Abdominal migraines in children: causes, symptoms, and treatment

Your child tells you that their stomach hurts. They immediately ask what they ate, and if it turns out they haven’t ingested what could be the culprit (like too many cookies, or worse, a battery), just assume it will go away on its own. But if the problem persists, you’ll find that ginger ale or bland foods like rice or toast aren’t enough. So if you are looking for answers online, you may come across this term: abdominal migraines. But what are abdominal migraines in children? These abdominal discomforts can be more serious than normal abdominal pain.

What are abdominal migraines?

Some abdominal pain here and there is common in children. As the episodes get more frequent (and severe), something more serious could happen, like abdominal migraines. “Abdominal migraines (AMs) are a cause of chronic and recurring abdominal pain in children,” says Dr. Denise Scott, MD, pediatrician at JustAnswer, told Romper. “They are characterized by moderate to severe, diffuse abdominal pain, usually in the midline, that can last 2-72 hours.”

In addition to the pain, your child may experience headaches, nausea, loss of appetite, and sensitivity to light when they have an abdominal migraine. They can also turn pale and interfere with their daily activities. Episodes can happen at least twice or more within 6 months, but if your child doesn’t experience them, they will likely feel fine.

How is an abdominal migraine different from an abdominal pain?

That’s pretty scary, you think. So how would you know if your child’s tummy is hurting from the spicy chicken nuggets they ate rather than from a stomach migraine? Well, one of the best ways to spot this is with the symptoms mentioned above. If your child has normal stomach aches, they may not have these other problems and definitely not as often. “Stomach pain in children can be due to a variety of problems, including stress and anxiety, which manifests as stomach pain,” says Dr. Alexander Perelman, MD, a certified gastroenterologist with Vanguard Gastroenterology in New York City, told Romper. “Common other conditions like constipation, infections, kidney problems, and even inflammatory bowel disease often have a different appearance and clinical history.” All of these conditions can be ruled out by testing to determine what the culprit is.

Is there a connection between abdominal migraines and head migraines?

If you thought migraines were only on your head, think again. While migraines are most commonly viewed as a head-related problem, they can occur in other parts of the body such as the abdomen. But is there a connection between the migraines in the stomach and in the brain? Absolutely, says Dr. Scott. “Usually there is a family history of migraine headaches,” she says. Dr. Perelman agrees, adding, “More than half of the patients diagnosed have a family history of migraines, which also suggests a genetic component.”

Kwanchai Chai-Udom / EyeEm / EyeEm / Getty Images

What causes abdominal migraines?

Unfortunately, the answer is: Nobody really knows. “Although there are numerous hypotheses about what causes abdominal migraines, the actual causes are unknown,” says Dr. Scott. “It is believed that there is a connection between the intestinal nervous system and the central nervous system that leads to intestinal hypersensitivity or possibly genetic factors, but nothing has been proven.” According to Dr. Scott, the median age for diagnosis is between 3 and 10 years, with a peak of 7 years. “Overall, abdominal migraines can affect 1-9% of children, but it makes up 4-15% of children with chronic abdominal pain,” she says. And according to a study, girls are more likely to suffer from abdominal migraines than boys.

How to treat abdominal migraines

It is difficult for doctors to treat a medical problem without a specific known cause. And while this can be frustrating for parents when their children are struggling with abdominal pain, there are ways to alleviate the discomfort. “Without a clear understanding of the disease mechanism, treatment is limited to eliminating more sinister problems and focusing on preventing AM episodes,” explains Dr. Perelman. “These include typical interventions like proper hydration, good sleep hygiene, and stress management.” You may even want to take your child to a therapist to address other issues, especially if AM is stress-related. “Give your child cognitive behavioral therapy (CBT) to reduce stress,” says Dr. Victoria Glass, MD, a practicing physician at the Farr Institute, told Romper. “This may improve some symptoms before you get to the doctor’s office.”

If the abdominal migraine could be due to something your child is eating, a nutritionist will be added to your child’s medical team to eliminate anything that could be irritating to their tummy. “There can also be certain food triggers: citrus fruits, caffeine, cheese, chocolate, carbonated beverages, colors and flavors like MSG,” says Dr. Scott, however, points out that triggers can be different for each child. However, if you can identify a possible reason for the pain – be it poor sleep, flashing lights, travel, or stress – these triggers should be avoided.

In some cases, medications can be prescribed to manage symptoms, and these medications are often also used to help people with migraines. “Medication options are limited with an emphasis on pain control and symptom relief during seizures,” explains Dr. Perelman. “Science is limited, but data suggest that ibuprofen can help reduce the duration of symptoms. In the case of severe nausea and vomiting, the doctor can prescribe an antiemetic, either in orally soluble form or as a rectal suppository. ”According to Dr. Perelman can have a pediatric gastroenterologist do more testing for frequent and debilitating seizures, and can suggest preventative daily medication like propranolol or cyproheptadine, two drugs commonly used to treat migraines, the National Institutes of Health reported.

But there is a silver lining. While abdominal discomfort may not feel good, the good news is that abdominal migraines go away on their own in almost all cases, according to a PubMed study.

You have to pay attention to this in the case of abdominal migraines

Although they can be uncomfortable (and sometimes painful), abdominal migraines go away. And most of the time they are not dangerous either. In some cases, however, you may need to see a doctor immediately, especially “if the pain is severe and accompanied by fever, loss of appetite, inability to urinate, bloody or black stools, a visit for urgent assessment should be recommended,” advises Dr. Perelman.

Abdominal migraines could be a precursor to more migraines in the future. “AMs dissolve with age and time,” says Dr. Scott. “However, a high percentage of these children will develop migraines later.” If a family has a history of migraines, you should speak to your child’s pediatrician and a pediatric oncologist to find out what the next steps should be.

While seeing your little darling in pain is annoying, keep in mind that the stomach migraines will eventually go away – permanently. But if you ever have questions about the severity of the condition (or wondering what’s normal and what’s not), trust your own gut instinct and speak to your child’s pediatrician to find the answers you need.

cited studies:

Popovich, D, Schentrup, D., McAlhany, A .. “Recognizing and Diagnosing Abdominal Migraines” 2010.

Mani, J., Madani, S. “Pediatric Abdominal Migraines: Current Perspectives on a Lesser-Known Entity” 2018.

Brenner, M., Lewis, D. “The Treatment of Migraine Headaches in Children and Adolescents” 2008.

Experts:

Dr. Denise Scott, MD, pediatrician at JustAnswer

Dr. Alexander Perelman, MD, certified gastroenterologist with Vanguard Gastroenterology in New York City

Dr. Victoria Glass, MD, practicing physician at the Farr Institute