Abdominal migraine is a common cause of abdominal pain in children. The issue usually resolves by adulthood, but some children go on to develop migraine headaches as adults.
In this article, we look at the causes and treatments of abdominal migraine in children, as well as how prevalent it is, and which prevention strategies might help.
Research from 2020 reports that abdominal migraine affects 0.2–4.1% of children, and doctors commonly diagnose it in kids aged 3–10 years. The condition usually peaks at around 7 years of age, and most children grow out of it by their teens.
The review notes that most relevant data comes from Europe and the United Kingdom, suggesting a lack of awareness among clinicians in other areas. This may mean that the condition is underdiagnosed and underreported.
Weeks or months may pass between abdominal migraine episodes. Usually, there are no symptoms during these lulls. The episodes may last 2–72 hours.
Abdominal migraine usually does not cause a headache in children. Instead, it may cause:
- moderate to severe stomach pain that interferes with daily activities
Abdominal headache may cause:
- a pale appearance
- a loss of appetite
- an aversion to bright lights or movement
- a headache
Younger children may not be able to explain how they are feeling. Parents and caregivers should look for nonverbal signs of pain — such as the child holding their belly, pulling their legs toward their belly, or crying inconsolably.
Abdominal migraine is an idiopathic disorder, which means that experts do not fully understand the cause. However, a family history of migraine headaches may increase the risk of a child experiencing abdominal migraine.
The 2018 review cited evidence that some people may have a higher sensitivity to the normal activity of the body’s organs, known as visceral hyperalgesia, and that this may make episodes more likely.
Stronger evidence shows that factors such as the following can trigger abdominal migraine episodes:
- bright light
- a lack of sleep
- stress or high emotions
- travel or motion sickness
- chemicals in foods, such as colorings and flavorings
- processed foods
- citrus fruits
There is no single test for abdominal migraine. Instead, a doctor considers the symptoms, including their frequency and severity, and does a physical examination.
The doctor may ask the child to point to the painful area, and they may listen to the bowels with a stethoscope. They may also ask the accompanying adult about any family history of migraine.
To rule out other potential causes of abdominal pain, such as appendicitis or constipation, the doctor may order:
- urine tests
- liver function tests
- stool tests
- an ultrasound scan
- a CT scan
- an MRI scan
A doctor will only diagnose abdominal migraine after they have ruled out other possible causes of the symptoms.
Treatment for abdominal migraine involves relieving current symptoms and preventing future episodes. Doctors usually recommend preventive strategies before they prescribe medication.
Doctors often begin by recommending that a child gets enough sleep and avoids common triggers, such as stress and bright lights.
Behavioral therapy, such as cognitive behavioral therapy, or CBT, may help when stress or anxiety are contributing to episodes. A doctor might also consider hypnotherapy, family therapy, or therapeutic exercise, such as yoga.
If lifestyle changes and therapy do not help, a doctor
- pizotifen, a drug that prevents migraine headaches and cluster headaches
- flunarizine, a calcium channel blocker that reduces muscle spasms
- cyproheptadine, an antihistamine
- propranolol, a beta-blocker that helps with migraine
- topiramate, a drug designed to treat epilepsy that helps prevent migraine episodes
To relieve the symptoms of an abdominal migraine episode, a doctor may recommend or prescribe:
- nonsteroidal anti-inflammatory drugs, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to relieve the pain
- serotonin receptor agonists, known as triptans, to alleviate the pain
- antiemetics, to reduce nausea and stop vomiting
Children with abdominal migraine may need to try more than one type of medication before their symptoms are under control.
Most children with the condition outgrow it, without treatment, by the time that they reach their teens. Although possible, it is rare for abdominal migraine to last into adulthood.
However, children with abdominal migraine are more likely to have migraine headaches when they are older, compared with kids who do not have the condition.