What Are Abdominal Migraines in Children and Adults?
An abdominal migraine is a variant of migraine headaches. It usually occurs in children who have a family history of migraines. Abdominal migraines are rare in adults, but about 2% of all children may get abdominal migraines. Females are more affected than males.
Children that experience abdominal migraines typically develop migraine headaches when they get older.
Although abdominal migraines are in the migraine family, the pain occurs in the belly. Usually, it's near the navel or midline. Abdominal migraines frequently occur as a reaction to a migraine trigger. They can cause severe stomach pain, nausea, abdominal cramping, and often vomiting.
What Causes Abdominal Migraines?
The exact cause of abdominal migraines hasn't been discovered, but one theory is that abdominal migraines are caused by changes in two chemicals, histamine and serotonin. Both of these occur naturally in the body. The chemical changes could contribute to both migraine headaches and abdominal pain. Experts now believe that daily stress and anxiety can cause fluctuations in these body chemicals. There is increasing support for the theory that unexplained abdominal pain may have a psychological trigger.
In addition, it's thought that foods such as chocolate, Chinese food, and processed meats that contain certain chemicals -- nitrites -- might trigger abdominal migraines. Excessive air swallowing may also trigger abdominal migraines or other similar gastrointestinal symptoms. The result is bloating and interference with eating.
What Are the Signs and Symptoms of Abdominal Migraines?
Symptoms of abdominal migraines may include:
- Acute, severe, midline abdominal pain that is associated with nausea
- Inability to eat
The abdominal pain may last for as short as one hour or as long as three days.
Migraine headaches are generally preceded by an "aura" by which the migraine sufferer can sense that a headache is coming on. Abdominal migraines, though, are frequently sudden and quite severe. They can occur without any warning signs and can increase anxiety in the person who gets them.
How Are Abdominal Migraines Diagnosed?
Diagnosing abdominal migraines is difficult. Children have difficulty distinguishing the features of an abdominal migraine from ordinary stomachaches, stomach flu, or other gastrointestinal illnesses.
Family history of migraine and abdominal migraines is a key factor in determining the possibility of abdominal migraines. So, the doctor will look at the patient's family medical history to assist in making an accurate diagnosis.
The first step is to eliminate other causes of stomach pain. Then the doctor may assess specific criteria developed by migraine experts. To determine the likelihood of an abdominal migraine, the doctor may check for some of the following symptoms:
- Moderate to severe midline pain lasting from one to 72 hours
- Symptoms of nausea and vomiting
- Anorexia (a decrease in appetite; inability to eat)
- Yawning, listlessness, drowsiness
- Pallor (paleness/abnormally pale skin color)
- Dark shadows under the eyes
How Are Abdominal Migraines Treated?
A specific treatment for abdominal migraines has not yet been established. Because little is known about treating abdominal migraines, doctors may treat them like other migraines.
For some patients, certain serotonin blockers and tricyclic antidepressants may be useful for treating abdominal migraines. Doctors have had some success treating older children with nasal sumatriptan, which is a drug in the triptan class. However, the triptans used for migraine headaches have not been approved for use in children.
Triptans may also help adults with abdominal migraines. In addition, valproic acid (Depakote, for example), which is used to treat migraine headaches, has been used with some success in treating abdominal migraines.
Can Abdominal Migraines Be Prevented?
With appropriate education, children and adults with abdominal migraine may be able to figure out their personal triggers. For example, sometimes food such as chocolate or Chinese food that contains monosodium glutamate (MSG) might increase the chance of abdominal migraines. Avoiding these foods may be useful for some. Many people, though, have no food triggers for abdominal migraines.
Self-managing stress, along with healthy lifestyle habits, may play a role in reducing the risk of abdominal migraines. Children and adults who get abdominal migraines may want to keep a diary of the times that abdominal symptoms occur. They should also consult with their doctors about the best course of action for treatment and prevention.
WebMD Medical Reference
Health Solutions From Our Sponsors
FDA: "Managing migraines."
eMedicineHealth: "Migraine Variants."
The National Migraine Association: "What is abdominal migraine?"
Neurology Channel: "Migraine Headaches."
National Headache Foundation: "Abdominal Migraine."
MedicineNet.com: "Migraine Headaches."
International Headache Society ICHD-II: "Abdominal Migraine Diagnosis."
Reviewed by Richard Senelick, MD on August 29, 2012