Understanding Abdominal Migraines

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Parents of children with recurrent abdominal pain of a chronic nature know all too well the extensive doctor visits and tests that their little ones have gone through. Hopefully, if you are the parent of a child with such pain, you have a diagnosis and good treatment plan by now.

Here is a closer look at a form of functional abdominal pain, called abdominal migraine that can be challenging to treat but is not life-threatening.

Who Gets Abdominal Migraines?

About 4 to 15 percent of children with chronic, recurrent abdominal pain of unknown cause have abdominal migraines, according to one study in Headache. These migraine attacks usually begin between the ages of 3 and 10.

Can Adults Get Abdominal Migraines?

While this headache disorder is classically diagnosed only in children, there is now more scientific evidence that this could be a diagnosis in some adults who see their doctors for abdominal pain, especially if they have a family history of migraines.

There is also thought that abdominal migraines in children are precursors to migraine attacks as an adult.

How is Abdominal Migraine Diagnosed?

There is no slam dunk test to confirm a diagnosis of abdominal migraine. Instead, a doctor will perform a physical examination and inquire about the person’s medical and family history.

In addition, a key part of diagnosing abdominal migraine is to rule out other sources of gastrointestinal illness or chronic abdominal pain, especially anatomic, infectious, inflammatory, or metabolic causes.

Where is the Pain of an Abdominal Migraine Located?

The obvious answer here is the abdomen. Usually children will point to their belly button or around their belly button, but the pain can be anywhere in the midline location, according to criteria from the International Classification of Headache Disorders.

What Does the Pain Feel Like?

The pain has a dull or “just sore” quality and is of moderate to severe intensity, so not something children can typically put out of their minds.

Are There Other Symptoms Associated with Abdominal Migraines?

At least two of the following symptoms are present during an abdominal migraine:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Paleness

Headache is not generally a significant symptom during an abdominal migraine attack. 

How Long Do Abdominal Migraine Attacks Last?

On average, an abdominal migraine attacks lasts 17 hours, although they can last anywhere from two hours to three days, if not treated or treated unsuccessfully. A prominent feature of abdominal migraine is that between attacks, children are pain-free.

How are Abdominal Migraines Treated?

Unfortunately there is not a lot of studies that have adequately assessed the treatment of abdominal migraines. Reassurance that there is no major abdominal pathology occurring and trigger avoidance (especially foods high in amines or xanthines) may be successful. Healthy sleep habits, adequate fluids, and avoiding stress when possible may also be helpful.

For an acute attack, Tylenol (acetaminophen) or ibuprofen can be useful, if given early enough. Nasal sumatriptan also has been shown to be effective in treating acute abdominal migraines.

Medications that have been found to be effective in preventing abdominal migraines for children include:

  • Cryproheptadine
  • Pizotifen syrup
  • Propranolol (a beta-blocker)

For adults, topiramate (Topamax) may be a reasonable option for preventing abdominal migraines, according to one study in Annals of Pharmacotherapy.

A Word From Tips For Healthy Living

Chronic abdominal pain in children can have a significant negative impact on their quality of life and interfere greatly with their peer relationships and school and social functions. If you or your child has chronic, recurrent abdominal pain, please be sure to undergo a thorough workup by a gastrointestinal specialist.

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