Is Helicobacter pylori the Infectious Trigger for Headache?: A Review
Lidia Savi, Davide G. Ribaldone, Sharmila Fagoonee and Rinaldo Pellicano
Affiliation: Department of Gastroenterology and Hepatology, Molinette Hospital, Outpatient Clinic, Via Cavour 31, 3rd Floor, 10123 Turin, Italy.
Keywords: Antimicrobials, antisecretive drugs, headache, Helicobacter pylori, migraine.
The interest that surrounds the bacterium Helicobacter pylori (H. pylori) is due not only to its causal role in
several gastroduodenal diseases, but also to its supposed involvement in the pathogenesis of extra-gastric manifestations.
This review provides a literature update on the hypothetic correlation between H. pylori and headache. To identify all publications
on this issue, a MEDLINE search of all studies published in English from 1965 to 2013 was conducted. The
authors examined three aspects of this potential association: epidemiology, intervention trials and pathogenesis. While in
the former, the results are contradictory, in the intervention studies, it has been documented that at 6 and 12 months, bacterial
eradication is associated to disappearance of symptoms in 23% and 28% of cases, and to a significant decrease of intensity,
frequency and duration of acute attacks in the remaining patients. Under a pathogenetic aspect, if H. pylori has a
role, it does not act through oxidative stress. In conclusion, the eradication of H. pylori seems efficient at least in a subgroup
of patients suffering from migraine. Further investigations should focalize on particular subgroups of patients and,
encouraged from data produced by intervention studies, evaluate the long-term benefit of eradication.
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