Relief And Medication For Migraine Nausea

Migraine related to nausea

If you feel an uneasy sensation in your stomach when you are having a migraine, it's probably not because of the food you last ate. A migraine episode can come alongside nausea and vomiting symptoms.¹ 

When you experience symptoms such as a throbbing headache and visual disturbances, you may know a migraine attack is on the horizon. However, it may be hard to understand how symptoms that occur way down in the stomach can have a relationship to the signs you associate with migraines. 

This post will discuss the relationship between migraine, nausea, and vomiting. You will also learn the treatment and prevention options for migraine-related nausea. 

Types of migraine that can cause nausea

A migraine is not just an intense, throbbing headache. It is a neurological disease with different types that share several symptoms. The types of migraine that have nausea as a symptom include:

Migraine with and without an aura

Migraines with auras come with a warning. You experience various symptoms, often visual disturbances, about 30 minutes before the headache starts. However, sometimes it comes without a headache. You may also experience tingling and numbness, motor problems, or lose the ability to speak for a short time. 

Migraines without an aura begin with pain, usually on one side of the head. This type is more common than migraine with aura. But people with either of the two can experience nausea and vomiting symptoms.

Vestibular migraine

Vestibular migraine can cause nausea, throbbing head pain, dizziness, and balance problems. The migraine has ties to the balance system and inner ear. However, nausea and vertigo symptoms can arise in people with vestibular migraine while the headache is absent. 

Abdominal migraine

Abdominal migraine usually affects children aged 5–9 but can also affect older people. It usually does not cause a headache. The symptoms include pain around the belly button, nausea, and vomiting. Children who have had this migraine for a long time may also show subtle signs of delayed development, attention deficit issues, and clumsiness. 

Hemiplegic migraine

Hemiplegic migraine prominently features nausea symptoms, in addition to weakness on one side of the body and head pain.

People with hemiplegic migraine may also experience temporal changes in speech, sensation, and vision. You may also experience paralysis on one side of the body. When this happens, many may think they are having a stroke.

Hemiplegic migraine can be familial or sporadic. The familial type is an inherited genetic disorder and thus runs in the family. You may have a higher chance of developing familial hemiplegic migraine if your parent or sibling has this type of migraine.

However, you can undergo genetic testing to establish whether you have gene mutations linked with this migraine variant. 

Sporadic hemiplegic migraine occurs in people without a family history of the genetic disorder. The two have similar symptoms but only differ in the presence of known genetic risk. 

Other symptoms of migraine

Nausea and throwing up are common symptoms in people with migraines, especially the types mentioned above. However, migraine has other symptoms, including:

• Blurred vision

• Extreme, pounding pain on one or both sides of the head

• Too much sensitivity to sounds, smells, or light

• Fainting

• Lightheadedness and weakness

• Stomach pain

Migraine symptoms can range from mild to severely painful. 

Diagnosis

You can begin by visiting your primary healthcare provider. However, you might need a neurologist for further tests and treatments. During the diagnosis, your doctor will inquire about your medical history, conduct an examination, and order scans that can help rule out other conditions.

Gathering your medical history

Your doctor will begin to gather information regarding:

• Your personal and family health history 

• Any other medical condition you have been diagnosed with in the past

• Your activity levels, stress levels, diet, and other aspects of your life

• Symptoms you have had recently

Ensure you give as many family medical history details as possible since migraines usually run in families. You may mention any close relative you know who has a migraine. Additionally, you can mention any other condition that runs in your family. 

Finally, your doctor may ask you to have a journal where you note every time you experience pain and describe what it feels like. You can also record your home remedies for the pain and whether they help at all. Carry the migraine journal with you during your next appointment. 

Performing a medical exam

Your doctor may then conduct neurological tests to see your reflexes and response to sensations. They may also perform short-term memory tests, take your blood pressure and pulse, and check your neck, head, and shoulders. Those checks are enough to diagnose migraine in most people. 

Generally, a doctor will diagnose you with migraine if you have experienced five or more headaches lasting 4–72 hours and the headaches were accompanied by two or more of the following characteristics:

• They cause a throbbing or pulsing pain

• They occurred on one side of the head

• They become worse when you do normal physical activity

• They led to moderate to severe pain

To confirm the diagnosis, your doctor may want to know whether you have had sensitivity to sound and light or experienced nausea. But even after a thorough medical history and physical exam, your doctor may not be certain that the symptoms aren't due to something else and may order scans to rule out other conditions. 

Tests to rule out other conditions

Your doctor may order further tests if you have symptoms that are not typical of migraine or if you experience sudden pain. The tests do not identify migraine but other things that could be causing the pain, such as brain tumors or aneurysms. 

Magnetic resonance imaging (MRI)

This scan creates a comprehensive image of your brain using magnetic waves. It looks for rare abnormalities, such as bleeding, infections, and tumors in the brain that could be behind your head pain. 

Computed tomography (CT scan)

This scan also creates a comprehensive image of the brain and can help look for medical issues behind your head pain. 

Blood tests

Your doctor may order blood tests to help identify any other condition causing your headaches. 

Although these tests do not identify migraine, they help rule out other causes, such as tumors and infections, so your doctor can settle on migraine. 

Risk factors for migraine with nausea

Generally, most factors that trigger migraine without nausea are the same as those that trigger migraine with throwing up. These include:

Hormonal changes 

Women are highly likely to experience migraines during their menstrual periods. Hormonal changes that trigger menstruation can also trigger migraines. Also, hormonal changes resulting from hormonal replacement therapy and birth control pills can trigger migraines. 

