Abdominal migraine is a chronic condition that causes severe, sometimes disabling abdominal pain. Specifically, abdominal migraine is characterized by recurrent abdominal pain without a physical cause. It is often associated with other periodic syndromes, such as cyclic vomiting syndrome and migraine limb pain.
Abdominal migraine is usually diagnosed in childhood, but adults, especially those with a family history of migraines, can also develop the condition. Abdominal migraines have a prevalence of about 2 percent to 4 percent of children, and girls are more likely to experience abdominal migraine than boys. Most people living with abdominal migraines begin to experience them between the ages of 3 and 10.
People living with abdominal migraine usually feel healthy between episodes, and children experience normal developmental milestones. Between episodes of pain, people living with abdominal migraine have normal physical and neurological exams.
The main symptom of abdominal migraine is severe abdominal pain. The pain can be in the midline of the abdomen, around the belly button, or spread out over the abdomen. Abdominal migraines are characterized by cyclical disease patterns. In other words, people living with abdominal migraines feel healthy most of the time, but will periodically experience symptoms.
During an episode, people who have abdominal migraine may experience intense abdominal pain and other symptoms. Usually, people will report some combination of the following:
The episodes of abdominal pain and other symptoms often interfere with daily life. The average duration of an episode is 2 hours to 13 hours, and episodes may be experienced between three and 50 times per year.
Abdominal migraine isn’t caused by a physical problem in the abdomen, which makes finding the cause of this condition challenging. Researchers are still working to figure out the processes that cause abdominal migraines. There does seem to be a genetic component, as the majority of people with abdominal migraine have a personal or family history of migraine headaches.
For people with abdominal migraines, certain triggers can sometimes bring on episodes. Triggers may include:
A thorough personal and family history of disease, a physical examination, and symptom-based guidelines are typically used to diagnose abdominal migraine. Usually, no tests are required to diagnose abdominal migraine, though several tests may be done to try to find a physical cause of abdominal pain.
A definitive diagnosis of abdominal migraines usually takes a long time because doctors have to rule out several other conditions that could be causing the symptoms. Abdominal migraine may be diagnosed in people who have abdominal pain that is not caused by any notable functional or physical differences in the abdomen. Abdominal migraine is even more likely when a person’s symptoms are unlike those of gastrointestinal disorders such as irritable bowel syndrome.
Once a diagnosis is made, health care providers must take into account the severity, frequency, and decreased quality of life associated with episodes when designing a treatment plan. Although there is currently no cure, some methods can help with symptom management and episode prevention.
Usually, avoidance of triggers (such as stress, travel, and fasting) is a first step in managing abdominal migraines and preventing episodes.
Specific dietary changes are often the first treatments recommended for abdominal migraine. In some cases, maintaining a diet that is low in amines (products of protein breakdown) reduces the frequency and severity of attacks. Other restrictive diets may also be recommended based on a person’s specific condition.
Cognitive behavioral therapy has also been beneficial in many cases of abdominal migraine.
Drug therapy is usually considered only after other interventions have not worked.
Methods that help treat migraine headaches, such as nasal sumatriptan, may also be effective for treating abdominal migraine symptoms. If attacks are severe and frequent, preventive drugs used for migraine, such as Inderal (propranolol) or cyproheptadine, may be required.
Many children diagnosed with abdominal migraine continue to have this condition through adulthood, though most grow out of the condition.
One study followed more than 50 children with abdominal migraine for over a decade. Researchers reported that abdominal symptoms went away in 61 percent of cases, but symptoms continued into the late teens in 38 percent of cases. Seventy percent of the children involved in the study developed migraine headaches over the course of observation. This study showed that children with abdominal migraine have a high risk of developing migraine later in life.
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