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Abdominal Migraine

Abdominal migraine, common in children, involves abdominal pain, vomiting, diarrhoea and other gastrointestinal upsets, and not necessarily headache. It is frequently misdiagnosed as Irritable Bowel Syndrome (IBS) in adults.

It most commonly affects children under the age of 7. Most children who experience abdominal migraine grow out of it by their teens and eventually develop other migraine variants with headaches, but it can persist into adulthood.

The pain associated with abdominal migraine is generally located in the middle of the abdomen around the belly button. It is often described as dull or “just sore” and may be moderate to severe. In addition to the pain, there can be loss of appetite, nausea, vomiting and those affected may look pale.

Very severe forms of abdominal migraine can include cyclical vomiting syndrome, where the affected person cannot stop vomiting for hours or even days. This must be carefully managed, including going to emergency if you feel it cannot be managed at home, to enable medications and fluids to be given intravenously.

The attacks have the same four phases of migraine, with the acute phase lasting between 2-72 hours.

As with any form of migraine, there is no diagnostic test to confirm abdominal migraine. Diagnosis is achieved by reviewing family and patient medical history, physical examination and performing investigations to rule out other causes of the symptoms.

One of the theories is that abdominal migraine stems 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 migraine has a clear genetic link, although the specific genes have not yet been identified. One study found that more than 90 per cent of kids with this condition had a parent or sibling with migraine.

And, just like most other migraine subtypes in adults, more girls than boys live with abdominal migraine.

Certain factors seem to trigger abdominal migraine attacks, 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
  • exhaustion
  • motion sickness

Some of the same medicines used to treat other types of migraine also help with abdominal migraine, including:

  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen)
  • anti-nausea medicines (like Stemitil or Ondansatron)
  • triptan migraine drugs

Best care for someone with significant abdominal migraine will include both a neurologist and a gastroenterologist. The gastroenterologist may suggest other medications from the wide variety available to calm the stomach.

Make sure you or your affected child gets enough sleep, eats regular meals throughout the day, and drinks plenty of fluids (without caffeine). If there is a lot of vomiting, remember to rehydrate.

An elimination diet to remove food triggers is also recommended. You will need the help of a dietician to do this properly.

Read more about abdominal migraine at the Migraine Trust and the American Migraine Foundation.

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