What is Abdominal Migraine?
Abdominal Migraine is a form of migraine that consists of abdominal pain, with associated symptoms of nausea and vomiting. It is described as a Recurrent Gastrointestinal Disturbance1 along with Cyclic Vomiting Syndrome. It is more commonly seen in children than in adults1, with children ages 5 to 15 most affected2. Cases of adults experiencing Abdominal Migraines are rare, but possible3. The pain is described as located in the middle of the abdomen around the belly button as a ‘dull’ or ‘sore’ ache that may be moderate to severe in intensity1. While Abdominal Migraine is considered to be a “migraine disorder”, it is rarely associated with headaches. This is due to attacks including headaches being classified as “classic” or “common” migraine. However, children who experience abdominal migraines will often suffer from migraine headaches in adulthood1,4.
Some other symptoms that may occur with an abdominal migraine attack are loss of appetite (anorexia), nausea, vomiting and paleness1. Episodes last between 1-72 hours1,2. In between the episodes, there will be complete relief of symptoms. Frequency can be up to 4 attacks per week4.
Abdominal Migraine vs Cyclic Vomiting Syndrome
Though they’re often mistaken for the same condition, there are differences between Abdominal Migraine and Cyclic Vomiting Syndrome.
Cyclic vomiting syndrome refers to waves of intense nausea, vomiting, and other stomach problems for no obvious reason. Cyclic vomiting syndrome may also last up to 10 days, compared to 3 days for Abdominal Migraine. While you may experience nausea and vomiting as a symptom of Abdominal Migraine, Abdominal Migraine is often experienced purely as abdominal pain.
In both cases, sufferers can experience loss of appetite and pale skin during an attack.
What is the cause of Abdominal Migraine?
Currently the exact cause of Abdominal Migraines is not known, however some theories suggest that certain chemicals produced by the body (histamine and serotonin) have a role to play5. Some common foods that have been known to trigger abdominal migraines include chocolate, foods with high MSG, and processed meats5.
Abdominal Migraine can be hard to diagnose as children may have difficulty distinguishing between normal stomach-aches, a stomach flu or abdominal migraine. Other causes for stomach pain should be ruled out such as Irritable Bowel Syndrome, gastroenteritis, appendicitis, etc.
In those individuals that may be suffering from Abdominal Migraine and have no underlying pathology or disorder that can be recognised, another known cause may be due to a sensitised brainstem.
A SENSITISED BRAINSTEM will perceive non-threatening stimuli (such as eating certain foods) and create pain to be felt where the sensory information was originally detected. This hyper-excitability of the pain sensation is due to the heightened arousal and sensitive brainstem. A sensitive brainstem will relay the sensory information to the brain, but will heighten the sensation so that the brain perceives the information as painful.
I’ve already tried everything. What else can be done to help Abdominal Migraine?
Over-the-counter painkillers, strong triptan medications, and even tricyclic antidepressants are some of the ways in which Abdominal Migraine sufferers have attempted to rid themselves or their child of the painful attacks. In some cases, these ways can alleviate the symptoms of Abdominal Migraine, however despite all of these treatment options, sufferers may still find themselves having painful attacks.
At the Brisbane Headache and Migraine Clinic™, we have seen countless Abdominal Migraine sufferers. So, if you suffer from Abdominal Migraine, or if you think it sounds like your symptoms, and medication has given you no significant relief, then we believe that you should have a thorough examination of your brainstem.
Imagine living a life free from headaches and migraines and saying goodbye to medications!
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- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. (2018). Cephalalgia, 38(1), 1-211. doi: 10.1177/0333102417738202
- Abu-Arafeh, I., & Russell, G. (1995). Prevalence and clinical features of abdominal migraine compared with those of migraine headache. Archives Of Disease In Childhood, 72(5), 413-417. doi: 10.1136/adc.72.5.413
- Kunishi, Y., Iwata, Y., Ota, M., Kurakami, Y., Matsubayashi, M., & Kanno, M. et al. (2016). Abdominal Migraine in a Middle-aged Woman. Internal Medicine, 55(19), 2793-2798. doi: 10.2169/internalmedicine.55.6626
- Lee, K., Kim, E., Lee, J., & Kim, S. (2013). The clincal characteristics of abdominal migraine and risk factors for developing migraine later in childhood. The Journal Of Headache And Pain, 14(S1). doi: 10.1186/1129-2377-14-s1-p4
- Mani, J., & Madani, S. (2018). Pediatric abdominal migraine: current perspectives on a lesser known entity. Pediatric Health, Medicine And Therapeutics, Volume 9, 47-58. doi: 10.2147/phmt.s127210