What is an abdominal migraine?
An abdominal migraine is a type of migraine that affects mostly children. Unlike migraine headaches, the pain is in the belly — not the head.
Symptoms of this type of migraine
The main symptom of an abdominal migraine is pain around the belly button that feels dull or achy. The intensity of the pain can range from moderate to severe.
Along with the pain, kids will have these symptoms:
Each migraine attack lasts between one hour and three days. In between attacks, kids are healthy and have no symptoms.
The symptoms of an abdominal migraine are similar to those of many other childhood gastrointestinal (GI) conditions — that is, those involving the digestive system. The difference is that abdominal migraine symptoms come and go with days to months of no symptoms. Also, each episode of abdominal pain is very similar.
Causes and triggers of abdominal migraines
Doctors don’t know exactly what causes abdominal migraines. It could share some of the same risk factors as migraine headaches.
One of the theories is that abdominal migraines stem from a problem in the connection between the brain and GI tract. One very small study also found a link between this condition and slower movement of digested food through the intestines.
Abdominal migraines are more common in children who have close relatives with migraine headaches. One study found that more than 90 percent of kids with this condition had a parent or sibling with migraines.
More girls than boys get abdominal migraines.
Certain factors seem to trigger abdominal migraines, including stress and excitement. Emotional changes might lead to the release of chemicals that set off migraine symptoms.
Other possible triggers include:
- nitrates and other chemicals in processed meats, chocolate, and other foods
- swallowing excessive amounts of air
- motion sickness
Some of the same medicines used to treat migraine headaches also help with abdominal migraines, including:
- nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin IB, Advil)
- anti-nausea medicines
- triptan migraine drugs, such as sumatriptan (Imitrex) and zolmitriptan (Maxalt), which are the only triptan drugs approved by the U.S. Food and Drug Administration (FDA) for children over 6 years old.
Other medicines used to prevent migraines may prevent abdominal migraines if your child takes them every day. These include:
- cyproheptadine (Periactin)
- propranolol (Hemangeol, Inderal XL, InnoPran XL)
- topiramate (Topamax, Qudexy XR, Trokendi XR), which is FDA approved for children over 12 years old
Be sure your child is getting enough sleep, eating regular meals throughout the day, and drinking plenty of fluids (without caffeine).
If your child is vomiting, give them extra fluids to prevent dehydration.
Certain foods — such as chocolate and processed foods — may set off abdominal migraines. Keep a diary of your child’s diet and migraine attacks to help you identify their trigger foods and avoid them in the future.
Cognitive behavioral therapy (CBT) can help relieve stress, which is thought to be another cause of abdominal migraines.
How are they diagnosed?
Doctors don’t have a test specifically for abdominal migraines. Your doctor will start by asking about your child’s medical history and your family’s medical history. Children with abdominal migraines often have family members who get migraines.
Then the doctor will ask about your child’s symptoms. Abdominal migraines are diagnosed in children who meet these criteria:
- at least five attacks of abdominal pain that each last 1 to 72 hours
- dull pain around the belly button that may be of moderate to severe intensity
- at least two of these symptoms: appetite loss, nausea, vomiting, pale skin
- no evidence of another GI condition or kidney disease
The doctor will also perform a physical exam.
Though usually ruled out by your child’s history and physical exam, tests such as ultrasound or endoscopy can be done to look for conditions that have similar symptoms, such as:
- gastroesophageal reflux (GERD)
- Crohn’s disease
- bowel blockage
- peptic ulcer
- kidney disease
Complications of abdominal migraines
Abdominal migraines can be severe enough to keep children out of school for a few days at a time. Because this condition is easy to mistake for other GI diseases, kids who are misdiagnosed may end up undergoing unnecessary procedures.