The concept of abdominal migraine seems strange to most people. Surely, migraine is a pain in the head and nothing to do with stomach ache? While this is true in most cases, we understand that migraine is a condition originating in the brain, which usually results in headache. And, similar physical conditions can sometimes trigger pain in the abdomen.

Who Gets Abdominal Migraine?

Anyone with a tendency towards classic migraine could get abdominal migraine, but it is more common in children than adults. Children whose parents have migraine are more likely to develop the abdominal variant, and are more likely to have migraine headaches as they grow into adults. It is estimated that around 2% of children have abdominal migraines, with girls being more susceptible than boys. The condition usually appears for the first time between the ages of two and 10 years.

Abdominal migraine can be preceded by aura with similar symptoms to those present in migraine headaches. They can include vomiting and nausea, along with photophobia, a heightened sensitivity to light.

Abdominal Migraine Symptoms

The pain can be severe and is centered in the middle of the abdomen around the belly button. It doesn’t usually extend to the sides. Pain can come on without warning and last anywhere from an hour to several days. Other symptoms typically associated with abdominal migraine include:

• Having no energy or feeling drowsy.
• No appetite.
• Feeling nauseous.
• Vomiting.
• Excessive yawning.
• Skin can be either pale or flushed.
• Dark circles around the eyes.

What Causes Abdominal Migraine?

As with migraine headache, no definitive causes have been identified. Some of the research to date indicates causes may be neurological, or related to hormonal or chemical changes in the body, such as histamine or serotonin levels. We also know family history plays a part, with around 60% of children who have a family history of migraine developing the condition.

Another similarity with migraine headaches is external triggers. Certain foods may bring on abdominal migraine pain such as those containing nitrites, or chocolate and Chinese food that tends to be high in monosodium glutamate (MSG).

Foods rich in nitrites include processed meats like bacon, hotdogs and sausages or cured and salted hams. They are common foods most of us eat every day, making them hard to avoid.

Stress or anxiety is thought to be another trigger, as it is with classic migraine.

Diagnosis

Children find it hard to describe pain, both in terms of quality and in identifying exactly where it hurts. Both these make it harder to accurately diagnose abdominal migraine when symptoms can be so similar to stomach flu, tummy upset or any other standard stomachache.

The doctor will take into account any family history for classic migraine since it often runs in families. Most diagnoses rely on ruling out other conditions that could cause stomach pain and may include imaging tests to look for physical conditions. If there is the possibility of a seizure disorder, the doctor may order an EEG.

Treating Abdominal Migraine

Standard anti-migraine medications and other over-the-counter medicines may help reduce the symptoms, although there is no single medication that has proved effective. An added complication is that ordinary anti-migraine medication is often not suitable for children. Older children have been successfully treated with triptans such as Sumatriptan, although these drugs are not approved for younger children.

Sleep is effective, and some antihistamines (such as cyproheptadine) works for some children. Other forms of treatment may include beta-blockers or anti-seizure medications.

Prevention

Sufferers of classic migraine headaches are often advised to keep a migraine diary, and this is effective in figuring out what causes abdominal migraines too.

Even older children will need help to get going with a diary, and ongoing help to keep it up. For younger ones, parents do it for them. When you’re keeping a migraine diary, things to note include:

• When the attack started - date and time.
• What foods children had eaten before the attack.
• What activities they were involved in.
• What medication they were taking.
• Current worrying situations or anxiety they’re feeling.
• What you did to help the pain previously, and if it worked.
• How long the attack lasted.

Over time, the answers to those questions help you identify patterns and triggers, making it easier to avoid migraine-causing conditions and situations in the future.

Having a healthy lifestyle is also thought to help prevent attacks, and this includes getting daily exercise, having regular sleeping patterns (even at weekends or on vacation), eating nutritious food as part of a balanced diet and learning coping strategies for stressful situations.

If your child gets frequent stomachaches, it could be they’re suffering from abdominal migraine. Adopting some of the prevention and coping strategies for classic migraine could provide the missing link that helps decrease the frequency and severity of their episodes.