Suffering from frequent headaches

Do you suffer from FMS as well as regular bouts with severe headaches? If so, you're certainly not alone. No one knows how many people with fibromyalgia suffer from periodic migraines or tension headaches, but doctors know that they happen a lot. The underlying problem could be that whatever in the body that controls pain has gone wrong. Or it could be that the body is overly sensitive to pain. It may even be both.

Diagnosing headaches

A migraine is a special kind of headache that can be extremely severe and is often accompanied by nausea and vomiting. The pain is usually excruciating;

people often describe it as "blinding." People with migraines often complain that light and sounds bother them, and they generally want to lie down in a dark place alone and in the same position as long as possible (or until their medication kicks in). (For more on migraines, check out Migraines For Dummies, by Diane Stafford and Jennifer Shoquist, MD [Wiley].)

A tension headache is another type of headache. It isn't necessarily caused by stress or tension, although it can be. Tension headaches stem from tightened muscles, often in the neck. Virtually everyone has had a tension headache at some point. When tension headaches (or any type of headaches) become chronic, though, you need to see your doctor to get a handle on the why of this frequency and to rule out any serious underlying problems.

If your headaches constantly occur and are severe, your doctor may order a magnetic resonance imaging (MRI) scan of your brain, a special test to rule out a brain tumor or other dangerous condition.

Treating your headache problem

If you have headaches that happen for no apparent reason (much like your fibromyalgia), your doctor will probably treat you with painkilling medications. Drugs such as Elavil (generic name: amitriptyline) — as used with IBS, interstitial cystitis, and fibromyalgia — are often prescribed to keep chronic headaches under control or (even better) to prevent them from happening in the first place.

Generally, doctors also recommend that you avoid acidic fruits, chocolate, and alcohol. (I'm not making this up. Are you starting to see a pattern here?) In addition, although caffeine may be used in some drugs to treat severe headaches, you'll generally be discouraged from heavy consumption of caf-feinated beverages, such as coffee, tea, and sodas.

Some research indicates that migraine headaches may be caused by a minor deficiency of magnesium, and in such cases, supplemental magnesium may help. Of course, before you consider adding magnesium to your diet, check with your doctor. Also realize that magnesium may stimulate your colon, so if you already have IBS and suffer from chronic diarrhea, magnesium may not be the right answer for you.

Hurting with heartburn

Many people who have fibromyalgia also suffer from chronic heartburn. They may have gastroesophageal reflux disease (GERD), a condition in which food comes partly up the esophagus, which connects to your stomach, instead of going down where it's supposed to go. The condition can be extremely irritating to the esophagus. Although the stomach has a protective layer of mucous, the esophagus has no such protection. Chronic heartburn can wear down the esophagus and may create a precancerous condition.

Diagnosing gastroesophageal reflux disease

Most primary-care doctors can easily diagnose GERD. If a person appears to have symptoms of chronic heartburn — belching, upset stomach, food that she tastes repeatedly a long time after she ate it, because it backs up (otherwise known as repeating) — the doctor may prescribe acid-blocking medications. If patients who take these medications feel better, they probably had heartburn.

Sometimes doctors refer patients with heartburn symptoms to gastroenterol-ogists. The gastroenterologist may perform an endoscopy, a procedure in which the doctor looks into the esophagus and stomach while the patient is mildly sedated. The endoscopy shows if there's any serious problem. It can also confirm if GERD is present.

(ftNG/ According to the book How to Stop Heartburn: Simple Ways to Heal Heartburn and Acid Reflux, by Anil Minocha, MD, and Christine Adamec (Wiley), strong painkillers, such as Percocet or Vicodin, can cause or worsen your GERD. So if you're finding that your painkiller or other medication for fibromyalgia seems to worsen your heartburn, let your doctor know so that you can be switched to another type of medication.

Treating gastroesophageal reflux disease

GERD is usually treated with acid-blocking medications. People with GERD are also usually given dietary recommendations, such as no acidic fruit, chocolate, or alcohol.

Many people with GERD also have problems with insomnia, as do people with FMS. A low dose of a sedating antidepressant may help resolve that problem, as may a prescribed sleep remedy. (Read more about sleep in Chapter 14.) In the case of GERD, however, this advice is accompanied with other recommendations, such as to raise the head of the bed and avoid late-night eating. Exercising and weight loss are also common recommendations given to people with chronic heartburn.

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