Abdominal Migraines

When you think of migraines, you might imagine the most awful and excruciating pain in your head. You might also imagine nausea, coupled with sensitivity to light and sound. If you’ve had a migraine, you know how intense and crippling they can become. However, did you know there is also a condition called abdominal migraines that mostly affects young children?

Many people are unaware that young children can suffer from a condition called abdominal migraines. It can also occur in adults too, but is much less common. As the name describes, the pain is felt in the abdomen instead of the head. As the child becomes an adult, they often continue to suffer with migraine headaches as well.

Abdominal migraines have been noted in children between the ages of 5 to 9 years old. Children that suffer from abdominal migraines report pain in the middle of their abdomen, around the belly button. The pain may feel just sore, but can become moderate to severe over time. Additionally, children can become nauseous, lose their appetite, begin vomiting and become pallor. These episodes can last anywhere from 2 to 72 hours. Between these episodes, children are generally symptom free.

Unfortunately, no one knows for sure what causes abdominal migraines in children. There are theories that is has to do with an imbalance in the two chemicals serotonin and histamine. While these two chemicals occur naturally in the body, daily stress and anxiety on the body can cause these to become imbalanced, which could potentially lead to the pain associated with abdominal migraines.

Another theory places the cause of abdominal migraines on food. It is thought that chocolate, Chinese food and processed meats containing nitrites could also trigger this type of pain. Excessive swallowing that leads to bloating, might also contribute to the cause of abdominal migraines.

The problem with properly diagnosing an abdominal migraine lies in the ability of the child to distinguish between a regular upset stomach or other gastrointestinal illness versus a true abdominal migraine. A key factor that doctors take into consideration is a family history of migraine headaches. A doctor will have rule out other causes of abdominal pain and begin to assess for the specific criteria of abdominal migraines. These symptoms include:

• Moderate to severe midline pain and cramping
• Nausea and vomiting
• Lack or non-existent appetite
• Listlessness or drowsiness
• Headache
• Pallor – a.k.a. paleness of the skin
• Dark shadows under the eyes
• Flushing

Additionally, blood may be drawn for lab tests and an EEG performed to rule out a seizure disorder.

There is no one specific treatment protocol set for abdominal migraines. The treatment plan is usually two fold. The first goal being to reduce current symptoms of the present attack. The second goal is to prevent future episodes or lessen the severity. The following medications have been known to be used in the treatment of abdominal migraines:

• Serotonin blockers
• Antidepressants
• Triptans: used to treat migraine headaches in adults
• NSAID: Non-Steroidal Anti-Inflammatories and analgesics to reduce pain
• Valproic Acid: anti-seizure medication
• Ergotamine medications
• Low dose aspirin
• Cyproheptadine: antihistamine

In severe cases where vomiting has been occuring, an intravenous drip of fluids may be necessary to rehydrate a patient, along with antiemetics and sedatives.

Finding the trigger may also be a simpler way to prevent abdominal migraines from happening in the first place. Children may need to refrain from eating chocolate or they may develop pain from the high amounts of MSG in Chinese food. If food is not the trigger, it could relate more to stress and anxiety. Working on a healthy lifestyle might contribute to less episodes. Keeping a diary to track these episodes may also lend a hand to discovering triggers that set off abdominal migraines.

The good news is that the prognosis for abdominal migraines is good. Most children will grow out of them. However, the downside is that many people will continue to suffer with migraine headaches throughout adulthood.

All in all, the chances for a child to have abdominal migraines is actually very small (about 4-5%). It might be a difficult diagnosis for a doctor to make since it is a poorly understood condition. Be sure to keep a diary and discuss your child’s symptoms in great detail with your doctor if you suspect your child might be possibly suffering from abdominal migraines. Be prepared to rule out many other conditions before receiving this as a diagnosis.