Gut–Brain Axis Dysregulation in Migraine: Clinical Improvement Following Unani Management: A Case Series

Authors

Abstract

Background: Migraine is a disabling neurological disorder frequently associated with gastrointestinal disturbances. Emerging evidence suggests an important role of the gut–brain axis in migraine pathophysiology. In Unani medicine, headache associated with gastrointestinal dysfunction is described as Sudaa-e-Shirki Maidi. Cases: Eight patients with migraine without aura associated with gastrointestinal disturbances attending the OPD of the Regional Research Centre (Unani), Prayagraj, were included. Common symptoms included recurrent headache, nausea, reflux, abdominal discomfort, constipation, and altered bowel habits. Intervention: Patients received Unani treatment comprising Itrifal Kishneezi and Khamira Gaozaban Sada for 12 weeks. Outcomes: The mean Visual Analog Scale (VAS) score decreased from 9.3 to 1.5, while the mean headache frequency reduced from 3.3 to 0.9 episodes per week. Complete symptomatic relief was observed in two patients, marked improvement in five patients, and moderate improvement in one patient. No adverse effects were reported. Conclusion: This case series suggests that Unani management may provide clinical benefit in migraine associated with gastrointestinal dysfunction and supports a possible role of gut–brain axis involvement in migraine pathophysiology.

Keywords: Migraine; Gut–brain axis; Sudaa-e-Shirki Maidi; Gastrointestinal disturbances; Integrative Medicine; Case series

Keywords:

Migraine, Gut–brain axis, Sudaa-e-Shirki Maidi, Gastrointestinal disturbances, Integrative Medicine, Case series

DOI

https://doi.org/10.22270/jddt.v16i7.7870

Author Biographies

Asia Khanam , Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

 

Javed Ali Khan , Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

Dr Rajesh, Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

Central Council for Research in Unani Medicine, Ministry of AYUSH, Government of India, Prayagraj, India

References

1. Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol. 2023;19:109-117. https://doi.org/10.1038/s41582-022-00763-1 PMid:36693999

2. Dodick DW. A phase-by-phase review of migraine pathophysiology. Headache. 2018;58:4-16. https://doi.org/10.1111/head.13300 PMid:29697154

3. Arzani M, Jahromi SR, Ghorbani Z, et al. Gut-brain axis and migraine headache: a comprehensive review. J Headache Pain. 2020;21:15. https://doi.org/10.1186/s10194-020-1078-9 PMid:32054443 PMCid:PMC7020496

4. Ailani J, Kaiser EA, Mathew PG, et al. Role of calcitonin gene-related peptide on the gastrointestinal symptoms of migraine-Clinical considerations. Neurology. 2022;99:e1332-e1343. https://doi.org/10.1212/WNL.0000000000201332 PMid:36127137 PMCid:PMC9651456

5. Khanam A, Khan J. Gastrointestinal headache: Exploring the Sudaa-e-Shirkimaidi in Unani medicine. Int J Sci Res. 2025;14(10):605-608. https://doi.org/10.21275/SR251010132430

6. Anonymous. National Formulary of Unani Medicine, Part-I. New Delhi: Central Council for Research in Unani Medicine, Ministry of Health and Family Welfare, Government of India; 2006. p. 94, 110.

7. Khan AJ. Haziq. Karachi: Madina Publishing Company; 2019: p. 21.

8. Khan MA. Aksir-e-Azam. New Delhi: Idara Kitab-us-Shifa; 2011: p. 68.

9. Riyazuddin M, Shahid A, Siddiqui M. Effect of habb-e-quqaya in shaqeeqa (migraine without aura) - An open label clinical trial. J Ayurveda. 2021;15:147-152. https://doi.org/10.4103/joa.joa_311_20

10. Nguyen L, Hindiyeh N, Ray S, et al. The gut-brain connection and episodic migraine: an update. Curr Pain Headache Rep. 2023;27:765-774. https://doi.org/10.1007/s11916-023-01175-6 PMid:37792173 PMCid:PMC10713702

Published

2026-07-15
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How to Cite

1.
Khanam A, Khan JA, Rajesh D. Gut–Brain Axis Dysregulation in Migraine: Clinical Improvement Following Unani Management: A Case Series. J. Drug Delivery Ther. [Internet]. 2026 Jul. 15 [cited 2026 Jul. 16];16(7):5-8. Available from: https://www.jddtonline.info/index.php/jddt/article/view/7870

How to Cite

1.
Khanam A, Khan JA, Rajesh D. Gut–Brain Axis Dysregulation in Migraine: Clinical Improvement Following Unani Management: A Case Series. J. Drug Delivery Ther. [Internet]. 2026 Jul. 15 [cited 2026 Jul. 16];16(7):5-8. Available from: https://www.jddtonline.info/index.php/jddt/article/view/7870