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Abstract
Background: Food-induced migraine is a clinically challenging condition often associated with gastrointestinal hypersensitivity and systemic allergic manifestations. In Ayurveda, migraine is described as Ardhavabhedaka, a disorder predominantly involving Vata with the association of Pitta and Ama. Co-existing digestive pathology, such as a peptic ulcer, further complicates management due to impaired Agni and hypersensitive gut-brain interaction.
Objective: To evaluate the efficacy of an Ayurvedic treatment protocol in the management of food-induced migraine (Ardhavabhedaka) associated with gastrointestinal disturbances and peptic ulcer.
Materials and Methods: A 30-year-old female patient diagnosed with food-induced migraine and peptic ulcer was treated with a structured Ayurvedic regimen including internal medications, external application, dietary regulation (Pathya-Apathya), and follow-up assessment over one month.
Results: The patient exhibited a marked reduction in the frequency and intensity of migraine attacks, a significant improvement in gastrointestinal symptoms, and a resolution of associated allergic skin manifestations.
Conclusion: Ayurvedic management focusing on Ama Pachana, Agni Deepana, Vata-Pitta Shamana, and dietary allergen elimination demonstrated effective clinical outcomes in food-induced migraine with associated peptic ulcer.
Introduction
Migraine is a common, disabling primary headache disorder characterized by recurrent, typically unilateral, pulsatile attacks accompanied by nausea, photophobia, and phonophobia. A subset of patients reports food-triggered attacks due to individual foods or food components, e.g., dairy, gluten, histamine-rich items, nitrates, alcohol, etc., that precipitate or worsen migraine in susceptible people.
Food-associated migraine is increasingly recognized not as a single simple phenomenon but as a clinical sign of broader gut-brain axis dysfunction that often coexists with gastrointestinal (GI) disorders such as irritable bowel syndrome (IBS), non-celiac gluten sensitivity (NCGS), celiac disease, dyspepsia, and, in some series, Helicobacter pylori-associated peptic disease.
1) Epidemiology and Clinical Relevance of Food-Triggered Migraine
Population and clinical studies show that dietary factors are commonly reported triggers by patients with migraines. Formal elimination or modification trials and case reports suggest that removing specific offending foods, such as gluten or milk, in patients with underlying sensitivities may reduce attack frequency and severity in a proportion of patients.
At the same time, observational data emphasize high comorbidity between migraine and GI disease. Patients with one or more GI diagnoses have substantially higher odds of reporting migraine. These associations make food-triggered migraine a clinically relevant phenotype that often requires combined gastroenterological and neuro-behavioral management.
2) Gut-Brain Pathways Matter in Migraine
Various research highlights several non-exclusive mechanisms by which food and GI pathology can generate migraine vulnerability. Immune/hypersensitivity and food antigens, i.e., IgE-mediated and non-IgE hypersensitivity to food components, mainly to gluten and dairy, in many reports can provoke systemic immune activation and release of inflammatory mediators that sensitize trigeminal-vascular pathways.
Case series and targeted studies have documented symptomatic improvement with the elimination of implicated foods in selected patients. Alterations in gut microbiota composition, gut permeability, i.e., leaky gut, and metabolite profiles may modulate systemic inflammation, serotonin and short-chain fatty acid signaling, and vagal afferent activity, all of which influence central pain processing and cortical excitability relevant to migraine pathophysiology.
Several recent reviews synthesize animal and human data supporting microbiome and migraine links and discuss probiotic/ dietary interventions as emerging approaches to treat it. Along with this, observational studies and meta-analyses have found associations between migraine and upper GI pathology, including dyspepsia, duodenal ulcer, and H. pylori infection. In some cohort studies, H. pylori eradication reduced headache frequency, suggesting a causal contribution in at least a subset of patients through chronic inflammation, altered gastric physiology, and systemic immune signaling.
