Helicobacter pylori and migraine: Systematic evaluation of 1084 cases with meta-analysis

Objectives: Helicobacter pylori (HP) is a gram-negative organism, which can cause gastritis, peptic ulcer disease, gastric lymphoma and gastric cancer. It has also been implicated in conditions such as coronary artery disease, short stature, iron deficiency anemia, hypertension, cerebral ischemia and migraine (MGR). The association of HP with MGR is controversial. We reviewed the literature on HP and migraine and performed a meta-analysis (QMA) on these cases. Methods: PubMed search for H. pylori and migraine was performed without time or language barriers. QMA was performed using the well-established methods of Qualitative Research e.g. Diagramming, Theme Repetition without Serious Contradiction, Theme Saturation and investigator Reflexivity. To facilitate QMA, summary sheets of publications were prepared. Results: The PubMEd search yielded 1084 cases of Migraine associated with HP. Information about gender was available in 48.4%. These included 65.4% women and 34.6% men. The possible mechanisms were vascular instability, production of histamine, oxidative stress and generation of nitric oxide. In some studies elimination of HP resulted in amelioration of MGR symptoms. HP was associated with both MGR with aura and MGR without aura. However, some investigators failed to show an association of MGR with HP. Conclusion: There are strong indications regarding the association between HP and MGR. Larger prospective case-control studies are needed to settle this issue.