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Diarrhea and Constipation

Reviewed by: HU Medical Review Board | Last review date: December 2019

Everyone has different migraine symptoms and those symptoms may change over time. However, people living with migraine who experience diarrhea or constipation often report a consistent pattern to their symptoms. For example, diarrhea may hit near the same period of each attack.

What is diarrhea?

Diarrhea is defined as loose, watery stools 3 or more times a day.1 Acute diarrhea lasts about 1 or 2 days and goes away on its own. Roughly 179 million cases of acute diarrhea occur in the U.S. every year.1

Symptoms of diarrhea can include:2

  • Loose or watery stool
  • Abdominal pain or cramping
  • Blood/mucus in stool
  • Bloating
  • Urgent need to get to the bathroom to have a bowel movement

Drinking plenty of liquids during a bout of diarrhea is especially important for children and older people. Call your doctor if:

  • Diarrhea lasts more than a few days
  • You get dehydrated
  • You feel severe abdominal or rectal pain
  • Your stool is black
  • You have a fever over 102 degrees Fahrenheit.2

What is constipation?

Constipation is defined as:3

  • Having fewer than 3 bowel movements a week
  • Hard, dry, or lumpy stools
  • Difficulty or pain passing stools
  • Feeling like not all stool is released

Bowel habits can vary widely, so one person’s “normal” may mean having fewer bowel movements a week. If your bowel habits suddenly change, your constipation symptoms may look different.

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About 15 percent of all adults experience constipation, but about 1 in 3 of those over age 60 are constipated.3

Why can diarrhea or constipation occur with migraine?

Migraine and tension-type headaches have been associated with irritable bowel syndrome (IBS). Although the exact link is not known, it may be genetic.4

Unfortunately, some drugs that help treat migraine may also cause diarrhea or constipation. For example, drugs for treating nausea and vomiting – called anti-emetics – may cause diarrhea in some patients. Triptan drugs may also cause diarrhea as a side effect, while treatments in the calcium channel blocker class may cause constipation.4

Sometimes it is difficult to tell if a symptom is due to the migraine attack or one of the drugs used to treat the migraine. That is why writing down symptoms and how long they last in a migraine journal can help you find patterns and triggers.

How are diarrhea or constipation treated?

If diarrhea or constipation is tied to a migraine attack, treating the migraine generally helps make these symptoms better. If the symptoms are a side effect of drugs that treat the migraine itself, you may still be able to find relief. Before taking any over-the-counter drug to treat diarrhea or constipation, talk with your doctor first.

To treat constipation, you can eat high-fiber foods, make sure you are drinking enough water, and get regular exercise.5 If your constipation lasts for a long time, ask your doctor if a stool softener is right for you.

To treat diarrhea, first make sure you do not have a fever or bloody stool, since these may be signs of something more serious.6 Drink plenty of fluids to stay hydrated. Ask your doctor before taking any over-the-counter drugs for diarrhea.

Tracking your migraine symptoms

Keeping a record of your migraine symptoms may help you figure out patterns and triggers to your attacks. It may be helpful to record such things as:

  • When and where your pain or symptoms start
  • Whether the pain spreads to your entire head or neck
  • How well and how quickly acute treatment helps reduce the pain or other symptoms
  • How long your pain or symptoms last
  • Whether you experience other symptoms such as vision changes, nausea, or light sensitivity

Community experiences of diarrhea and constipation advocates often write about their symptoms, including their experiences with diarrhea and constipation. Some advocates have talked about the connection between migraine and IBS and what it's like to live with both. Others have shared their experiences with constipation as a side effect of drug treatments, including CGRPs. The impact of side effects on daily life can sometimes lead people to weigh the risks of treatment. Advocates have also shared tips on how to stay hydrated, which is important for those treating constipation or diarrhea.