Abdominal Migraine In Children: Signs, Causes, Risks, Treatment

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Abdominal migraine in children is characterized by severe abdominal pain that may last for more than an hour. The condition often remains undiagnosed and may cause recurring chronic abdominal pain, mostly accompanied by headache, nausea, and vomiting (1). Abdominal pain is often mistaken for cyclic vomiting syndrome since both condition are closely associated (2).

Read this post to learn about the signs and symptoms, triggers, risks and complications, treatment, and prevention of abdominal migraine in children.

Causes And Triggers Of Abdominal Migraine In Children

The exact cause of abdominal migraine in children is not known, but scientists believe it might stem from a problem in the brain-gut pathway (2). “We don’t know the exact causes of abdominal migraine, but we do know there is a connection between the brain and the gut,” says Deena Kuruvilla, MD, a neurologist and specialist in facial and headache pain at Yale Medicine (3).

Studies have shown that abdominal migraine and migraine share many common triggers that are either food-related or non-food-related (4) (5).

Food-related triggers of abdominal migraine include

  • Citrus food, caffeine, cheese, chocolate, carbonated drinks
  • Foods containing high concentrations of amine
  • Foods with additive flavoring
  • Foods that contain artificial colors
  • Foods containing monosodium glutamate

Non-food related triggers of abdominal migraine might include

    • Sleep deprivation and irregular sleep habits
    • Dehydration
    • Stress
    • Travel
    • School and family stressors
    • Bright or flickering light
    • Prolonged fasting
    • Exercise

Symptoms Of Abdominal Migraine In Children

Episodes of Moderate to severe abdominal pain lasting between one and 72 hours is the most common symptom of abdominal migraine. Other symptoms that may accompany abdominal pain include (2) (5)

  • Nausea and vomiting
  • Headache
  • Loss of appetite
  • Pale skin
  • Sensitivity to light (photophobia) and sound
  • Anorexia

In between episodes of abdominal migraine, your child might not show any of the symptoms mentioned above.

Apart from the symptoms stated above, watch out for the following potential alarm signs and symptoms (4).

  • Persistent right upper or right lower quadrant pain
  • Pain radiating to the back
  • Involuntary weight loss
  • Recurrent or unexplained fever
  • Delayed puberty
  • Rash with no identifiable cause
  • Joint pain or swelling

If you suspect abdominal migraine in your child, seek a doctor to determine the underlying cause as certain gastrointestinal, urogenital, or metabolic conditions may mimic abdominal migraine (6).

Risk Factors For Abdominal Migraine

Abdominal migraine affects children more than adults, and the first episodes are known to occur at three to ten years. It also affects more females than males. Furthermore, research suggests that psychological factors such as abuse and stressful events may increase a child’s risk for abdominal migraine (5).

Like migraine, abdominal migraine is believed a polygenic disease (a genetic disorder caused by the combined action of more than one gene), and the chance of your child getting it depends on the history of migraine in other family members. For example, a child with a family history of abdominal migraines is more likely to develop it.

Studies have suggested that children usually outgrow the symptoms and risks of abdominal migraine in their late teens (3) (7) (8).

How To Diagnose Abdominal Migraine In Children?

No specific test exists for the diagnosis of abdominal migraine. Your child’s doctor will make the diagnosis based on the frequency and severity of the symptoms (3). The child should be carefully evaluated for the presence of any alarming symptoms or signs.

The diagnosis also includes a thorough review of the child and family’s medical history, physical examination, and investigations to rule out other causes that mimic abdominal migraine.

Certain diagnostic studies that might be considered for children showing signs of chronic and recurrent abdominal pain include (4)

  • Blood tests
  • Urine and stool tests
  • Radiological studies such as X-ray, MRI, and ultrasound
  • Endoscopic procedures

Treatment For Abdominal Migraine In Children

Most of the treatments used for treating typical migraine are also applied in treating abdominal migraine in children because there are no FDA-approved treatments for treating this condition. The doctors may prescribe the following medications (3) (8).

  • NSAIDs (such as Ibuprofen) for relieving pain
  • Triptans to prevent the symptoms from progressing
  • Anti-nausea medication to prevent vomiting.

How To Prevent Abdominal Migraine In Children?

One of the best ways to prevent abdominal migraine in your child would be to avoid the triggers that cause it. You can work with your doctor and family members to devise strategies to avoid the triggers that might cause abdominal migraine in your child.

  • If your child experiences frequent abdominal migraine attacks, consult your child’s doctor about exploring preventive therapies such as beta-blockers, cyproheptadine, and topiramate.
  • You might also want to try biofeedback and cognitive behavioral therapy as they are known to show positive results in treating migraines (8).
  • In addition to therapy and avoiding the trigger points, a well-balanced diet and a stress-free environment might also go a long way in preventing the symptoms of abdominal migraine in children.

Frequently Asked Questions

1. When should I be concerned about my child’s stomach pain?

If the abdominal pain does not subside within 24 hours and persists with additional symptoms such as diarrhea, vomiting, fever, difficulty in passing stool, and hardening of the belly, you must consult a doctor immediately (9).

2. Do children outgrow abdominal migraines?

Children may outgrow abdominal migraines around the age of puberty. About 60% of children suffering from abdominal pain will not show any symptoms by their late teenage years (6).

Abdominal migraine in children is a sub-type of migraine that causes chronic stomach ache with headache and nausea. Children may outgrow it by adolescence. Some foods such as coffee, chocolate, cheese, flavoring agents, stress, sleep problems, and flickering lights may trigger the pain. Other conditions such as gastrointestinal or urogenital issues may also mimic the symptoms of abdominal migraine. Consult a doctor if you suspect your child has abdominal migraine. You can help your child manage the condition through medications, a balanced diet, and behavioral therapy.

Key Pointers

  • The precise cause for abdominal migraine in children is unknown, but experts believe a problem in the gut-brain pathway could be the reason.
  • Some common food and non-food-related triggers include citrus fruits, caffeine, irregular sleep patterns, and stress.
  • Moderate to severe abdominal pain lasting between one and three days, nausea, vomiting, appetite loss, and pale skin are common symptoms to observe.
  • The treatment focuses on providing symptomatic relief, whereas avoiding the triggers could help prevent its occurrence.

References:

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Sanjana Bhattacharjee

Sanjana did her post graduation in Applied Microbiology from Vellore Institute of Technology, India. Her interest in science and health, combined with her passion to write made her convert from a scientist to a writer. She believes her role at MomJunction combines the best of both worlds as she writes health-based content based on scientific evidence. Sanjana is trained in classical... more

Dr. Dur Afshar Agha

(MS)
Dr. Dur Afshar Agha is a consultant pediatrician with decades of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association. She has also completed her Post Graduate Program... more

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