What are abdominal migraines?

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Similar to migraine headaches, abdominal migraines are characterized by intense episodes of abdominal pain lasting two or more hours followed by long periods without symptoms. During an attack, a child’s pain might be so severe that he or she is screaming and/or nonfunctional. These children are often brought to the emergency room, and parents and doctors might suspect appendicitis or another need for emergency surgery because of the child’s extreme pain.

Abdominal migraines are closely associated with cyclic vomiting syndrome, and about half of children with abdominal migraines also meet the criteria for cyclic vomiting.

Causes of abdominal migraines

Although the exact cause is unknown, researchers think migraines stem from a problem in the brain-gut pathway. 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.

This condition usually starts at age 7 and peaks at age 9 to 11. As children become teenagers, their abdominal migraines are often replaced by migraine headaches.

Symptoms of abdominal migraines

In addition to intense belly pain that can last two or more hours, other symptoms could include:

• Nausea (often intense)
• Vomiting
• Loss of appetite
• Pale skin
• Fatigue/listlessness
• Headache
• Sensitivity to light and sound

Prevalence of developing this condition

This condition is slightly more common in girls. Affected children often have a family history of migraines, and children who experience motion sickness are also more likely to develop abdominal migraines.

Concerns of abdominal migraines

Although the pain will come and go, it is severely debilitating during a migraine episode and can cause children to miss a significant amount of school over time. Children could be subjected to unnecessary surgery if the condition is misdiagnosed.

Talk to your pediatrician if your child is experiencing belly pain that is severe enough to disrupt normal activities.

Diagnosis of abdominal migraines

Practice varies, but your child’s doctor might use abdominal ultrasound or endoscopy to check for other potential causes of your child’s pain. The doctor will also evaluate your child’s medical history to determine a pattern. Abdominal migraines usually follow a stereotypical (same time of day, same appearance, same duration) pattern of attacks (five or more episodes) with a complete resolution of symptoms between the migraines.

Treatment for abdominal migraines

Your child’s doctor might prescribe anti-migraine medications that your child can use daily to prevent future attacks or at the time to relieve discomfort during an attack. Cognitive behavioral therapy can also be helpful when managing chronic pain or reducing stress that could trigger a migraine episode. Occasionally your child’s doctor might recommend complementary therapies such as acupuncture.

Once your child’s abdominal migraines are under control, you will no longer need to see a GI specialist.

Living with abdominal migraines

As children become teenagers, their migraine pain might move from the belly to the head as they develop more typical migraine headaches.

Follow your doctor’s advice on how to best prevent and treat migraines, and try to avoid your child’s migraine triggers whenever possible.