Certain foods contain vasoactive amines like tyramine, histamine, nitrates or nitrites, monosodium glutamate, or other compounds that can alter vascular tone, nitric oxide signaling, or neurotransmitter release and thereby trigger attacks in sensitive individuals. Evidence is heterogeneous and individual variability is large, so personalized trial and error, i.e., elimination, etc., remains the pragmatic approach.
3) Peptic Ulcer, Dyspepsia, and Migraine-Clinical and Mechanistic Overlap
Clinical series indicate that migraines are more prevalent among patients investigated for dyspepsia and peptic ulcer disease than in the general population, and that successful treatment of upper GI disease, including H. pylori eradication where relevant, may improve headache outcomes in some patients.
Pathways proposed include persistent mucosal inflammation, altered gastric emptying, and neural sensitization of shared visceral-somatic reflexes that converge on central pain modulatory systems. Thus, the presence of peptic disease should be actively considered in patients with recurrent, diet-related migraine.
4) Ayurvedic Understanding of Ardhavabhedaka, Ama, Agni
Classical Ayurvedic texts describe a syndrome called Ardhavabhedaka, a condition of severe, often unilateral, splitting head pain that closely resembles migraine in modern science. In classical texts, it is mentioned that Ardhavabhedaka occurs due to the predominance of Vata with co-involvement of Kapha or Pitta in different situations.
Classical etiologies explicitly include dietary indiscretion, impaired digestion, and seasonal or environmental triggers. Ayurvedic pathogenesis emphasises vitiated Agni, i.e., digestive or metabolic fire producing Ama, i.e., undigested toxic metabolites, which, together with Doshic imbalance, lodge in the head and provoke episodic, often periodic attacks. Treatment classically combines removal of Ama, restoration of Agni, dosha-specific Ayurvedic measures, and strict diet/lifestyle modification, i.e., Pathya-Apathya.
Case Presentation
1) Patient Details
A 30-year-old female patient presented to the IAFA Ayurveda with recurrent episodic headache and associated gastrointestinal and cutaneous symptoms. The patient was registered and first evaluated on 13 October 2021. There was no documented history of major systemic illness, long-term medication use, or surgical intervention before presentation.
2) Chief Complaints
The patient reported a history of recurrent food-induced migraine attacks, characterized by episodic headache occurring after ingestion of specific food items. These episodes were consistently associated with gastrointestinal disturbances, including constipation, flatulence, and frequent bowel movements, particularly after consumption of gluten- and dairy-containing foods. Additionally, the patient complained of cutaneous hypersensitivity, manifested as red bumps on the hands following intake of identified allergenic foods.
3) Diagnosis
Based on clinical history, symptom pattern, and dietary correlation, the patient was diagnosed with:-
- Ardhavabhedaka (Migraine due to food allergy)
- Anadrava Shula (Peptic ulcer disease)
From an Ayurvedic standpoint, the condition was interpreted as Ardhavabhedaka associated with impaired Agni and Ama involvement, with concomitant features suggestive of Amlapitta and gastrointestinal mucosal pathology.
4) Triggers and Exacerbating Factors
Identified Allergens:-
- Gluten
- Dairy products
- Avocado
The migraine episodes and associated systemic symptoms were found to be consistently triggered by dietary exposure. The patient identified gluten, dairy products, and avocado as definite aggravating factors, with reproducible onset of headache, bowel disturbances, and skin reactions following their intake.
Symptoms were further exacerbated by improper digestion and intolerance to allergenic foods, indicating a strong food-gut-headache linkage. No significant non-dietary triggers were documented during clinical evaluation.
Materials and Methods
1) Intervention Protocol and Monitoring
This case was managed using a structured Ayurvedic treatment protocol, which helps to treat food-induced migraine (Ardhavabhedaka) associated with gastrointestinal hypersensitivity and peptic ulcer pathology.
The treatment strategy focused on:
- Elimination of dietary triggers
- Correction of impaired digestion (Agni)
- Management of Ama
- Symptomatic control of migraine episodes.