Estrogen fluctuations mostly occur in women who are between puberty and menopause age. Therefore, post-menopausal women may experience fewer headaches if hormones have been a strong factor in their migraines. 

Emotional stress

When you are emotionally stressed, your brain releases certain chemicals to combat the situation. The chemical release can cause migraine and upset stomachs. Besides, emotions such as worry and anxiety can increase muscle tension and cause dilation of blood vessels. 

Skipping meals

Delaying and skipping meals can trigger headaches with stomach problems leading to migraine with throwing up. 

Caffeine

Caffeine withdrawal can trigger migraine with nausea and throwing up. The blood vessels become used to caffeine, and stopping its uptake abruptly may lead to headaches. 

Sensitivity to certain foods

Taking some foods and beverages such as chocolate, aged cheese, alcoholic beverages, and fermented and pickled foods may trigger migraines with nausea. 

Light

Some people experience migraines when exposed to fluorescent lights, flashing lights, light from electronic devices, or even sunlight. 

Other potential triggers of migraine with nausea include:

• Exposure to perfumes, smoke, or other odors

• Changing weather conditions, e.g., strong winds and changes in altitude

• Changes in the normal sleep pattern

What medication can help relieve nausea from migraine?

Treatments for migraine-related nausea and vomiting include anti-nausea drugs. Your doctor can recommend these medications in addition to pain relievers. 

Examples of anti-nausea medications include:

• Metoclopramide (Reglan)

• Prochlorperazine (Procomp) 

• Chlorpromazine

These medications are available in various forms, such as: 

• Syrups

• Injections

• Suppositories

• Dissolvable pills

Your doctor may recommend anti-nausea medications even if you are not experiencing nausea as the major symptom during the migraine attack. 

Over-the-counter therapies 

Over-the-counter (OTC) medications for migraine nausea relief include:

• Bonine (meclizine)

• Benadryl (diphenhydramine)

• Dramamine (dimenhydrinate)

OTC medications help treat motion sicknesses and other symptoms, such as dizziness. 

Home remedies 

Other than taking medications, you can try some home remedies for migraine nausea relief. 

• Avoid constrictive clothes, especially around your abdomen

• Sip water regularly or suck on ice chips to stay hydrated 

• Ensure proper ventilation or step outside when you experience migraine with nausea

• Use the cold compress technique or apply an ice pack on the back of your neck or where you experience head pain

• Avoid consuming foods with strong odors and tastes 

• Avoid contacting substances with a strong smell, e.g., cleaning products, kitty litter, cat or dog food

• Take slow deep breaths when you experience migraine with nausea and throwing up

How are nausea and vomiting associated with migraine?

A migraine attack is a neurological condition affecting the brain and central nervous system. It is thought to result from inflammation of blood vessels when certain nerves transmit pain signals to the brain, thus releasing inflammatory substances in the head.

But how do nausea and vomiting come in when you have migraines?

Generally, a migraine attack starts in the brain, with the central nervous system contributing to the initiation and maintenance of the problem. During the attack, gastric stasis occurs when the digestive system slows down. The undigested food in the stomach may cause nausea, vomiting, or even constipation if the slowdown happens in the intestines.

Consequently, it becomes difficult or impossible to eat during the attack. 

That is why people with chronic migraine or those who experience 15 or more headache days in a month may experience weight loss. They have frequent migraine nausea, which can happen in all the phases of the attack meaning the stomach upset persists even after the intense headache subsides. 

Gastric stasis may also make it difficult to take pain relievers for a migraine attack. A person with the condition may delay taking an oral drug due to stomach upset; once they take the medication, it may take more time to absorb in the stomach.

Treating migraine attacks is easier the moment you observe the first sign. The attacks may prolong, and the amount of relief weakens if you delay taking the medication. 

Although gastric stasis sheds some light on why migraine attacks come alongside nausea and vomiting symptoms, this is not the whole story. You may continue to experience nausea even after the slowdown in the digestive system stops. Therefore, more research is crucial to paint a clear picture. 

Preventing nausea with migraine

Identifying and avoiding your triggers is the best way to prevent migraines with nausea and vomiting. You can take preventive or prophylactic medication. These include:

CGRP receptor agonist medications

• Galcanezumab (Emgality)

• Atogepant (Qulipta)

• Erenumab-aooe (Aimovig)

• Fremanezumab-vfrm (Ajovy)

• Eptinezumab-jjmr (Vyepti)

Antidepressants 

• Amitriptyline

• Venlafaxine (Effexor XR)

Anticonvulsant medications

• Topiramate (Topamax, Qudexy XR, Trokendi XR)

• Divalproex (Depakote ER, Depakote)

• Gabapentin (Neurontin)

Beta-blocker medications

• Propranolol (InnoPran XL, Inderal LA)

• Timolol

• Metoprolol (Toprol XL, Lopressor)

Although CGRP receptor agonists and other medications listed above for migraine relief are FDA-approved, some have yet to receive the approval. They are off-label treatments. Examples are InnoPran XL, metoprolol, gabapentin, and antidepressants. 

The lowdown

Migraine attacks may come alongside nausea and vomiting. The combination can be devastating and reduce your quality of life. Trying home remedies can help in migraine nausea relief. However, if the problem persists, you should seek medical attention. Your doctor can help you find relief.