The Mystery of Abdominal Migraines
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When the topic of migraine headaches comes up, most people think of episodic and sometimes severe headaches. For the parents of 1 to 4 percent of children, however, migraines can take a different and distressing form. These children cope with severe and occasional episodes of stomach-area distress, nausea, and vomiting that are known as abdominal migraines.
According to the American Migraine Foundation, abdominal migraines typically appear around the age of 7 and affect more girls than boys. They often resolve by the late teenage years, although some individuals will continue to experience them later in life.
What are the symptoms of abdominal migraines?
Children who experience abdominal migraines may have migraine headaches, as well. The Migraine Trust says that 7 out of 10 people with abdominal migraines have a current or previous migraine headache.
Head pain is usually not a symptom when abdominal migraines occur.
The pain of an abdominal migraine episode often begins around the belly button and progresses to loss of appetite, vomiting, nausea, and a pale appearance.
“These episodes can be quite severe and debilitating,” says Morgan Allyn Sendzischew Shane, M.D., a gastroenterologist with the University of Miami Health System. “Some patients develop severe cramping or intractable vomiting or diarrhea, which can be awful, but just as quickly as the symptoms come on, they can resolve with or without intervention.”
What triggers abdominal migraine?
There often aren’t clear triggers for the condition. This means an abdominal migraine attack may seem to strike without warning.
“Some patients have triggers that are similar to their headache triggers — too little sleep, other illness, environmental or food triggers — however, many have no identifiable trigger,” says Dr. Shane.
“Some women experience more around their menstruation (similar to many with migraine history), but this is not an absolute rule.”
Since abdominal migraines present with symptoms in the abdomen rather than the head, they can be tricky to diagnose.
This type of migraine typically occurs in children, who often have trouble describing their symptoms and how they feel. You can understand why abdominal migraines can be difficult for doctors to diagnose. In fact, the American Migraine Foundation reports that the average length of time it takes to get an abdominal migraine diagnosis after first experiencing symptoms is two years.
“The key to diagnosis is obtaining a good history and asking detailed questions about symptom complexity, frequency of symptoms, and symptom-free periods. This can really help clinch the diagnosis,” says Dr. Shane. “There are no specific tests that confirm this diagnosis, but testing can be done to rule out other illnesses that can sometimes present similarly.”
How do you treat an abdominal migraine?
The good news is once a diagnosis is made, doctors can help formulate a treatment plan to address symptoms as they arise and minimize the severity of future abdominal migraine attacks. The primary treatment approach is to reduce the severity of symptoms such as nausea, vomiting, or abdominal cramping with the appropriate medication.
“Once a diagnosis has been established, patients who can recognize the onset of symptoms early may be prescribed medications that stop the progression, similar to those used in migraines,” says Dr. Shane.
“The key is to recognize symptoms early and kind of ‘nip it in the bud.’”
Wyatt Myers is a regular contributor for UHealth’s news service.