The patient was evaluated at baseline, i.e., 13/10/2021, and followed up after one month, i.e., 10/11/2021. Clinical monitoring was performed through symptom reporting, dietary compliance assessment, and evaluation of gastrointestinal tolerance and migraine recurrence.
2) Ayurvedic Treatment Approach
From an Ayurvedic perspective, the condition was approached as Ardhavabhedaka associated with Ama, Anadrava Shula, and Amlapitta, precipitated by incompatible and allergenic foods, i.e., Viruddha Bhojana. The treatment plan was formulated on the following principles:
- Elimination of causative dietary allergens, i.e., Nidana Parivarjana
- Ama Pachana and Agni Deepana to correct digestive impairment
- Vata and Pitta Shamana to reduce headache severity and frequency
- Gastroprotective and mucosal healing measures for peptic pathology
The intervention combined internal medications, external application, and strict dietary and lifestyle regulation.
3) Treatment Protocol at Different Follow-Ups
Table 1. Treatment Protocol: First Visit (13/10/2021)
| Formulation | Dose | Frequency | Route | Time of Administration | Duration |
| AF-7 Bar | As directed | Daily | External | During bath | 1 month |
| Dadima Avaleha | 2 teaspoons | Twice daily | Oral | After meals | 1 month |
| Pitpapra Capsules | 2 capsules | Twice daily | Oral | Early morning and early evening, on an empty stomach | 1 month |
| Aam Visha Balance Tablet | 1 tablet | Twice daily | Oral | 1 hour after meals | 1 month |
| Triphala Capsules | 2 capsules | Once daily | Oral | At bedtime | 1 month |
Table 2. Treatment Protocol: Follow-Up Visit (10/11/2021)
| Formulation | Dose | Frequency | Route | Time of Administration | Duration |
| AF-7 Bar | As directed | Daily | External | During bath | Continued |
| Aahar Amrutham Rasa | 30 ml | Twice daily | Oral | After meals with equal water | 1 month |
| Dadima Avaleha | 2 teaspoons | Twice daily | Oral | After meals | Continued |
| Pitpapra Capsules | 2 capsules | Twice daily | Oral | Empty stomach | Continued |
| Aam Visha Balance Tablet | 1 tablet | Twice daily | Oral | 1 hour after meals | Continued |
| Moringa Capsules | 1 capsule | Twice daily | Oral | Anytime | 1 month |
| Triphala Capsules | 2 capsules | Once daily | Oral | At bedtime | Continued |
Table 3. Ayurvedic Treatment Phases, Objectives, Clinical Outcomes, and mode of action
| Phase | Ayurvedic Principle and Objective | Clinical Focus | Clinical Outcome | Mode of action |
| Phase I | Nidana Parivarjana (Elimination of causative factors) | Identification and complete avoidance of dietary allergens, i.e., gluten, dairy, avocado, and incompatible foods, i.e., Viruddha Bhojana | Prevention of immediate triggering of migraine, GI symptoms, and cutaneous reactions | Removal of food antigens reduces immune activation, gut inflammation, and migraine triggers |
| Phase II | Ama Pachana and Agni Deepana | Correction of impaired digestion and metabolic dysfunction | Reduction in bloating, flatulence, bowel irregularity, and post-prandial discomfort | Improved digestion and gut barrier function lower systemic inflammatory mediators |
| Phase III | Amlapitta and Gastro-mucosal healing | Healing of gastric irritation and peptic pathology | Decrease in epigastric discomfort, improved food tolerance | Reduction in gastric inflammation and visceral afferent sensitization linked to migraine |
| Phase IV | Vata-Pitta Shamana (Sirogata Vikara Chikitsa) | Control of neurovascular and pain components of migraine | Reduction in frequency, duration, and intensity of migraine episodes | Modulation of neurogenic inflammation and trigeminal vascular sensitization |
| Phase V | Rasayana and Recurrence Prevention | Stabilization of digestion and systemic tolerance | Sustained symptom control and reduced relapse | Restoration of gut-brain homeostasis and immune tolerance |
Table 4. Monitoring Parameters
| Parameter | Method of Monitoring | Assessment Frequency |
| Migraine frequency | Patient-reported episodes | Baseline and follow-up |
| Migraine intensity | Subjective severity grading | Baseline and follow-up |
| GI symptoms | Stool pattern, bloating, pain | Baseline and follow-up |
| Food tolerance | Dietary history | Continuous |
| Skin reactions | Visual inspection | Baseline & follow-up |
4) Dietary and Lifestyle Monitoring
Dietary regulation plays a primary role in this case. The patient was strictly advised to avoid identified allergens, including gluten, dairy products, and avocado. A light, easily digestible diet was recommended, emphasizing warm, freshly prepared foods, adequate hydration with lukewarm water, and avoidance of incompatible food combinations, i.e., Viruddha Bhojana.
