Abdominal migraines aren’t headaches. As their name suggests, they make your belly ache instead. But they often happen as a reaction to the same triggers as migraine headaches. They can hurt a lot and cause nausea, cramps and often vomiting. Cyclic vomiting syndrome (CVS) and abdominal migraines (AM) are two different conditions. Both are rare and both cause a lot of belly discomfort. They do have some similarities, but they’re treated differently.
Abdominal migraine episodes are separated by weeks to months and there is a stereotypical pattern and symptoms in each patient 3). The pain is severe enough to interfere with normal daily activities. After appropriate medical evaluation, symptoms cannot be attributed to any other medical condition. Abdominal migraines often affect kids between ages 7 and 10, but sometimes adults can get them too. Foods such as chocolate, food with monosodium glutamate (MSG), and processed meats with nitrites might trigger abdominal migraines in some people. Swallowing a lot of air may also trigger them or set off similar tummy symptoms.
Abdominal migraine symptoms
It will hurt in the center of your child’s body or around their belly button (not their sides), what doctors call midline abdominal pain. Stereotypical pattern and symptoms are seen in the individual patient. At least two episodes in a 6-month period are needed to confirm the diagnosis. 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.
- Stomach pain that isn’t in one specific spot (non-localized pain)
- Pale skin
- Be pale or flushed
- Pain is described as dull or sore
- Appetite loss
- Absence of another illness, including a gastrointestinal disorder
- Sensitivity to light or sound
- General malaise, overall discomfort, uneasiness
- Feel queasy or throw u
- Often there is no head pain, just the stomach discomfort and pain
- Have dark shadows under their eyes
- Symptoms completely go away between attacks
Abdominal migraines are often sudden and quite severe. They can hit without any warning signs. The pain may go away after an hour, or it may last as long as 3 days.
Causes and Triggers
We don’t know their exact cause. One theory is that changes in the levels of two compounds your body makes, histamine and serotonin, are responsible. Experts think that being upset or worried can affect them.
Foods such as chocolate, food with monosodium glutamate (MSG), and processed meats with nitrites might trigger abdominal migraines in some people. Certain triggers such as stress or excitement might trigger an abdominal migraine episode. Abdominal migraines are less common than migraine headaches, affecting about 4 percent of school-aged children.
- Stress, positive or negative stress such as excitement before a family trip or worry over a school test
- Prolonged fasting
- Fasting and skipping meals
- Changes in sleep patterns
- School or family songstress
- Exposure to flickering, glaring or bright lights
- Exercise causes flare ups in some people
- Dietary triggers (citrus food, caffeine, cheese, chocolate, carbonated drinks, colorings and flavorings)
No specific diagnostic test is available to confirm abdominal migraine. A diagnosis is made through a thorough evaluation of the patient’s medical history, incidence of migraine headache in the family, symptoms, and a physical exam and tests to rule out other conditions. Laboratory tests and imaging studies are usually directed to rule out other conditions that could be responsible for the symptoms. Electroencephalography is sometimes done to rule out a seizure disorder as the cause of the symptoms.
- Evaluation of a patient’s medical history
- Incidence of migraine headaches
- Physical Exam
This is often difficult for doctors to diagnose, especially if you as a parent are not familiar with abdominal migraine symptoms. The symptoms so closely resemble ordinary colds and flu, stomach ache and other gastrointestinal diseases.
Treatment for abdominal migraines in children and teens includes rest, plenty of fluids, over-the-counter pain relievers and relaxation/behavioral therapy techniques. Treatment for abdominal migraines in adults and older children may include prescribed medications used for other forms of migraine, such as NSAIDs, anti-nausea medication and triptans if the attacks are infrequent. Sometimes, simply knowing what the problem is makes it easier to deal with. Because we don’t know much about abdominal migraines, doctors may treat them like other migraines. But they usually don’t prescribe drugs unless the symptoms are very bad or happen a lot. Research to date has not provided sufficient data to firmly establish the role of any particular medication in either treating symptoms or preventing future episodes of abdominal migraine.
- Analgesic drugs such as nonsteroidal anti-inflammatory medications NSAIDs or acetaminophen
- Valparaiso acid (Depakote), an antiseizure medication, has been used to treat abdominal migraine.
- Ergot amine medications, also used for adults with migraine, are used to treat some childhood variants of migraine.
- Over-the-counter pain relievers
- Relaxation and behavioral therapy techniques
The two oral abortive medications are now approved for adolescents are:
- Almotriptan is recommended for ages 12-17
- Rizatriptan is recommended for ages 6 – 17. Both are on label.
Other aspects of treatment may include the administration of intravenous fluids if vomiting is severe, and the use of sedatives or anti-emetic drugs.
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.
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