A Guide to Abdominal Migraine
The disorder is idiopathic, meaning doctors do not know the cause. Treatment involves medications for acute migraine attacks, medications to prevent attacks, and lifestyle changes.
This article looks at abdominal migraine in detail, including symptoms, causes, treatment options, and foods to avoid with abdominal migraine.
Abdominal migraine is a variant or subtype of migraine that involves abdominal pain along with other symptoms. It mainly affects children who have a family or personal history of migraine. About 1 in 4 children with the disorder also have migraine headaches.
It is also common to develop migraine headaches later in life if they are not already present during childhood. The International Headache Society (IHS) classifies abdominal migraine as an episodic syndrome that may be associated with migraine.
Abdominal migraine in adults is also possible. Researchers have identified a link between migraine and other functional gastrointestinal disorders, including irritable bowel syndrome (IBS) and functional dyspepsia (FD) in adults.
The main symptom is a recurrent attack of abdominal pain. The pain is usually in the middle of the belly, either in the midline or belly button area. However, it can also be diffuse. Most people describe the pain as dull or sore. It can range from moderate to severe and lasts from 2–72 hours. Between episodes, people are free of symptoms.
Other possible abdominal migraine symptoms include:
Scientists who study abdominal migraine have found several factors that increase the risk of developing it. Risk factors for abdominal migraine include:
- being between 3–10 years of age, with an average age of 7 years at onset
- having a family history of migraine headache
- being assigned female at birth
- having a history of motion sickness
Triggers of abdominal migraine may include:
- certain food additives, such as monosodium glutamate
- emotional excitement
- flashing lights
- foods high in amines, such as chocolate or cheese
- poor or irregular sleep
How do doctors diagnose abdominal migraine?
To diagnose abdominal migraine, the doctor will concentrate on your child’s medical history and physical exam. Questions your doctor may ask about a medical history include:
- How many episodes of abdominal pain has your child had?
- How severe is the abdominal pain?
- How long does the abdominal pain last?
- What other symptoms occur with the abdominal pain?
- Does your child get migraine headaches?
- Does anyone in your family get migraine headaches?
The physical exam will focus on ruling out other causes of abdominal pain. Testing may be necessary to help exclude these other causes. This could include imaging exams such as ultrasound and endoscopy.
The IHS diagnostic criteria for abdominal migraine include:
- at least five attacks of abdominal pain
- pain with at least two of the following characteristics:
- dull or sore in quality
- moderate to severe in intensity
- midline, belly button, or diffuse in location
- at least two of the following other symptoms:
- attack lasting 2–72 hours without proper treatment
- complete absence of symptoms outside of an attack
- unattributable to any other disorder
How do you prevent abdominal migraine?
Preventing abdominal migraine can involve taking medications and making lifestyle changes to avoid triggers.
Medications to Prevent Abdominal Migraine
Doctors may prescribe the following drugs to prevent attacks:
- cyproheptadine (Periactin), a antihistamine
- propranolol (Hemangeol), a beta-blocker
- topiramate (Topamax), an anticonvulsant that can also treat nerve pain
Keeping a headache diary can help identify things that trigger abdominal migraine.
Foods to Avoid With Abdominal Migraine
For some people, high-amine foods set off attacks. These foods include:
- citrus fruits
- aged or processed meats
- certain vegetables, such as mushrooms
Ask your doctor about avoiding these foods.
Lifestyle Tips for Abdominal Migraine
Physicians may recommend a helpful strategy called STRESS for abdominal migraine. This stands for:
- Stress management: Practice stress reduction and relaxation techniques, such as deep breathing, exercising regularly, eating a nutritious diet, enjoying a hobby, and balancing demands.
- Travel tips: Avoid motion sickness by breaking up long trips with frequent stops and avoiding high altitude, if possible.
- Rest: Get adequate sleep. Practice good sleep hygiene, including a regular bedtime routine and a dark, quiet room.
- Emergency symptoms: Be familiar with the symptoms that warrant medical care. These include:
- Sparkling lights: Avoid visual disturbances, such as flashing lights.
- Snacks to avoid: Avoid foods know to trigger symptoms, mentioned above.
Like other forms of migraine, abdominal migraine treatment involves strategies to relieve symptoms, as well as prevent attacks.
Drugs to treat an acute abdominal migraine attack include:
- antinausea medicines
- pain relievers, including acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)
- triptans, such as rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
Hydration with clear fluids is also important during an attack, especially if your child is vomiting. While experiencing an attack, resting in a quiet place with little to no light may help ease symptoms.
Abdominal migraine can cause belly pain severe enough to interfere with daily life. This means children with the disorder may miss school due to the disorder. Over time, missed school days can add up and affect a child’s learning.
Talk with your doctor if your child is frequently staying home from school due to belly pain. Depending on your child’s triggers, making lifestyle changes may help reduce the number of missed school days. However, stress from school can be a trigger in itself. Your doctor may recommend stress reduction and relaxation techniques if this is the case.
In most cases, children with abdominal migraine will grow out of the episodes of belly pain. However, it is common to go on to develop migraine headaches if they were not already present. This transition to migraine headaches usually occurs during the teenage years.
Contact your doctor if your child has recurrent episodes of abdominal pain. It can be difficult to diagnose abdominal migraine because the symptoms are common to several other conditions. This includes conditions like kidney and urinary tract problems, IBS, and other digestive or bowel problems. Getting a second opinion may give you more information and answers.
Abdominal migraine is a form of migraine that includes abdominal pain around the navel. Common migraine triggers can bring on abdominal migraine. It is more common in children, especially in families with a history of migraine. Adults can experience abdominal migraine as well.
Abdominal migraine treatments include medications to treat migraine and gastrointestinal symptoms. Managing stress, exercising regularly, getting adequate sleep, and avoiding certain foods can help.