Processed foods, fermented items, alcohol, and high-fat diets were prohibited. Lifestyle guidance included maintaining regular meal timings, avoiding suppression of natural urges, ensuring adequate sleep, and minimizing known stressors that could aggravate Vata. Dietary and lifestyle adherence were reviewed during follow-up.
Results
The patient was assessed at baseline on 13/10/2021 and re-evaluated at follow-up on 10/11/2021 after implementation of dietary elimination, Ayurvedic treatment, and lifestyle and dietary modification. Clinical outcomes were assessed based on symptom frequency, intensity, gastrointestinal tolerance, and associated systemic manifestations.
1) Overall Clinical Outcome
Following one month of intervention, the patient demonstrated clinically meaningful improvement in migraine frequency and severity, along with significant resolution of gastrointestinal hypersensitivity symptoms. Cutaneous allergic manifestations were no longer reported during the follow-up period when dietary avoidance was maintained.
Table 5. Symptom-wise Clinical Outcomes
| Symptoms | Baseline Status (13/10/2021) | Follow-Up Status (10/11/2021) |
| Migraine attacks | Recurrent food-induced episodes | Markedly reduced frequency |
| Headache intensity | Moderate to severe | Mild or occasional |
| Post-prandial GI symptoms | Constipation, flatulence, frequent bowel movements | Significant improvement |
| Food intolerance | Gluten, dairy, and avocado are causing symptoms | Improved tolerance with avoidance |
| Cutaneous reactions | Red bumps on hands after allergen intake | Not reported |
| General well-being | Disturbed due to recurrent symptoms | Subjectively improved |
2) Gastrointestinal Outcome Assessment
Improvement was most notable in gastrointestinal parameters. The patient reported normalization of bowel habits, reduction in abdominal discomfort, and better digestive tolerance to permitted foods. These changes were temporally associated with strict dietary modification and Agni (digestive fire) targeted therapy.
Table 6. Gastrointestinal Symptoms Improvement
| Parameter | Baseline | Follow-Up |
| Constipation | Present | Reduced |
| Flatulence | Frequent | Occasional |
| Post-meal bowel urgency | Present | Absent |
| Epigastric discomfort | Present | Reduced |
| Digestive tolerance | Poor | Improved |
3) Migraine Outcome
The patient experienced a reduction in migraine burden, particularly in attacks related to food exposure. No acute exacerbations were reported during the follow-up period under dietary compliance.
Table 7. Migraine Outcome
| Outcome Measure | Observation |
| Attack frequency | Reduced |
| Attack severity | Reduced |
| Duration of episodes | Shortened |
| Food-triggered recurrence | Absent with avoidance |
| Need for additional medication | Not reported |
4) Safety and Tolerability
No adverse drug reactions or treatment-related complications were reported during the intervention period. The patient feels better with both pharmacological and dietary recommendations.
