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Abdominal Migraine - Causes, Symptoms, and Treatment

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Abdominal migraine is a variety of migraine characterized by pain in the belly. Read the article to learn more about abdominal migraine.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Veerabhadrudu Kuncham

Published At November 21, 2022
Reviewed AtJanuary 22, 2024

Introduction:

Abdominal migraine is a kind of migraine primarily affecting the stomach. Abdominal migraines are also called stomach migraines. They are not headaches. They cause belly aches. Stomach migraines especially 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. This article elaborates on the causes, triggering factors, symptoms, management, and prevention of stomach migraine.

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, caffeine, aged cheese, alcohol, aspartame, and food with monosodium glutamate may trigger stomach migraine in some people. Abdominal migraine in children can be triggered by many factors. Children are at more risk of getting abdominal migraines.

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 abdominal migraine symptoms are the same as 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. Stomach migraines are closely associated with cyclic vomiting syndrome. All the following symptoms rarely occur between the episodes of abdominal migraine in children.

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.

  • Throwing pain.

  • Yawn or be drowsy.

  • Little energy.

  • Appetite loss.

  • Dark shadows under the eyes.

  • Sensitivity to light or sound.

Abdominal migraines in children 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 to Diagnose Abdominal Migraine?

Abdominal migraine in children 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 depends on 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 may range from moderate to severe.

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

  • There is 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 migraines like other migraines. They usually do not prescribe drugs until it is severe. Migraine medicine prescriptions can be taken online through teleconsultation or through in-office doctor's visits.

  • 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 sprays.

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

  • Tricyclic antidepressants and some other drugs that block serotonin effects 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 lives.

  • Kids can avoid the foods that 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.

What Is the Difference Between Abdominal Migraine and Migraine Headache?

Abdominal migraine and migraine headaches have the same causes beginning in the neurological system.

  • Migraine Headaches: It is 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.

  • Abdominal Migraine: 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 stomach migraine are similar to migraine headaches.

Conclusion:

Stomach migraine can have an effective impact on day-to-day life. Abdominal migraine in children may cause the children to 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 stomach migraine attacks. Prognosis is usually good in children. Reaching out to the specialized healthcare professionals may be beneficial.

Frequently Asked Questions

1.

Is a Migraine in the Abdomen a Serious Condition?

Migraines in the abdomen are frequently abrupt and rather severe. They may strike with no prior warning. However, it is not harmful but might be stressful or impairing. The majority of the children have been reported not to experience abdominal migraine after childhood. However, studies also reveal developing migraine headaches in these children during adulthood.

2.

How Can One Stop a Migraine in the Stomach?

Abdominal migraine can be managed using the following methods
- Adequate sleep.
- Reduced exposure to screens.
- Proper hydration.
- Medications like pain-relievers belonging to the class of NSAID (non-steroidal anti-inflammatory agents) or Acetaminophen, medications belonging to the triptan class (e.g., Eletriptan, Sumatriptan) or over-the-counter anti-nausea drugs.

3.

Are Migraines in the Abdomen Neurological?

The exact etiology of abdominal migraines is not yet established. However, there is a connection that exists between the stomach and the brain. Further investigations are required to assess the relationship between the neurological influence causing gut migraines.

4.

What Foods Cause Migraines in the Abdomen?

Studies have shown that the consumption of certain foods can trigger an abdominal migraine. They include caffeine, chocolate, monosodium glutamate (MSG), and processed foods. Hence, identifying and avoiding such triggers can help reduce the frequency of abdominal migraines.

5.

Do Migraines in the Abdomen Go Away?

They last 17 hours on average. The pain can be excruciating, making daily tasks difficult. Children are mostly affected by migraines, with the first episode typically occurring between the ages of three and ten. However, the majority of kids appear to outgrow the problem

6.

Can One Frequently Experience Stomach Migraines?

The episodes of abdominal migraine can vary between children. Some may experience it frequently, followed by weeks to months without attacks, whereas, in some children, these migraines can occur in a periodic manner. Intake of food triggers that can cause the migraine can also affect the frequency of the attack.

7.

Can Stomach Migraines Be Caused by Dehydration?

Dehydration is reported to be a strong trigger for developing abdominal migraine. Staying hydrated and avoiding other causative triggers can help prevent these attacks. Always talk with the doctor if abdominal migraines become more frequent or severe.

8.

Why Is It Called a Migraine in the Abdomen?

Abdominal migraine involves episodes of mild to severe stomach pain characterized by nausea and vomiting. It differs from regular migraine attacks because head pain is not typically a symptom. It is mostly seen in children.

9.

Are Stomach Migraines Common?

Abdominal migraines are considered less common. The disorder affects one percent of adults and two percent to five percent of children. It has also been reported that abdominal migraines in childhood can increase the risk of developing migraine headaches in adulthood.

10.

Where Does a Migraine in the Abdomen Occur?

The area of the stomach where the pain from an abdominal migraine typically occurs is around the belly button. It may be mild to severe and feel like a dull discomfort or soreness. Additionally, there may be pallor, nausea, vomiting, and loss of appetite.
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Dr. Veerabhadrudu Kuncham
Dr. Veerabhadrudu Kuncham

Pediatrics

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