Abdominal Migraine - Causes, Symptoms, and Treatment

Introduction:

Abdominal migraine is a kind of migraine primarily affecting the stomach. They are not headaches. They cause belly aches. Abdominal migraines mostly affect children between the ages of seven and ten. Abdominal headaches are rare in adults. Mostly girls are affected. This type of migraine is uncommon.

What Are the Causes and Triggers of Abdominal Migraine?

The exact cause is not known. They often happen as a response to triggers that cause a migraine headache. Abdominal migraine is a common cause of chronic and recurrent abdominal pain in children. Changes in histamine and serotonin levels in the body are responsible for this migraine. Stress can affect them. Foods such as chocolate and food with monosodium glutamate may trigger abdominal migraine in some people.

Swallowing a lot of air may also trigger abdominal migraine. Exhaustion and motion sickness can also trigger abdominal migraine. 15 % of the patients who have chronic stomach pain may have abdominal migraine. Kids who have abdominal migraines may get migraine headaches when they get older. Abdominal migraine tends to run in families. Genetic factors are involved as the condition is more common in children with a migraine family history. About 60 % of children with the condition have a positive family history of migraine.

What Are the Symptoms of Abdominal Migraine?

Abdominal migraine is often sudden and severe. Every migraine attack has a duration of one hour to three days. The symptoms of abdominal migraine are similar to those of many other gastrointestinal conditions. Abdominal migraine is different from other gastrointestinal conditions in the fact that symptoms of abdominal migraine come and go with no symptoms in between. Abdominal migraines are closely associated with cyclic vomiting syndrome.

The symptoms include:

• Midline abdominal pain - pain around the belly button. The intensity of the pain in abdominal migraine varies from moderate to severe.

• Nausea.

• Abdominal cramps.

• Be pale.

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• Throwing up.

• Yawn or be drowsy.

• Have little energy.

• Appetite loss.

• Dark shadows under the eyes.

• Sensitivity to light or sound.

Children with abdominal migraine generally start to outgrow the abdominal pain symptoms around puberty. About 60 % of children with abdominal migraine no longer have abdominal pain by their late teenage years.

How Can We Diagnose Abdominal Migraine?

Abdominal migraine is hard to diagnose because kids have trouble telling the symptoms. Abdominal migraine is easily confused with other causes of stomach ache in children like irritable bowel syndrome and Crohn's disease.

The doctor will ask about the family history of migraine headaches. Abdominal migraine follows a stereotypical pattern of attacks (same time of day and same duration) with no symptoms in between the attacks. There is no specific test for the diagnosis of abdominal migraine. Mostly the diagnosis is based upon the symptoms.

Migraine is diagnosed in children with the following criteria:

• Minimum of five attacks of abdominal pain that last from one hour to three days.

• Dull pain around the belly button. The intensity of the pain is moderate to severe.

• At least two of the symptoms: nausea, vomiting, pale skin, and appetite loss.

• No evidence of other gastrointestinal disease or kidney disease.

Imaging tests like ultrasound and endoscopy look for other conditions with similar symptoms. For example, doctors will have to rule out conditions like ulcers, disorders involving the bladder, reproductive system, and kidneys, Crohn’s disease, and irritable bowel syndrome.

What Is the Treatment of Abdominal Migraine?

Treatment for abdominal migraine is divided into two categories: relieving symptoms during the migraine attack and preventing future attacks. Children are subjected to unnecessary procedures if not properly diagnosed. Doctors treat abdominal migraine-like other migraines. They usually do not prescribe drugs until it is severe. Migraine medicine prescription can be taken online through teleconsultation or through in-office doctor's visit.

• If the child is vomiting, maintain fluid intake to prevent dehydration.

• Medications like Ibuprofen and Acetaminophen are given initially to stop the attack.

• If this does not work and if the child is over five years of age, the doctor suggests triptans like Rizatriptan, Zolmitriptan, and Sumatriptan. They are available as dispersible tablets or nasal spray.

• Antiemetics like Metoclopramide and Domperidone can help with nausea and vomiting.

• Tricyclic antidepressants and drugs that block the effects of serotonin are used in some patients to reduce abdominal migraine attacks.

• Valproic acid, an anti-seizure medication, is also used to treat abdominal migraine.

• Cognitive-behavioral therapy helps reduce the stress that triggers a migraine attack.

How Can We Prevent Abdominal Migraine?

Kids with abdominal migraine should maintain a diary of the date and time of migraine attacks, foods that triggered the attack, what they were doing before the attack, if they took any new medication, or any stressful or anxious events happening in their life.

• Kids can avoid the foods which trigger abdominal migraine.

• Lifestyle changes can help prevent migraine attacks.

• Kids should eat nutritious food with a lot of fiber. Daily exercise and getting enough sleep may help in preventing the attacks.

• Drinking plenty of fluids is necessary.

• Medicines that prevent migraine headaches may also prevent abdominal migraines if the child takes them daily.

Those include:

• Propranolol.

• Topiramate is approved for children over 12 years of age.

Abdominal Migraine vs. Migraine Headache

Abdominal migraine and migraine headache have the same causes beginning in the neurological system. Migraine headaches are characterized by pain in one side of the head. People with migraine headaches are sensitive to light and sound and experience an aura that includes vision changes. In abdominal migraine, the pain is around the belly button. In both types, pain is severe and disturbs normal day-to-day activities. Although the symptoms are different, the diagnosis and treatment of abdominal migraine are similar to migraine headaches.

Conclusion:

Abdominal migraine can have a significant impact on day-to-day life. Children may miss school and other activities. It is unclear what causes abdominal migraine, but the symptoms are treatable with medication. There are many methods to prevent and interrupt abdominal migraine attacks. Prognosis is usually good in children.