As with fibromyalgia, irritable bowel syndrome (IBS) is seen in higher percentages of headache patients than in others. IBS may present with a myriad of symptoms, from constipation/diarrhea to acid reflux to gastritis. The key from a physician’s standpoint is to not exacerbate the IBS, but rather to utilize meds that actually help that particular person’s symptoms.
For instance, if someone has daily headaches, insomnia, and IBS with (primarily) diarrhea, a tricyclic (such as amitryptylline or doxepin) is probably the best choice of preventative. Constipation is actually a tougher symptom to treat. In those with IBS, med choices are more restricted because IBS sufferers tend to be sensitive to the meds (or, at least their GI system is…).