Abdominal Migraine

A difficult to diagnose condition characterized by stomach pain, nausea, and vomiting in children

Abdominal migraine is common in children and usually begins between the age of 3 and 10 years of age.

Symptoms of abdominal migraine

Symptoms of abdominal migraine include a sore tummy, nausea and vomiting and can lead to days off school and time out of normal activities. Children may also have other symptoms with their tummy pain such as light sensitivity, nausea, sensitivity to movement. Children may have a loss in appetite.

While children often grow out of abdominal migraine, many will go on to develop migraine as adults.

Cause of abdominal migraine

Children with a family history of migraine are more likely to have abdominal migraine. Genetics play a role, there is a family history of migraines in about 60% of cases. While the exact cause is not known, it is thought to be a problem with the gut/brain connection. Overactivation of the nerve connections between the gut and the brain stem may be responsible for the symptoms experienced. Interestingly children are often treated with similar medications given to adults with migraine.

The team at Auckland's new Headache & Migraine Clinic have specific training in abdominal headaches, and are here to help you.

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What are triggers for abdominal migraine?

The triggers’ for abdominal migraines are similar to those of common migraine:

  • Stress

  • Travel (or change in routine)

  • Skipping meals or dehydration

  • Weather changes

  • Lack of sleep

  • Excessive afferent stimuli (eg. flashing lights, strong odours)

How are they Diagnosed?

There are no specific tests to confirm abdominal migraine, it is usually diagnosed by ruling out other conditions that cause similar symptoms for example reflux, irritable bowel syndrome, celiac and stomach ulcers.

The following factors help to rule in abdominal migraine:

The child has had at least five attacks of abdominal pain, and include:

  • Tummy pain in the midline behind the belly button, which is "sore” , moderate or severe in intensity

  • At least two of the following four associated symptoms or signs:

    1. Loss of appetite

    2. Nausea

    3. Vomiting

    4. Pallor (pale skin)

    1. Attacks that last between 2 to 72 hours without treatment

  • No symptoms between attacks

  • The symptoms are not attributed to another disorder

Medication for abdominal migraine

While abdominal migraine isn’t serious or dangerous, it can take some time to be diagnosed and cause much stress to the child and parents. As most children with abdominal migraine go on to develop common migraine, medical treatment for abdominal migraine is similar to that of common migraine. It is thought that both conditions share a common underlying pocess, a ‘sensitised’ brainstem. The upper cervcial spine has a close relationship with the brainstem and may play a role in the sensitisation along with the gut brain nervous pathways.

Our approach

Because of the relationship between the upper cervical spine and the brainstem in both migraine and abdominal migraine, it makes sense to have a skilled examination of the neck to ‘rule in’ or ‘rule out’ your neck as a cause of your ‘sensitised’ brainstem.

Our approach involves finding the neck segments involved, treating them, and desensitising the brain stem for long term relief from abdominal migraines.