable
[12:48]
bloating, nervous system sensitivity, and irregular symptoms with disturbed vata, the principle linked
[12:54]
with movement. From this philosophical perspective, both migraine and bloating may worsen when the
[12:59]
system loses rhythm through irregular meals, excessive stimulation, poor sleep, travel,
[13:05]
overwork, or constant mental activity. So, the suggested direction is not punishment or
[13:11]
rigid control. It's rhythm, regular nourishment, warmth, rest, and enough space for the body to
[13:17]
complete one process before being asked to begin the next. I find these days, if you're alone,
[13:23]
there's a tendency, you know, it's quite hard to watch Netflix. You watch a TV series, it's the
[13:29]
time of your break, and it's so nice. But it really makes your mind quite busy and not able to eat
[13:34]
mindfully. Something to think about. Like for me, I find it quite hard if I'm working and I'm a whole
[13:39]
day in meetings and I'm alone at home, I find it quite hard to abstain from watching something
[13:45]
while I eat. But I know it's just better just for that digestive process. So, the Eastern perspective
[13:50]
is going to remind us not to ask only what is wrong with my stomach or what is wrong with my
[13:55]
head. It's going to invite us to ask where has my system lost its ability to move, transform,
[14:01]
or descend, or recover. It also reminds us that a person can experience both deficiency and excess.
[14:07]
This is a really important, important notion. You can feel exhausted, yet tense. You can feel
[14:15]
hungry, yet unable to digest. I don't know if it resonates. You can feel constipated,
[14:21]
yet completely bloated. You can feel overstimulated, yet depleted. Your head may feel
[14:27]
full, while the rest of you feels empty. These apparent contradictions are not evident that
[14:33]
your symptoms are imaginary. They may indicate that your body is struggling to regulate competing
[14:38]
demands. The goal is not to force your body into submission. The goal is to help it recover rhythm,
[14:43]
movement, and safety. This is something I see again and again in my work. People often carry
[14:49]
both excesses and deficiencies at the same time. You may be taking supplements to repair something
[14:54]
that feels deficient, while an excess is still standing in the way. When you have both bloating
[15:00]
and migraines, the bigger question becomes, where do you start? What needs to be addressed first?
[15:07]
This is why healing can feel so convoluted and complicated. Every one of you listening
[15:13]
will have a different situation. The way we solve this, because we're really in it to solve this for
[15:19]
a million people. What we did is that in the Migraine Heroes app, we start now by identifying
[15:25]
what we call your primary pattern. It's not necessarily the biggest problem, but the pattern
[15:30]
that is significant enough to show us where to begin. Over the years, we've realized just how
[15:36]
important that starting point is, even though finding it can be confusing right now. Because
[15:41]
I don't know your individual situation, I would like to invite you to pay close attention to the
[15:46]
details and to listen to your intuition. Remember that your needs can change. Something that worked
[15:52]
beautifully for a while may eventually stop working, not because you were wrong, but because
[15:57]
it may have helped resolve one pattern and reveal another. Perhaps you first needed to clear an
[16:03]
excess, and now your body's asking you to rebuild the deficiency. Keep listening, keep observing,
[16:09]
and do not assume your intuition is wrong simply because things change. And remember,
[16:16]
every small step you take moves you closer to freedom. You are powerful,
[16:21]
you are resilient, and you're not alone. Keep rising, Migraine Hero.
