Abdominal Migraine
Understanding What Is Stomach Migraine

What Is Abdominal Migraine? Is It Always Associated With Headache?

Abdominal Migraine, also called stomach migraine, is a not too well understood condition, more often found in children, but can occur at any age. It is characterized by bout of repeated abdominal pain, vomiting and pale discoloration of the skin. It is a condition seen in those with family history of migraine.

abdominal migraine in a child

Does your child aged between 3 to 14 years complain of frequent abdominal pain, associated with vomiting and loss of colour?

Has he or she been tested for almost every other causes of abdominal pain and nothing found, yet still comes on with this repeated form of abdominal pain lasting anywhere from a few hours up to 3 days at a stretch?

If a older child, or adult, is there also a history of headaches occasionally with this episodes of abdominal pain? Does anyone in your family suffer with migraine? This could be due to this condition doctors are increasingly coming to recognize, called abdominal or stomach migraine.

What Is Abdominal Migraine

Abdominal migraine is a form of migraine that occurs commonly in children, with our without the headache component of migraine. It can start at the age of three or less, but more often at age 3 and half and again around age 9 in girls and age 14 in boys. Most often, there would be a history of migraine in the family, but not necessarily.

The following symptoms are commonly seen in people suffering with this condition:

  • Recurrent upper or central abdominal pain
  • There may or may not be associated headache
  • If headache occurs, it could be initially on both sides of the front or sides of the scalp and may later settle to one side
  • Nausea or actually vomiting
  • Feeling and looking flushed with pale colouration
  • Restless and easily irritable
  • In severe cases attacks could be as much as 2 to 3 episodes in a week
  • Each attacks of abdominal pain may last from a few hours up to 3 to 4 days
  • There may be associated loose stools or diarrhoea briefly
  • face could become slightly puffy with abnormal response to light and altered smell sensation
  • There may be increased frequency of passing urine, or increase in the volume of urine passed during the attacks
  • Reduced appetite
  • Yawning
  • Syncope or "passing out"

In between attacks, the child or adult feels completely well again, until the next episode.

Causes Of Abdominal Migraine

The exact cause of abdominal migraine is not known. Because of the fact that they respond to certain type of treatment, it is believed that they are caused by imbalance in a number of chemicals in the brain, affecting the stomach. Serotonin and histamines are two of the chemicals thought to be involved in causing the symptoms found in abdominal or stomach migraine.

In more than half of children with tummy migraine, there is usually someone in the family who suffers some form of migraine. With such background predisposition, the following are the common triggers or causes of stomach migraine:

  • Moderate to severe emotional or physical stress
  • Little or too much sleep
  • Eating certain type of food items like cheese, chocolate, or acidic drinks, fizzy drinks, red wine, or for some, any form of alcohol, caffeine, food additives like mono sodium glutamate (common in Chinese food and included in many African dishes too - seasoning cubes)
  • Hunger
  • Travelling or fear of travelling - cases of abdominal migraine has been reported to start at the airport or just as the child or adult boards a plane or car or boat
  • Dehydration following excessive heat, or exercise, or fever, or diarrhoea or simply not drinking enough water
  • Following injury to the head - minor head injury
  • Exposure to loud music or flashing lights as in cinema or disco rooms, or flickering lights on telly or computer screens
  • Following an episode of cold or other minor illnesses.

Diagnosis Of Abdominal Migraine

The diagnosis of abdominal migraine is never straight forward. All other possible causes, or dangerous causes of stomach pain has to be excluded before a child or adult can be labelled to have abdominal or stomach migraine.

If the symptoms as discussed above seems to mach those of your child, and all blood tests, urine tests and physical examination does not pick up any other problem, then it is most likely that the cause of frequent upper or central abdominal pain with vomiting and feeling flushed and irritable plus or minus any of the other symptoms is due to stomach migraine.

There are things that can be done to support this. Basically two types of tests are available to support or confirm the presence of abdominal migraine. There are:

  • An EEG (brain wave scan called electro-encephalography) may demonstrate an abnormal intermittent paroxysmal high voltage slow and sharp discharges on the brain, patterns suggestive of epilepsy.
  • Visual Evoked Response (VER) test to red and white flash light may give further indication of the presence of this form of migraine in a child. Those with tummy migraine display a fast wave form response to flashing light than normal children.

Negative results does not exclude this disorder, just like taking a snap of a field with red and white roses from a moving car and not catching a glimpse of the white roses in your picture does not mean that there no white roses on that field.

Treatment Of Abdominal Migraine

If a child or adult is suspected to be suffering with abdominal migraine, treatment is usually symptomatic. This means that there are no definite cure or treatment for this condition.

The child should be explained to, if of appropriate age, what is happening, and be reassured that the abdominal pain will get better soon.

Simple pain killers like paracetamol or ibuprofen could be given to help with the pain, if there are no contraindications to taking any of these medicines like asthma or stomach ulcer (for ibuprofen) or allergies.

Anti sickness medicines like domperidone has also be found to help with the vomiting and many of the other symptoms associated with stomach migraine.

Where episodes are recurrent and very troublesome, some patients have found the use of sodium valporate, or pizotifen or nasal sumatriptan (a form of triptans), useful. So too is propanolol and fluoxetine in some other patients (mainly in adults).

Feel free to discuss any of these options with your doctor or health care provider who can either prescribe one or a combination of these to you, or refer you or your child to see a paediatrician with specialist interest in childhood migraines.

You can read about real life story of abdominal migraine here.

Abdominal Migraine - Tell Us Your Story

Do you have a great story or experience about abdominal or stomach migraines? Share it! Tell us your story.


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