ABDOMINAL MIGRAINES IN CHILDREN AND ADULT
Abdominal migraines are a form of migraine characterized by severe cramp or pain in the center of the abdomen, around the belly button.
- This type of migraines are not headaches, but they often happen as a reaction to the same triggers for migraine headaches.
- They are more common in children ages 5-8, but can also occur in adults, commonly with a family history of migraines.
- When adult experience abdominal migraine, disorders such as irritable bowel syndrome, lactose intolerance are first considered. This is because the condition isn’t often diagnosed in adults.
- Children who have abdominal migraines grow out of it by their teens and eventually go on to develop migraine headaches as adults.
- Abdominal migraines are more prevalent in female than in the male.
- Children who suffer from abdominal migraines are more likely to have mental health issues, such as anxiety as adults.
CAUSES
The exact cause of an abdominal migraine is unknown.
Some studies have shown that the condition is triggered by endocrinologic and neurologic changes and may be caused by an alteration in levels of two compounds – histamine and serotonin, which the body makes.
Genetic factors may also be involved as the condition is prevalent in children who have a family history of migraines.
Common triggers for abdominal migraines are:
- Stress either negative or positive such as worrying over a certain situation or excitement before a situation.
- Changes in sleep pattern
- Swallowing lot of air
- Fasting and skipping meals
- Exercises may trigger the condition in some people
- Food triggers such as chocolate, cheese, citrus fruits, processed meats with nitrites, Chinese foods with monosodium glutamate (MSG), and alcohols.
SYMPTOMS
The most common symptom is a severe pain at the center of the abdomen usually around the belly button. This pain may be accompanied by:
- nausea and vomiting
- loss of appetite
- skin paleness
- weakness
Symptoms are usually relieved by sleep and may last from 2-72 hours.
DIAGNOSIS AND TREATMENT
Making diagnosis can be hard because of the absence of a headache and because kids have a big trouble telling the difference between an ordinary stomach ache and an abdominal migraine.
No diagnostic test exists to confirm the condition. However, diagnosis can be achieved by reviewing family history, medical history, physical examination and carrying out other investigations to rule out other medical conditions such as irritable bowel syndrome, peptic ulcers, kidney disorders, bowel obstruction, and gastroesophageal reflux.
The diagnostic criteria set out by the International Headache Society may also be used. The criteria have the following characteristics:
- At least five attacks of abdominal pain, fulfilling criteria B-D
- Pain that has at least two of the following:
- Occurs in the middle of the body, near the belly button and is poorly localized.
- Has dull or ‘just sore” quality
- Is moderate or severe
- Abdominal pain characterized by at least two of the following
- Anorexia
- Nausea
- Vomiting
- Pallor or paleness of the skin
- Attacks at least 2-72 hours when left untreated or unsuccessfully treated
- Complete freedom from symptoms between attacks
- Not caused by another disorder
TREATMENT
Treatment options aim to reduce symptoms of an acute attack and to prevent and reduce the severity of future episodes.
Medications such as NSAIDs, antinausea medications, triptans used for other forms of a migraine may be used for abdominal migraine attacks.
The choice of medications is often dependent on the age of the patient.
Preventive therapies used for other migraines may be explored for recurrent abdominal migraine attacks.