Causes, symptoms, treatment and prevention
With abdominal migraine, a headache does not occur during the episode of abdominal pain. Between abdominal migraine attacks, a person has no abdominal symptoms.
The disorder is idiopathic, which means doctors don’t know the cause. Treatment involves medication for acute migraine attacks, medications to prevent attacks, and lifestyle changes.
This article takes an in-depth look at abdominal migraine, including symptoms, causes, treatment options, and foods to avoid for abdominal migraine.
What is 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 this disorder also suffer from migraines.
It is also common to develop migraines later in life if 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.
Learn more about migraine with this detailed guide.
What are the symptoms of abdominal migraine?
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 in the navel area. However, it can also be diffuse. Most people describe the pain as dull or aching. It can vary from moderate to severe and lasts from 2 to 72 hours. Between episodes, people are symptom-free.
Other possible symptoms of abdominal migraine include:
- loss of appetite
- sensitivity to light or sound
It is also possible to have a prodromal phase before the onset of abdominal pain. Typical symptoms can include diarrhea, mood swings, numbness, tingling, flashing lights, and other visual changes.
Learn more about migraine symptoms you should never ignore.
What causes abdominal migraine?
Scientists studying abdominal migraine have discovered several factors that increase the risk of developing it. Risk factors for abdominal migraine include:
- be between 3 and 10 years old, with an average age of 7 at the start
- have a family history of migraine
- to be assigned female at birth
- have a history of motion sickness
Abdominal migraine triggers can include:
- certain food additives, such as monosodium glutamate
- emotional arousal
- flashing lights
- foods high in amines, such as chocolate or cheese
- poor quality or irregular sleep
- to travel
To diagnose abdominal migraine, the doctor will focus on your child’s medical history and physical exam. Questions your doctor might ask you about your medical history include:
- How many episodes of abdominal pain has your child had?
- How severe is abdominal pain?
- How long does abdominal pain last?
- What other symptoms occur with abdominal pain?
- Does your child suffer from migraines?
- Does anyone in your family suffer from migraines?
The physical exam will focus on ruling out other causes of abdominal pain. Tests may be needed to help rule out these other causes. This could include imaging tests 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 painful quality
- moderate to severe
- midline, navel or diffuse in location
- at least two of the following other symptoms:
- attack lasting 2 to 72 hours without proper treatment
- complete absence of symptoms other than a seizure
- not attributable to any other disorder
Abdominal migraine prevention may involve taking medications and making lifestyle changes to avoid triggers.
Medicines to prevent abdominal migraine
Doctors may prescribe the following medications to prevent seizures:
- cyproheptadine (Periactin), an antihistamine
- propranolol (Hemangeol), a beta-blocker
- topiramate (Topamax), an anticonvulsant that can also treat nerve pain
Keeping a headache diary can help identify triggers for abdominal migraine.
Foods to avoid with abdominal migraine
For some people, foods high in amines trigger 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
Doctors can recommend a helpful strategy called STRESS for abdominal migraine. That means :
- Stress management: Practice stress reduction and relaxation techniques, such as deep breathing, regular exercise, a nutritious diet, a hobby, and balanced demands.
- Travel tips: Avoid motion sickness by breaking up long journeys with frequent stops and avoiding high altitudes, if possible.
- Rest: Get enough sleep. Practice good sleep hygiene, including a regular bedtime routine and a dark, quiet room.
- Emergency symptoms: Familiarize yourself with the symptoms that warrant medical attention. These include:
- Twinkling lights: Avoid visual disturbances, such as flashing lights.
- Snacks to avoid: Avoid foods known to trigger symptoms, mentioned above.
What are the treatments for abdominal migraine?
Like other forms of migraine, treating abdominal migraine involves strategies to relieve symptoms and prevent attacks.
Medications to treat an acute abdominal migraine attack include:
- antinausea drugs
- 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 a seizure, especially if your child is vomiting. During a seizure, resting in a quiet place with little or no light can help relieve symptoms.
Probiotics may help reduce pain in people with functional abdominal pain disorders, including IBS and FD, which share a connection with migraine.
Learn about medications and drug classes to prevent and treat migraine.
How does abdominal migraine affect quality of life?
Abdominal migraine can cause abdominal pain severe enough to interfere with daily life. This means that children with the disorder may miss school due to the disorder. Over time, missed school days can accumulate and affect a child’s learning.
Talk to your doctor if your child often stays home because of stomach pain. Depending on your child’s triggers, making lifestyle changes can help reduce the number of missed school days. However, school stress can be a trigger in itself. Your doctor may recommend stress reduction and relaxation techniques if this is the case.
What are the potential complications of abdominal migraine?
In most cases, children with abdominal migraine will come out with bouts of abdominal pain. However, it is common to develop migraines if they were not already present. This transition to migraines usually occurs during adolescence.
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 such as kidney and urinary problems, IBS, and other digestive or intestinal issues. Getting a second opinion can give you more information and answers.
Abdominal migraine is a form of migraine that includes abdominal pain around the navel. Common migraine triggers can cause an abdominal migraine. It is more common in children, especially in families with a history of migraine. Adults can also suffer from abdominal migraine.
Abdominal migraine treatments include medications to treat migraine and gastrointestinal symptoms. Managing stress, exercising regularly, getting enough sleep and avoiding certain foods can help.