In addition to severe headaches, migraine episodes can cause stomach pain in some people. This may be due to a link between your brain and your gut. But other causes include pregnancy or medication side effects.

Migraine is a common headache disorder that affects about 12% of people. It causes symptoms that include pain, sweating, and sensitivity to light and sound. These painful headaches usually occur on one side of your head.

But a migraine headache can also cause all sorts of unusual symptoms that you may not think are related to headaches, such as stomach pain. These symptoms could be related to a proposed connection between your brain and gut.

In other cases, you may experience stomach pain that occurs alongside a migraine headache but may be due to a co-occurring condition. In some cases, the gut-brain connection may explain why these conditions frequently occur together.

How you treat stomach pain with migraine will depend on the underlying cause.

Keep reading to learn more about the potential connections between stomach pain and migraine.

Researchers from several studies have identified a close connection between migraine and increased incidence of gastrointestinal (GI) conditions. According to 2021 research, nausea and vomiting are common in people with migraine.

Researchers don’t yet know the exact cause of the connection. But there seems to be a close link between your brain and gut. They call this the gut-brain connection (or gut-brain axis).

This link means you might experience uncomfortable and even painful stomach symptoms due to migraine. Some research also suggests that stomach pain is associated with more severe headache symptoms.

Some possible reasons for this link include:

  • Immune system mediators: Components of your immune system that control inflammation may contribute to both migraine headaches and stomach pain.
  • Calcitonin gene-related peptide (CGRP): Release of CGRP can trigger migraine pain and affect acids in your stomach.
  • Neurotransmitters: Microbes in your gut can affect the activity of glutamate and serotonin, which play an important role in your central nervous system. Both may be involved in headache pain during migraine.
  • Stress hormones: Hormones like cortisol can cause headache pain but can also alter the balance of microbes in your gut.

How to manage

If stomach pain is a common symptom of your migraine episodes, consider talking with a doctor. They may prescribe antiemetics to help reduce symptoms of nausea and vomiting. Options include:

  • metoclopramide
  • chlorpromazine
  • prochlorperazine

According to 2020 research, some dietary changes may also help reduce stomach symptoms and migraine headaches in general. Researchers suggest:

What is abdominal migraine?

Abdominal migraine is a condition that may occur in children and causes severe stomach pain that can last up to 3 days. The symptoms of abdominal migraine include nausea, vomiting, and appetite loss.

Similar migraine triggers in adults can lead to abdominal migraine in children. These include:

  • stress
  • exposure to bright light
  • certain foods, such as chocolate
  • caffeine

Children with abdominal migraine are more likely to experience migraine headaches as adults. They also usually have a family history of migraine.

Learn more about the symptoms and treatment for abdominal migraine.

People with migraine often take over-the-counter (OTC) and prescription medications to prevent or reduce their headache symptoms. But these medications may sometimes cause stomach pain as well.

GI symptoms are the most common side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen. Possible GI symptoms include:

Other common migraine treatments can cause GI symptoms such as nausea, vomiting, diarrhea, or constipation. They include:

Triptans are a common form of migraine treatment. While they don’t typically affect your stomach directly, they may cause other side effects that lead to an upset stomach.

Some research links triptans to gastroesophageal reflux disease (GERD). This condition can cause heartburn, bloating, and upset stomach. But more research is needed to determine the exact cause of the link.

In the above study, triptans were the most common medications among those who had both GERD and migraine.

How to manage

If your migraine medication is causing your stomach pain, you might find relief when you stop taking the medication. But it’s best to talk with a doctor before stopping your medication. If a doctor thinks your medication is causing your stomach pain, they can suggest an alternative.

Several small studies have found up to 45% of people with migraine and stomach pain also have Helicobacter pylori infection. This bacteria can cause stomach ulcers.

But again, the link is unclear. Some studies have found conflicting information. Others have found a link between H. pylori and migraine with aura only.

