Abdominal migraines are mostly seen in children ages five to nine years old, but can be seen in adults as well. Interestingly, they present much like other gastrointestinal infections or disturbances primarily with abdominal pain, nausea and vomiting. This form of migraine disease was originally recognized because it was linked to other family members and children who have the same disorder. Most children who experience an abdominal migraine often develop standard migraine headaches either with or without aura.
The primary characteristic of an abdominal migraines is pain located in the midline but poorly localized. This pain is dull and has a moderate to severe intensity. During the migraine the child will experience anorexia, vomiting or pallor and it is not attributed to any other disorder that the child may have.
On physical examination in history the child will have no other signs of gastrointestinal or renal disease. The pain will be severe enough to interfere with normal daily activities and the child may find it difficult to distinguish a lack of appetite from nausea.
As with most forms of migraine there is no conclusive diagnostic tests to confirm its and it must be achieved through both medical history and physical examination to rule out other causes of the symptoms. Children who present with these symptoms should have urogenital disorders, peptic ulcer, gallbladder disorders, duodenal obstruction, gastroesophageal reflux, and irritable bowel syndrome ruled out prior to a diagnosis.
Most children have these abdominal migraine attacks infrequently and don’t require specific medications for treatment. It is however important to recognize the things that trigger these migraines for children. These triggers can be dehydration, low blood sugar and barametric weather changes. Medications which can be used include nonsteroidal anti-inflammatory drugs such as ibuprofen, anti-nausea medications and triptans. The choice of medication will depend upon the age of the patients, but preventative therapies are the treatment of choice.
No one really knows what causes an abdominal migraine. One theory is that they are caused by changes in two specific neurotransmitters in the body – histamine and serotonin. Both of these are naturally occurring but can contribute when daily stresses and anxiety cause fluctuations. In addition researchers believe that chocolate, Chinese food and processed meats which contain nitrates may also trigger abdominal migraines.
The duration of the pain can be anywhere from one hour to four hours and during that time the individual can suffer all of the symptoms concurrently. In most instances there will be a recurrence at least once a month and the pain and nausea that the person also experience a short periods of vomiting and dry heaving.
If the parents also experience migraine headaches on a regular basis there is an increased risk to the children for developing abdominal migraines. Fortunately the frequency of abdominal migraine attacks will lessen as the child grows older and are likely to vanish by the time they reach adulthood. Unfortunately, they are often replaced by typical migraine headaches, often with the same triggers that would trigger an abdominal migraine.
Through self-management, stress reduction, healthy lifestyle choices and recognizing triggers, most children and adults who get abdominal migraines are able to keep them at the lowest number possible and avoid long-term medical treatments that can also have their own side effects. Consult with your primary care physician or neurologists to decide upon the best course of action for treatment and prevention.
Journal of Nurse Practitioners: Abdominal Migraine in Children: Is It all in their Heads?
National Headach Foundation: Headache Types
National Headache Foundation: Abdominal Migraines
Pediatric Drugs: Abdominal Migraine: Evidence for Existence and Treatment Options