Migraine is a neurovascular disorder, earmarked by extreme, pounding pain, typically on one side of the head. The severe pain of a migraine attack can feel debilitating. Often, migraine pain is accompanied by nausea and vomiting.
It’s been shown that vomiting may, in some instances, alleviate or halt migraine pain. In fact, some people with migraine induce vomiting in order to make their head pain stop. In this article, we’ll go into the possible reasons why vomiting may sometimes have this effect.
It’s not definitively known why vomiting stops migraine pain for some individuals. There are several possible explanations.
Other potential explanations they considered were that vomiting may elicit involuntary chemical or vascular effects that work to diminish migraine pain, or that vomiting simply represents the final stage of a migraine headache’s progression.
Rachel Colman, MD, director of the Low-Pressure Headache Program at the Center for Headache and Pain Medicine and an assistant professor of neurology, Icahn School of Medicine at Mount Sinai, further explains these theories:
End of a migraine theory
“Vomiting for some marks the end of a migraine. For others, it is merely a feature that accompanies migraine. It’s not fully understood why a migraine may end with vomiting. During a migraine, the gut slows or even stops moving (gastroparesis). As the migraine ends, the gut begins to move again, and the vomiting is an accompanying feature of the migraine ending, as the GI tract starts to work again,” she says.
“Or conversely, once the GI tract rids itself of the sensory stimuli, it aids in a feedback loop to stop the migraine,” she adds.
Complex interaction theory
“Another theory,” she says, “is that a migraine [attack] is a complex interaction by the central nervous system, the enteric nervous system (in the gut), and the autonomic nervous system. Vomiting is seen to be the final process of these interactions, and vomiting hallmarks the shutting down of the migraine.”
Vagus nerve theory
A third theory involves the vagus nerve, which is stimulated by vomiting.
“It’s well known that vagal stimulation can lead to breaking of migraine, as there are medications categorized as vagal nerve simulators available that have been FDA-approved to treat a migraine attack,” she says.
“Vomiting may also lead to more arginine-vasopressin (AVP) release,” she says. “AVP increases have been associated with relief of migraine.”
“Finally, she says, “vomiting can cause peripheral blood vessel vasoconstriction, which could, in turn, reduce blood flow to pain sensitized vessels, leading to a decrease in pain.”
Nausea and vomiting are common symptoms associated with migraine. This may be because the brain and gut are connected and able to communicate with each other. An example of this is the butterflies you feel in your stomach when you’re nervous.
This communication is bidirectional, meaning that the brain can send messages to the gut, and the gut can also send messages to the brain.
This is known as the gut-brain axis. It connects the central nervous system to the enteric nervous system through the vagus nerve, which runs from the brain to the gut.
In fact, a specific type of migraine that typically occurs in children is known as abdominal migraine. Nausea and vomiting are known symptoms of this condition. Abdominal migraine pain centers in the stomach rather than in the head. Children prone to abdominal migraine often have migraine attacks as adults.
In addition to nausea and vomiting, other migraine symptoms may include:
- intense, pounding pain on one or both sides of the head
- extreme sensitivity to light, sound, or smells
- blurry vision
- weakness or lightheadedness
- stomach pain
Treatments for nausea and vomiting associated with migraine include taking anti-nausea medication. Your doctor will most likely recommend that you take these in addition to pain-relieving drugs. Anti-nausea medications include:
- metoclopramide (Reglan)
- prochlorperazine (Compro)
There are also home remedies and over-the-counter solutions that may help alleviate nausea during migraine. These include:
- taking motion sickness medication
- trying acupressure by putting pressure on the inside of the wrist
- avoiding constrictive clothing around your abdomen
- using an ice pack on the back of your neck or on the area where you feel head pain
- sucking on ice chips or drinking small sips of water to stay hydrated
- drinking ginger tea, ginger ale, or sucking on raw ginger or ginger candy
- avoiding foods with strong tastes or smells
- avoiding contact with strong-smelling substances, such as dog or cat food, kitty litter, or cleaning products
- opening the window to let fresh air in, provided that the air outside doesn’t have a smell you’re sensitive to, such as car exhaust
Migraine attacks with nausea and vomiting can feel debilitating, stopping you from enjoying and participating in life.
See your doctor if you have migraine attacks combined with nausea or vomiting. They’ll be able to prescribe medications to help your symptoms.
Nausea and vomiting are common symptoms of migraine. In some people, vomiting seems to alleviate or even stop migraine pain completely. The reason for this isn’t completely understood, though several theories hold promise.
If you have vomiting and nausea related to migraine, seeing your doctor may help you find symptom relief.