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Abdominal migraines

In an abdominal migraine, pain is felt in the abdomen rather than the head.

Abdominal migraines are rare in adults, but about 4% of all children with migraines experience abdominal migraines.

Children who experience abdominal migraines often go on to suffer migraine headaches later in life.

Abdominal migraines can cause severe stomach pain, nausea, abdominal cramping and vomiting.

What causes abdominal migraines?

No one knows what causes abdominal migraines. One theory is that abdominal migraines are caused by changes in two chemicals, histamine and serotonin. Both of these occur naturally in the body. The chemical changes could contribute to both migraine headaches and abdominal pain. Experts now believe that daily stress and anxiety can cause fluctuations in these body chemicals. There is increasing support for the theory that unexplained abdominal pain may have a psychological trigger.

In addition, it's thought that foods such as chocolate, Chinese food and processed meats that contain certain chemicals (nitrites) might trigger abdominal migraines. Excessive air swallowing may also trigger abdominal migraines or other similar symptoms of the digestive tract. The result is bloating and interference with eating.

What are the signs and symptoms of abdominal migraines?

Symptoms of abdominal migraines may include:

  • Acute, severe, midline abdominal pain that is associated with nausea
  • Vomiting
  • Pallor
  • Inability to eat

The abdominal pain may last for one hour or up to three days.

Migraine headaches are sometimes preceded by an aura, a symptom that can alert the person that a headache is coming on. However abdominal migraines are frequently sudden and quite severe. They can occur without any warning signs and this can increase anxiety in the person who gets them.

How are abdominal migraines diagnosed?

Diagnosing abdominal migraines is difficult. Children have difficulty distinguishing the features of an abdominal migraine from ordinary an upset stomach, stomach flu or other gastrointestinal illnesses.

Family history of migraine and abdominal migraines is a key factor in determining the possibility of abdominal migraines. So the doctor will look at the patient's family medical history to assist in making an accurate diagnosis.

The first step is to eliminate other causes of stomach pain. Then the doctor may assess specific criteria developed by migraine experts. To determine the likelihood of an abdominal migraine, the doctor may check for some of the following symptoms:

  • Moderate to severe midline pain lasting from 1 to 72 hours
  • Symptoms of nausea and vomiting
  • Anorexia (a decrease in appetite; inability to eat)
  • Yawning, listlessness, drowsiness
  • Headache
  • Pallor (paleness/abnormally pale skin colour)
  • Dark shadows under the eyes
  • Flushing

 

How are abdominal migraines treated?

A specific treatment for abdominal migraines has not yet been established. Because little is known about treating abdominal migraines, doctors may treat them like other migraines.

For some patients certain serotonin blockers and tricyclic antidepressants may be useful for treating abdominal migraines. 

Triptans may also help adults with abdominal migraines. Valproic acid, which is used to treat migraine headaches, has been used with some success in treating abdominal migraines.

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