Abdominal Migraine Symptoms

Abdominal migraine is a type of migraine that causes moderate to severe stomach pain, rather than a headache. It is most common in children, particularly those between ages 5 and 9, and often runs in families. Attacks typically involve pain around the belly button, along with symptoms like nausea, vomiting, and paleness, lasting from 1 to 72 hours.

What is Abdominal Migraine Symptoms?

Abdominal migraine is a condition primarily affecting children, characterized by sudden, intense episodes of stomach pain (abdominal pain) instead of the typical head pain associated with migraines. These attacks usually involve moderate to severe discomfort around the belly button, often accompanied by other symptoms like nausea or vomiting, and can last for several hours to a few days.

Abdominal migraine is a type of migraine variant, meaning it's related to classic migraine headaches but presents differently. While adults usually experience head pain with migraines, children with abdominal migraine primarily feel pain in their abdomen. This condition is more common in children aged 5 to 9 years old, though it can affect individuals of any age. The exact cause of abdominal migraine is not fully understood, but it is thought to involve issues with the connection between the brain and the digestive system. It often runs in families, suggesting a genetic link, especially if other family members experience migraines. Many children who have abdominal migraines eventually develop traditional migraine headaches as they get older.

Symptoms

The main symptom of abdominal migraine is moderate to severe stomach pain, typically felt around the belly button (periumbilical pain). This pain is often described as dull or sore, rather than sharp, and can last anywhere from one hour to three days. Other common symptoms that occur alongside the pain include nausea, vomiting, loss of appetite, and looking pale.

During an abdominal migraine attack, the stomach pain comes on suddenly and can be quite intense. It's important to note that the pain is usually not localized to one specific spot but rather felt generally around the navel. Unlike some other stomach conditions, the pain from an abdominal migraine is not typically sharp or stabbing. In addition to the central stomach pain, individuals usually experience at least two other symptoms. These can include feeling sick to your stomach (nausea) and throwing up (vomiting). Other common signs are not wanting to eat (loss of appetite), having pale skin (pallor), looking tired (fatigue), and sometimes having dark circles under the eyes. These attacks can be quite disruptive, often causing a child to miss school or other activities.

Causes & risk factors

The exact cause of abdominal migraine is unknown, but it is thought to involve a complex interaction between the brain and the gut, possibly related to chemical imbalances like serotonin. Key risk factors include a strong family history of migraines, being a child between 5 and 9 years old, and being female. Stress, anxiety, and certain foods can also trigger attacks.

While the precise reasons for abdominal migraine are still being researched, experts believe it may stem from problems with the signals sent between the brain and the digestive system. An imbalance in brain chemicals, such as serotonin, which influences mood, sleep, and pain, is also considered a potential factor. This suggests a neurological basis, similar to classic migraines. Several factors can increase a person's risk of developing abdominal migraine or trigger an attack. The most significant risk factor is having a family history of migraines; about 7 out of 10 children (70%) with abdominal migraine have a close relative who also experiences migraines. The condition is also more common in girls than boys and typically affects children between the ages of 5 and 9. Stress, anxiety, and certain foods like chocolate, processed meats, caffeine, and cheese have been reported as potential triggers for some individuals.

How it's diagnosed

Diagnosing abdominal migraine involves a thorough medical evaluation because there isn't a specific test for it. A doctor will review your symptoms and medical history, and conduct tests to rule out other conditions that cause stomach pain, such as irritable bowel syndrome or appendicitis. The diagnosis relies on meeting specific criteria, including recurrent episodes of moderate to severe abdominal pain with associated symptoms.

Because abdominal migraine symptoms can mimic those of many other conditions, a doctor will first need to rule out other potential causes of stomach pain. This process often includes a detailed physical examination, blood tests, urine tests, and sometimes imaging studies like an ultrasound or CT scan. Conditions like appendicitis, celiac disease, Crohn's disease, gallstones, or kidney stones must be excluded before an abdominal migraine diagnosis can be made. The diagnosis is based on criteria established by the International Classification of Headache Disorders (ICHD-3). These criteria require at least five attacks of moderate to severe abdominal pain lasting 1 to 72 hours, typically around the belly button, and accompanied by at least two other symptoms like nausea, vomiting, loss of appetite, or paleness. Keeping a symptom diary, noting the timing, severity, and associated symptoms of each attack, can be very helpful for your doctor in making an accurate diagnosis.

Treatment options

Treatment for abdominal migraine focuses on relieving symptoms during an attack and preventing future episodes. During an attack, rest in a quiet room, over-the-counter pain relievers, and sometimes prescribed anti-nausea medications or migraine-specific drugs like triptans may help. For frequent attacks, doctors might suggest lifestyle changes or preventive medications, though evidence for specific interventions is limited.