There’s also limited research to suggest that treating the infection with antibiotics could improve symptoms. Still, more research is needed.

How to manage

A doctor can determine if an infection is co-occurring with your migraine headache. Doctors typically treat H. pylori infections with three drugs: a proton-pump inhibitor (PPI) to reduce stomach acids and two antibiotics to kill the bacteria.

Common antibiotic choices include:

Some probiotics and natural remedies may enhance the effect of antibiotics.

Can COVID-19 cause migraine and stomach pain?

The Delta and Omicron variants of COVID-19 strains were known to cause headaches as a symptom. Some patients also report a migraine-like headache after they’ve gotten over the most acute COVID-19 symptoms. These headaches can cause pain on one side, along with sensitivity to light, noise, touch, and smell.

Researchers are a still learning a lot about post-COVID symptoms. At this time, there are not many reports of post-COVID migraine occurring with stomach pain.

There may be a link between migraine and irritable bowel syndrome (IBS). About 34% to 50% of people with IBS also have chronic headaches, though not necessarily migraine. But the two share similar risk factors, including being assigned female at birth and being a younger age.

Depending on your type of IBS, it can lead to symptoms such as:

  • abdominal pain and cramping
  • frequent or infrequent bowel movements
  • diarrhea or constipation

Researchers don’t fully understand why people with IBS and migraine experience each at higher rates than the general population. It may be related to serotonin, a hormone that plays a role in both conditions.

How to manage

Consider talking with a doctor if you have symptoms of IBS with migraine. They may want to determine if something else is causing your IBS. In that case, they may recommend certain dietary or lifestyle changes to help reduce symptoms.

Since there’s no cure for IBS, a doctor may suggest OTC or prescription medications to treat specific symptoms.

Gastroparesis is a condition that causes food to stay in your stomach longer than it should. This causes uncomfortable symptoms such as:

  • nausea
  • bloating
  • unexplained weight loss
  • vomiting

Some studies have found a link between headache pain and an increased incidence of gastroparesis during a migraine episode.

Doctors do not know exactly why this occurs, but they think migraine may activate the sympathetic nervous system. This system causes a “fight-or-flight” response, which works to divert blood away from your stomach to key organs like the brain and heart. As a result, your digestion may slow down, leading to stomach pain.

How to manage

If you have gastroparesis due to migraine, your doctor will first try to find treatments to reduce your number of migraine days. They may also recommend or prescribe medications to help reduce your GI symptoms.

But medications you take by mouth may not be effective if they move through your stomach too slowly for your gut to absorb them quickly enough. A doctor may recommend a different way to administer your medication, such as by injection.

Gluten is a protein naturally present in many grain-containing foods. Food producers often add it to other foods as a thickener.

People with celiac disease have a significant intolerance to gluten. This can lead to bloating, abdominal discomfort, and headaches that closely resemble migraine.

But researchers are yet to identify a connection between a gluten-free diet and reduced incidence of migraine in those who don’t have celiac disease.

How to manage

If gluten is the source of your stomach pain with migraine, your best bet is to avoid gluten. Research from 2019 suggests that elimination diets can be effective in preventing migraine.

Having a history of migraine can increase your risk of nausea and vomiting during pregnancy. This risk may be greater due to an increase in the hormones estrogen and progesterone. Other risk factors for nausea during pregnancy include a history of motion sickness.

How to manage

If you’re pregnant and experience significant nausea, consider talking with a doctor about potential treatments. It’s important to use medications and approaches that are safe for both you and your baby.

Migraine can be a severe and debilitating condition that results in decreased quality of life and missed work or school days. A connection between your brain and gut may also explain why migraine can lead to stomach pain and other GI symptoms.

If you experience nausea or other abdominal discomforts with migraine, consider talking with a doctor about treatment options and underlying conditions that could worsen your symptoms. Ideally, you can find a management plan to help reduce both your migraine days and any associated stomach pain.