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

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.