Abdominal Migraine


Abdominal migraine is a type of migraine attack that commonly occurs without the headache. It presents as central upper abdominal pain with facial flushing and pale coloration, and with episodes of vomiting in both children and adults.



What Is an Abdominal Migraine?

An abdominal migraine is a form of migraine that occurs commonly in children, with or without the headache component of migraine. Abdominal migraines start as early as three years of age and peaks around age 9 for girls and age 14 for boys. Both abdominal and head migraines are hereditary.

People suffering from abdominal migraines often present several symptoms:

  • Recurrent upper or central abdominal pain
  • Headaches (may or may not accompany abdominal pain)
  • If headache occurs, pain could occur on either side of the head, both sides, or the front
  • Nausea and/or vomiting
  • Feeling and looking flushed with pale colouration
  • Restless and irritable
  • In severe cases, attacks could occur as frequently as 2 to 3 episodes in a week
  • Each attack of abdominal pain may last from a few hours up to 3 to 4 days
  • There may be associated loose stools or diarrhoea
  • Puffiness in the face
  • Abnormal response to light and altered smell sensation
  • There may be increased frequency of passing urine, or an increase in the volume of urine passed during the attacks
  • Reduced appetite
  • Yawning
  • Syncope or "passing out"

Abdominal migraine is a totally different entity from recurrent abdominal pain syndrome. Between attacks, abdominal migraine sufferers can feel completely well. 

Symptoms of Abdominal Migraine

Abdominal migraine typically causes recurrent attacks of central abdominal pain, usually around the umbilicus or belly button, lasting for several hours with associated nausea, vomiting and occasionally one sided headache.

The sufferer may become pale and the pulse may be difficult to feel, or even run very slowly. They may also become very flushed.

Like those with migraine, there may be a preceding aura of visual disturbance, flashing lights, numbness or tingling sensation around the mouth, arm or a side of the body, slurred speech, muscle weakness or even paralysis.

The child or adult may become emotionally withdrawn, with altered sleep pattern. There is associated dislike or sensitivity to light and sound too. The pain typically starts in the morning. It is so serious to interfere with day to day life.

In between episodes, they are usually totally free from abdominal pain and feel okay again. The pain typically last for about 2 - 72 hours. In reality, the abdominal pain last for at least four hours, and may keep re-occurring for the next three to four days with symptoms free interval.

Diagnosis of Abdominal Migraine

The diagnosis of abdominal migraines hinges on running tests to eliminate the possibility that the patient is actually suffering from another ailment presenting similar symptoms. Though painful, in most estimations, an abdominal migraine will be one of the least threatening causes of severe, recurring abdominal pain. Thus, a doctor’s job in diagnosing abdominal migraine is to ensure the patient is not actually suffering from a more dangerous physical problem.

Healthcare professionals use two types of tests to diagnose abdominal migraines:

  • An EEG (electro-encephalogram) detects abnormalities in brain waves
  • Visual Evoked Response (VER) tests the visual nervous systems and ensures the visual disturbances a patient may be experiencing are not the result of tumours,  optic neuritis, retinal disorders, or other diseases of the eye 

Triggers and Causes of Abdominal Migraine

Much like migraine headaches, the exact cause of abdominal migraine is somewhat a mystery. They may be the result of chemical changes in the body which originate in specific parts of the brain, namely the amygdala, area post-trema and hippocampus. Serotonin and histamines are two of the chemicals thought to be involved in causing the symptoms found in abdominal or stomach migraine.

A high incidence of abdominal migraines have been reported in individuals with neurofibromatosis, especially type one. It is a very common cause of abdominal pain in these patients.

In more than half of children with tummy migraine, there is usually someone in the family who suffers some form of migraine. Stomach migraines are often triggered by:

  • Moderate to severe emotional or physical stress
  • Little or too much sleep
  • Eating certain types of food items like cheese, chocolate, or acidic drinks, fizzy drinks, red wine, or for some, any form of alcohol, caffeine, food additives like mono sodium glutamate (common in Chinese food and included in many African dishes too - seasoning cubes)
  • Hunger
  • Anxiety associated with travel
  • Dehydration following excessive heat, exercise, fever, diarrhea
  • Minor head injuries
  • Exposure to loud music, flashing or flickering lights
  • A cold or other minor illness 

Treatment of Abdominal Migraine

If a child or adult is suspected to be suffering with abdominal migraine, treatment is usually symptomatic, meaning the healthcare professional will aim to alleviate the symptoms, as no cure for migraines – even abdominal migraines – current exists.

Over the counter pain killer are suitable remedies for the pain if there are no contraindications to taking any of these medicines such as asthma or stomach ulcer (for ibuprofen) or allergies.

Anti-sickness medicines like domperidone have also been found to help minimize vomiting and many of the other symptoms associated with stomach migraine.

Where episodes are recurrent and very troublesome, some patients have found the use of sodium valporate, or pizotifen or nasal sumatriptan (a form of triptans), useful. So too is propanolol and fluoxetine in some other patients (mainly in adults).

Feel free to discuss any of these options with your doctor or health care provider who can either prescribe one or a combination of these to you, or refer you or your child to see a paediatrician with specialist interest in childhood migraines.

You can read a real life story of someone managing abdominal migraines here.



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