Article by Dr Katy Munro
What is an abdominal migraine?
Mostly common in children, abdominal migraine are episodic abdominal pains with various other migraine features. The child might complain of severe abdominal pains without any headache symptoms. This condition is largely misunderstood and under diagnosed due to lack of information and awareness.
This condition is common in children with abdominal pain especially if there is a family history of migraine. Abdominal migraine (AM) is one of the most common causes of functional abdominal pain in children. Many sufferers will have headaches at other times too or go on to get more classical symptoms of migraine later. Some continue to get abdominal migraine symptoms into adulthood.
Chronic and recurrent abdominal pain is a very distressing symptom that causes significant morbidity in affected children impairing their school performance and overall quality of life. Abdominal migraine (AM) is one of the most common causes of functional abdominal pain in children
Chronic abdominal pain in childhood accounts for 2%–4% of office visits to primary care clinicians and 50% of referrals to paediatric gastroenterologists.
What are the common symptoms to look out for ?
Episodes of abdominal pain lasting more than an hour on a recurring basis in children with accompanying features which are typical of migraine like light sensitivity, nausea, sensitivity to movement, may be abdominal migraine. The child is completely well in between attacks. Also bouts of abdominal pain may also be accompanied by vomiting. This condition is relatively common but often not diagnosed because of the absence of headache at the time.
Abdominal migraine can lead to frequent school absences, inappropriate and sometimes intrusive investigations and even unnecessary surgery. As many as 4-5% of children with abdominal migraine have been found to have had unnecessary operations in one study. Hence an early diagnosis is important.
Treatment of abdominal migraine follows the same principles as treating any migraine sufferer with regular routines of eating and sleeping being very important. Advice to eat regularly, slow release energy foods, not too many carbs, and to try adding in a bedtime snack can transform the symptoms. Eating and staying hydrated before and after exercise can help too. Sleep routines and quality of sleep are important. Stress management with techniques like mindfulness, writing out feelings, relaxation exercises or cognitive behavioural techniques may be helpful too.
Simple painkillers and resting in a dark quiet room often will be enough to relieve the symptoms. medications like Sumatriptan for acute attacks or Pizotifen to prevent them may be needed. A medication to improve gastric emptying like Domperidone can reduce abdominal pain, nausea and vomiting.
For more information on treatment options click HERE.
If your child is exhibiting these symptoms, speak to your GP or see a headache specialist. Migraine can start early and small children can and do get headache disorders. Early intervention increases the odds of good migraine control for a lifetime.
So if your child has recurrent tummy aches, think about migraine. It’s not always in their heads!
p.s. Adults can get abdominal migraines, too!