We may all jokingly refer to the festive season as "a bit of a headache", but for those migraine and headache sufferers, this is not just a throwaway line.

Instead of being a time of quiet relaxation and festive joy, for some people it can be one of the most painful and difficult times of the year when they are exposed to many factors that trigger their headaches.

This is traditionally a time to eat, drink and be merry, but if you are a headache or migraine sufferer, you?re strongly advised to take care with what you eat and drink at the Christmas and New Year parties ahead.

Dr Elliot Shevel, Maxillo-facial and oral surgeon, chairman of the South African branch of the International Headache Society, and medical director of The Headache Clinic, is definitely qualified to judge.

He says the combination of summer heat, rich food, stress and noise triggers headaches for many patients.

"For people who are predisposed to migraines and headaches, the stress of last-minute shopping, overcrowded malls and noise is almost guaranteed to trigger an attack," Shevel says. But he does offer some helpful suggestions.

In his recently published paper in the South African Medical Journal, Shevel says it's important that migraine patients, and those who live and work with the problem, need to understand that migraine pain is a real neurobiological disease, and can be treated following proper diagnosis.

The symptoms of a migraine include throbbing head pain, nausea, and sensitivity to noise and light. An attack can last between four and 72 hours. They are also hereditary, and women are three times more likely to suffer them than men

Shevel says that although patients can try to avoid triggers, like noisy shopping malls, this may come at the cost of reducing quality of life and day-to-day functioning.

Over-indulgence in festive food and beverages are a very bad way to cope.

Ingredients and food such as caffeine, sugar, monosodium glutamate, processed meats and cheeses, and chocolate ? sadly ? are known to trigger migraines and headaches among many patients.

Shevel suggests that people who suffer acute or chronic headaches should keep track of which ingredients trigger their attacks ? and resist the temptation to eat these things.

During summer, these people should take in plenty of fluids, because dehydration is also known to trigger migraines in some people.

"It is best to drink plain water, as many carbonated soft drinks contain substances that can trigger headaches, and common ingredients that should be avoided are caffeine and aspartame," he says.

Excessive alcohol also leads to dehydration, so there is another thing to take care with. Try not to drink too much liquor, and ensure that you drink plenty of water both during and following a session of indulgence.

Too much hard partying until the early hours may of course also mean that headache patients don't get enough sleep ? also a major trigger of headaches and migraines, according to Shevel.

And what about time in the sun? Shevel has co-authored an article published in international medical journals that explains the mechanism by which the small arteries of the scalp are known to be the source of migraine pain for many people.

"It is possible," he says, "that summer heat triggers migraines by causing these arteries to dilate." Put simply, when body temperature rises because of exercise or heat from the sun, the small blood vessels in the skin dilate to allow us to lose heat. This heat regulation system may also play a part in the dilation of scalp arteries, according to Shevel.

While many migraine and headache sufferers are sensitive to bright light, and avoid it when they have a headache, they are perhaps not so up on the fact that bright light could also be a trigger.

So don your dark glasses, and a hat if necessary, but above all, have a fabulous Christmas.