Effect of Helicobacter pylori Eradication on Migraine Headache: A Before -After Clinical Trial

Background: Migraine is the most frequent type of primary headache. It has been demonstrated that H. pylori infection eradication has a possible role in the reduction of migraine headache but needs to be examined in different settings using Urea Breath Test (UBT). This clinical trial was conducted to evaluate the effect of the H. pylori eradication on improvement of migraine. Methods: This clinical trial was conducted in Farshchian Hospital in 2012. Eighty patients with migraine headache who were seropositive for H. pylori infection were enrolled in the trial. Migraine was defined according to the International Headache Society criteria. H. pylori infection was diagnosed according to the detection of anti-H. pylori IgG antibody in the blood sample. Standard four-drug protocol for H. pylori eradication was prescribed with Omeprazole 20 mg Bid, Bismuth 240 mg Bid, Tetracycline 500 mg Qid, and Metronidazole 500 mg Bid for four weeks. The outcomes of interest were the severity and frequency of migraine headache. Results: The mean scores of the severity of headache decreased from 8.20 before H. pylori eradication to 2.91 after that (P<0.001) and the frequency of headache from 7.45 to 2.73 (P<0.001).The reduction in severity and frequency of headache was much more in patients with negative UBT (P<0.001) compared to those with positive test results (P=0.002). Conclusion: This trial indicated that H. pylori eradication can efficiently reduce the severity and frequency of migraine headache shortly after treatment in patients who were infected with H. pylori. However, the long-term effect of the treatment was not explored and needs to be investigated.