5) Final Clinical Outcomes
- Reduction in frequency and severity of food-induced migraine attacks
- Significant improvement in gastrointestinal symptoms and food tolerance
- Resolution of allergen-related cutaneous manifestations
Discussion
Food-induced migraine represents a complex, multi-system disorder where neurological symptoms are closely linked with gastrointestinal hypersensitivity and immune metabolic dysregulation. In the present case, migraine attacks following ingestion of specific foods, along with gastrointestinal disturbances and peptic pathology, highlight the relevance of a gut-brain axis-centred pathophysiology.
Ayurveda explains this through the concepts of Agni, Ama, and Dosha involvement, particularly Vata and Pitta, correlated clinically as Ardhavabhedaka. The observed outcomes support the effectiveness of a phased Ayurvedic approach addressing both causative factors and systemic imbalance.
1) Pathophysiological Understanding
Food allergens such as gluten and dairy are known to trigger immune-mediated hypersensitivity reactions in susceptible individuals, leading to intestinal inflammation, altered permeability, and dysbiosis. These changes can activate systemic inflammatory pathways and sensitize trigeminal vascular networks involved in migraine generation.
Co-existing peptic ulcer disease further contributes through chronic gastric inflammation, altered gastric emptying, and visceral somatic neural sensitization. Together, these mechanisms explain the association between food intake, gastrointestinal symptoms, and migraine attacks observed in this patient.
From an Ayurvedic point of view, repeated intake of incompatible and allergenic foods, i.e., Viruddha Bhojana, leads to impairment of Jatharagni, resulting in the formation of Ama. This Ama, in association with vitiated Vata and Pitta, circulates systemically and localizes in the Siras, producing classical features of Ardhavabhedaka, i.e., unilateral headache, throbbing pain, and episodic recurrence.
Simultaneously, gastric involvement manifests as Amlapitta and Annadrava Shula, correlating with peptic ulcer pathology. Thus, migraine in this case is not an isolated neurological disorder but a systemic manifestation of digestive and metabolic dysfunction.
2) Phase-Wise Therapeutic Understanding
The management strategy followed a phase-wise Ayurvedic approach:-
Phase I- Nidana Parivarjana
The first intervention involved the complete elimination of identified dietary triggers, i.e., gluten, dairy, avocado, and avoidance of incompatible foods. This immediately reduced ongoing antigenic and metabolic issues, preventing repeated provocation of both gastrointestinal inflammation and migraine episodes.
Phase II- Ama Pachana and Agni Deepana
Once causative factors were removed, therapy focused on improving digestion and clearing accumulated Ama. This phase was critical in reducing bloating, bowel irregularity, and post-prandial discomfort, thereby addressing the root pathology rather than only symptomatic headache control.
Phase III- Amlapitta and Gastro-Mucosal Healing
Targeted measures were employed to soothe gastric irritation and promote mucosal healing. Improvement in digestive tolerance and reduction in epigastric symptoms during follow-up suggest successful action on peptic pathology, which likely reduced visceral triggers contributing to migraine.
Phase IV- Vata Pitta Samana (Sirogata Chikitsa)
With digestive stability achieved, attention was directed towards balancing Vata and Pitta at the neurological level. This resulted in a measurable reduction in migraine frequency, intensity, and duration, supporting the classical principle that Shiroroga management is most effective after Ama clearance.
Phase V- Stabilization and Recurrence Prevention
Continued dietary regulation, digestive support, and mild Rasayana measures helped maintain symptom control and prevent relapses, emphasizing the importance of long-term gut health in chronic migraine management.
