Abdominal MigraineWhat are the symptoms?The symptoms of abdominal migraine are multiple episodes of abdominal (stomach) pain with no associated headache. The pain may last from 1 to 72 hours. Associated symptoms include nausea, occasionally vomiting, and patients often appear pale. The abdominal pain is usually described as being in the center (not to the left or right), around the umbilicus (the ‘belly button), or it can be difficult to localize. The pain can be moderate or severe and is usually described as dull (not sharp). This type of migraine may occur in as many as 12% of school children, usually in the very young (between ages 4 and 9). It rarely occurs in adults. What other problems must be ruled out?Abdominal migraine is a ‘diagnosis of exclusion’ meaning other causes of abdominal pain must be ruled out before coming to a decision about the diagnosis. Other problems to exclude are: cyclic vomiting (a childhood disorder with frequent, recurrent vomiting and dehydration), kidney disease, or gastrointestinal diseases.How is this related to migraine?Why is this called a migraine at all, given that there is no headache?Physicians feel that abdominal migraine is a childhood manifestation of migraine because these same children often develop migraine later in life. Also, the symptoms tend to respond to similar medications as other migraine headaches. In addition, a family history of migraine is more common in these children. How is it treated?These migraines can be treated with the same medications used to treat other migraines. Given the associated nausea, I would tend to use the anti-nausea medications such as Phenergan (promethazine)or Reglan (metoclopramide), as these can have anti-migraine effects as well. Other options are NSAIDS (such as ibuprofen or naproxen) or a class of medications called triptans (for example, Imitrex, especially the nasal form). Triptans are more difficult to use in this situation because they may exacerbate nausea and vomiting and because they are not officially approved to treat young children.Preventatives that are used for common migraine can also be used to prevent abdominal migraine (see
Migraine Prevention
). A physician must be consulted to determine what medications are appropriate for young children to take for this purpose. Return from ABDOMINAL MIGRAINE to HOME |