When an abdominal migraine attack occurs, immediate steps can help manage the discomfort. Resting in a quiet, dark room can often provide relief. Over-the-counter pain medications, such as ibuprofen, may help reduce the pain. For more severe nausea and vomiting, a doctor might prescribe anti-nausea medications (antiemetics). In some cases, particularly if the child also experiences headaches, migraine-specific medications called triptans might be considered. For individuals experiencing frequent or severe attacks, preventive strategies are often discussed. These can include identifying and avoiding personal triggers, maintaining a regular sleep schedule, eating regular meals, and practicing stress management techniques like relaxation exercises. While various medications, such as beta-blockers, antidepressants, or anticonvulsants, are sometimes used to prevent attacks, it's important to note that the Cochrane Library states there is currently insufficient evidence to determine the effectiveness of any specific intervention for abdominal migraine. Your doctor will weigh the potential benefits against any risks when considering preventive treatments.

Recovery & outlook

The outlook for abdominal migraine is generally positive, as many children tend to outgrow the condition as they get older. However, it's common for about 7 out of 10 children (70%) with abdominal migraine to develop classic migraine headaches later in life. With proper diagnosis and management, the frequency and severity of attacks can often be controlled, allowing for a better quality of life.

While abdominal migraine can be distressing during childhood, most children experience a significant reduction in symptoms or complete resolution as they mature. This natural improvement is a reassuring aspect of the condition's prognosis. However, parents and individuals should be aware of the strong link between abdominal migraine in childhood and the development of traditional migraine headaches in adulthood. Even if the condition transitions to classic migraines, understanding the pattern and having a history of abdominal migraine can help in diagnosing and managing future headaches. Effective management strategies, including identifying triggers and using appropriate medications, can significantly improve the quality of life for those affected. Working closely with a healthcare provider is key to navigating the condition and its potential progression.

When to see a doctor

You should see a doctor for any new, severe, or persistent abdominal pain, especially in children, to ensure an accurate diagnosis and rule out other serious conditions. Seek immediate medical attention if abdominal pain is accompanied by red flag symptoms such as fever, bloody stools, pain that wakes you from sleep, severe vomiting, unexplained weight loss, or yellowing of the skin or eyes.

It is always important to consult a healthcare provider if you or your child experiences recurrent or severe abdominal pain. While abdominal migraine is a possibility, many other conditions can cause similar symptoms, some of which require urgent medical care. A doctor can perform the necessary tests to rule out other causes and establish a correct diagnosis. Certain symptoms warrant immediate medical attention as they could indicate a more serious underlying condition. These "red flag" signs include a high temperature (fever), blood in your stool (bloody stools), pain that is so severe it wakes you up at night, significant or persistent vomiting or diarrhea, unexplained weight loss, or a yellow tint to the skin or eyes (jaundice). Other concerning symptoms include pain that moves to the lower right abdomen, which could signal appendicitis, or any sudden changes in bowel habits.

Frequently asked questions

Is abdominal migraine a real type of migraine?

Yes, abdominal migraine is recognized as a type of migraine variant. Unlike classic migraines that cause head pain, abdominal migraine primarily causes moderate to severe stomach pain, often accompanied by other symptoms like nausea and vomiting. It is most common in children and is considered part of the migraine spectrum.

Can adults get abdominal migraines?

While abdominal migraine is most commonly diagnosed in children, particularly between the ages of 5 and 9, it can occasionally affect adults. In many cases, children with abdominal migraine may go on to develop classic migraine headaches as adults, but some may continue to experience abdominal symptoms.

What triggers an abdominal migraine attack?

The exact triggers can vary from person to person, but common ones include stress, anxiety, and certain foods. Some people report triggers like chocolate, processed meats containing nitrites, caffeine, cheese, and MSG. Keeping a symptom diary can help identify specific triggers for an individual.

How is abdominal migraine different from irritable bowel syndrome (IBS)?

Abdominal migraine and irritable bowel syndrome (IBS) both cause stomach pain, but they differ in their symptom patterns. Abdominal migraine attacks are typically sudden, intense, and episodic, lasting hours to days, with specific associated symptoms like nausea and paleness. IBS, on the other hand, is characterized by chronic abdominal pain or discomfort linked to changes in bowel habits (diarrhea, constipation, or both) over a longer period. A doctor will perform tests to distinguish between these conditions.

Are there any home remedies for abdominal migraine?

During an attack, resting in a quiet, dark room can often help. Over-the-counter pain relievers like ibuprofen may also provide some relief. Identifying and avoiding personal triggers, maintaining a regular sleep schedule, and practicing stress-reduction techniques are important preventive measures that can be done at home. Always consult a doctor before trying new remedies or supplements.

Will my child outgrow abdominal migraines?

Many children do outgrow abdominal migraines as they get older, which is a positive aspect of the condition's outlook. However, it's important to know that about 7 out of 10 children (70%) who experience abdominal migraines in childhood will eventually develop classic migraine headaches later in life.

Sources

• MedlinePlus — Abdominal Migraine Symptoms
• Mayo Clinic — Abdominal Migraine Symptoms
• Cochrane Library — Abdominal Migraine Symptoms