3) Pharmacological Correlation of Ayurvedic Formulations
Table 8. Pharmacological Correlation of Prescribed Ayurvedic Formulations
| Formulation | Key Herbs | Primary Ayurvedic Action | Mode of Action (Modern Correlation) |
| Dadima Avaleha | Dadima, Trikatu, Tamal Patra, Jaiphala | Agni Vardhana, Amlapitta Shamana, Vata-Kapha Anulomana | Enhances gastric secretion and motility, reduces fermentation, and provides antioxidant and gastric mucosal protection |
| Pitpapra Capsules | Fumaria parviflora (Pitpapra) | Pitta Shamana, Raktaprasadana, Yakrit Anulomana | Anti-inflammatory and hepatoprotective activity reduces systemic inflammatory mediators contributing to migraine. |
| Aam Visha Balance Tablet | Kamdudha Rasa, Giloy Satva, Akik Pishti, Praval Pishti, Jahar Mohra Pishti, Godanti Bhasma, Mukta Pishti, Shankha Bhasma, Kapardaka Bhasma | Ama Visha Hara, Pitta Shamana, Daha Shula Prashamana | Neutralizes acidic and toxic metabolites, reduces oxidative stress, buffers gastric acidity, and modulates immune hypersensitivity |
| Triphala Capsules | Haritaki, Bibhitaki, Amalaki | Anulomana, Mridu Rechana, Rasayana | Regulates bowel motility, improves gut microbiota balance, and has antioxidant and anti-inflammatory effects |
| Aahar Amrutham Rasa | Choti Dudhi, Nirgundi, Bilva, Bhumi Amlaki, Punarnava | Agni Deepana, Grahi, Amapachana, Shotha Hara | Improves digestive enzyme activity, reduces gut inflammation, supports mucosal integrity, and fluid balance |
| Moringa Capsules | Moringa oleifera | Balya, Dhatu Poshana, Rasayana | Anti-inflammatory, micronutrient-rich support improves immune tolerance and systemic resilience. |
| AF-7 Bar (External) | Lodhra, Madhuka, Nimba, Asana, Chakramarda, Rakta Chandana, Coconut oil | Twak Shodhana, Kapha-Pitta Shamana, Kandughna | Supports skin barrier function, reduces inflammatory skin reactions linked to allergen exposure |
The favorable clinical outcome in this case can be attributed to the integration of Nidana Parivarjana, digestive correction, gastro-mucosal healing, and dosha-specific therapy, rather than isolated symptomatic treatment of migraine.
The pharmacological actions of the prescribed formulations align well with both Ayurvedic principles and the understanding of gut-brain axis modulation. This case reinforces the concept that food-induced migraine requires a systemic, digestion-centered therapeutic strategy and highlights Ayurveda’s relevance in managing complex hypersensitivity-driven neurological disorders.the patient feels 100% relief from the condition and she visited IAFA® and expressed her immense gratitude to Dr. Gupta.
Happy Note
After personally visiting IAFA®, I am happy to share that my food allergies, intolerances, and digestion issues are completely resolved. I feel immense gratitude toward the entire IAFA® team and especially Dr. Sahil Gupta for his excellent Ayurvedic approach in treating my food-induced migraine and peptic ulcers. I no longer suffer from the throbbing, excruciating pain that once affected my daily life. — Patient
Conclusion
This case demonstrates that food-induced migraine associated with gastrointestinal hypersensitivity and peptic ulcer pathology can be effectively managed through an Ayurvedic approach when the treatment is directed at root digestive and metabolic disturbances rather than isolated symptomatic relief. The association between dietary allergens and migraine episodes in this patient highlights the critical role of Nidana Parivarjana as the primary therapeutic step.
Correction of impaired Agni, clearance of Ama, and targeted management of gastric pathology preceded and supported the successful control of migraine symptoms, concluding the Ayurvedic principle that Sirogata Vikara should be addressed only after stabilization of digestive function. The phased intervention resulted in a meaningful reduction in migraine frequency and severity, improvement in gastrointestinal symptoms, and resolution of associated allergic manifestations without reported adverse effects.
This case supports the relevance of Ayurveda in managing complex, multi-system disorders involving the gut-brain axis and food hypersensitivity. While findings from a single case cannot be generalized, the observed clinical outcomes suggest that individualized, digestion-centered Ayurvedic protocols may offer a safe and effective therapeutic option in food-triggered migraine with associated gastrointestinal pathology. Further controlled studies are needed to validate these observations and to establish standardized integrative treatment models.
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