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Headache and Stomach Pain: Understanding the Connection & Potential Causes
The Gut-Brain Axis in Headache
Severe headaches (especially migraine) activate the trigeminal nerve, which converges with the vagus nerve in the brainstem. This cross-talk triggers nausea, vomiting, and gastric stasis (gastroparesis).
Migraine as a Primary Cause
- Throbbing, often unilateral headache
- Nausea/vomiting (diagnostic criterion)
- Photophobia, phonophobia
- Abdominal migraine (in children): recurrent midline abdominal pain with headache features
Other Causes of Combined Headache & Stomach Pain
- Tension headache + stress-induced dyspepsia
- Medication overuse: NSAIDs cause gastritis; triptans can cause nausea.
- Dehydration/electrolyte imbalance
- Caffeine withdrawal
- Viral illness (flu, COVID-19)
- Increased intracranial pressure (IIH, tumor): Headache + vomiting (often projectile, morning).
- Cervicogenic headache + referred pain
When to Seek Care
- Sudden "thunderclap" headache
- Headache with fever, stiff neck, confusion
- Persistent vomiting, dehydration
- New/worsening pattern after age 50
- Focal neurological signs
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