Definition and Overview
An abdominal migraine is a sub-type of migraine. But instead of headaches, it causes pain around the belly button.
It is common in children between the ages of five and nine. It is rarely seen in adults. The pain it causes can be mild, moderate, or severe. It also causes vomiting and nausea. The symptoms can come and go. They can last between two hours and three days.
The condition can be painful and very uncomfortable. But it is rarely a cause for concern. In some cases, it gets better on its own or with sleep. If not, medications are prescribed. It does not pose serious health problems and goes away completely when the child is about 11 or 12 years old.
Its causes are unknown. However, genetics is believed to play a part. The disorder is often found in children with a family history of migraine headaches. Based on research, it affects 2-4% of all children around the world. Many of them go on to develop migraine headaches as they reach adulthood.
Its symptoms can occur for the first time between the ages of two and nine. In some cases, they show when a child becomes too upset or worry too much.
The condition is more common in girls than boys.
Causes of Condition
What causes the condition to occur is unknown. However, it is believed that it occurs due to abnormal serotonin and histamine levels. Serotonin is a neurotransmitter that is involved in regulating cyclic body processes. It also contributes to a person’s well-being and happiness. Those with low levels of this chemical can suffer from depression. Histamine, on the other hand, is another chemical produced by the body. It is released during an allergic reaction.
Genetics is also believed to play a role. Up to 60% of patients have a family history of the disorder.
Other studies, on the other hand, suggest that anxiety and too much stress can cause the levels of histamine and serotonin to go down. Experts say that this can cause the condition to occur.
Other factors that are believed to trigger the disorder are foods that contain too much nitrates (such as processed food) and swallowing too much air.
Just like headache migraines, the condition can also cause severe pain. But instead of a headache, the pain is felt in the middle part of the belly. Other symptoms are vomiting and nausea. Some children also have severe headaches and cramping. These can occur suddenly and without a warning.
Many children lose their appetite because of too much pain. This causes them to lose weight, especially when their condition is chronic. The disorder also causes panic attacks and severe anxiety because some children can find each episode traumatic.
Most patients often feel sleepy and less energetic. Many opt to stay home instead of playing or joining school activities.
Who to See and Types of Treatments Available
The illness can be difficult to diagnose in many cases. This is because there are currently no specific tests for it and many children struggle to describe their symptoms very well.
A number of medical tests are used to rule out diseases and disorders that produce the same symptoms. These include bowel obstructions, Crohn’s disease, and irritable bowel syndrome (IBS). Seizure disorders should be ruled out, too.
Doctors also review the patient’s medical history and perform a physical exam. These are followed by laboratory tests, which may include blood and urine tests. Imaging tests are not always used because they can be expensive. However, in some cases, doctors may request for an MRI or a CT scan.
If the results of all medical tests rule out all disorders that cause the same symptoms, the patient is diagnosed with abdominal migraine.
Treatment of the illness starts with relieving its symptoms. Often, doctors prescribe the same medications used to treat migraine headaches. Patients are also given oral rehydration solutions to replace the fluids and minerals they lose due to vomiting. When needed, they are admitted to the hospital where they are provided fluids through an IV for a couple of days. They are also prescribed with medications to prevent nausea.
Aside from providing symptom relief, the other goal of treatment is to prevent future attacks. This too can be achieved with the use of drugs. Commonly used are drugs used to treat depression. These can block the effects of serotonins. Drugs that are used for the treatment of seizures, as well as antihistamines and low-dose aspirin, are also used.
Other preventive measures may include avoiding certain triggers. These include foods that contain nitrates. If the triggers are unknown, doctors advise the patient (or their parents) to keep a diary of everything they eat or do. This can help identify the factors that may cause the symptoms to appear.
Patients are also advised to:
Eat a well-balanced diet that is rich in fruits and vegetables.
Avoid processed, junk, and fast foods.
Drink plenty of water to help the body flush out toxins.
Get enough sleep.
Learn to manage stress and anxiety.
Be more physically active.
The prognosis for patients with the disorder is good. Treatments are very effective not just in relieving symptoms but also preventing future attacks.
Dignan F, Abu-Arafeh I, Russell G. The prognosis of childhood abdominal migraine. Arch Dis Child. 2001 May;84(5):415-8.
Gelfand AA. Episodic syndromes that may be associated with migraine: A.K.A. “the childhood periodic syndromes”. Headache. 2015;55(10):1358-1364.
The International Headache Society. https://www.ichd-3.org/1-migraine/1-6-episodic-syndromes-that-may-be-associated-with-migraine/1-6-1-recurrent-gastrointestinal-disturbance/1-6-1-2-abdominal-migraine/