Abdominal Migraine In Adults Symptoms

Abdominal Migraine From Childhood To Adulthood

Children and teens who have abdominal migraine are more likely to have migraine attacks as adults. One study found that 7 out of 10 children with abdominal migraine went on to have migraine attacks as an adult.2

Abdominal migraine is less common in adults but it does occur, most often in people with a family history of migraine. In both children and adults, the person is healthy in between episodes.1-3

Treatment For Abdominal Migraine

Treatment for abdominal migraine often focuses on prevention rather than abortive methods. There are medications that are effective for some patients, but doctors are usually hesitant to prescribe them to children unless the attacks are frequent, or the symptoms are very severe.

One of the major problems is that, while typical migraine medications may work, many are not approved for children. This is the case with two popular triptans, Maxalt and Imitrex . The medications are not approved for children, but some older children may be able to use sumatriptan delivered as a nasal spray.

Other medications for abdominal migraines include:

• Periactin is an antihistamine that also helps calm stomach problems
• Inderal is a beta blocker used to treat heart conditions but is also effective for migraines
• Sandomigran is benzocycloheptene-based drug that is often used to treat migraine headaches
• Depakote or Depakene is used to treat seizures as well as bipolar disorder and can help stop abdominal migraine attacks

Unfortunately, most treatments for abdominal migraines are pharmacological in nature, Dr. Caminez says. Anti-seizure, anti-inflammatory or even anti-depressants are common treatments and, in many cases do help, but fail to address the underlying condition which caused the problem in the first place.

What Is Abdominal Migraine

Healthcare providers are still trying to figure out exactly how or why thebrain communicates with the gut during an episode of abdominal migraine. It seems like the same neurological trajectory as a traditional migraine is triggered, except for the fact that pain receptors in the abdomennot the headbegin firing.

In fact, other than this one difference, an abdominal migraine attack is extremely similar to a common migraine attack there is a surprising amount of overlap between symptoms, triggers, and treatment. The most common symptoms of abdominal migraine are abdominal pain, nausea, and vomiting. The abdominal pain is usually in the central abdomen and often described as soreness or achiness.

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Who Is At Risk For Abdominal Migraine

Abdominal migraines mostly affect children, with the first episode occurring between 3 and 10 years old. Most children seem to outgrow the condition, though abdominal migraines in adulthood are just starting to be studied. A child with a family or personal history of migraine headache has an increased chance of developing abdominal migraine.

Is There A Connection Between Migraine Headaches And Abdominal Migraines

Children with abdominal migraines usually have a family history of migraine headaches. According to a review published in Pediatric Health, Medicine and Therapeutics, a history of migraine headache in a first-degree relative is described in 34 percent 90 percent of patients.1

Theyre also more likely to get migraine headaches when they get older. Between 24 percent and 47 percent of kids with abdominal migraine develop migraine headaches.2 Abdominal migraines are also more common in girls than boys.

Doctors often treat abdominal migraine similarly to migraine headaches. Depending on the childs age and the severity and frequency of the attacks, a doctor may start with non-drug treatments and progress to other therapies.

Education is the first step to feeling better. Sometimes, knowing the attacks will improve on their own, as well as knowing the triggers, will ease a childs worries. Cognitive Behavior Therapy can also help manage chronic pain as well as the stress that may trigger an abdominal migraine.

In certain cases, doctors may prescribe over-the-counter anti-inflammatory medication, acetaminophen and/or antinausea medication. Sumatriptan, used to treat migraines in adults, taken as a nasal spray, has shown some success in children with abdominal migraine.3 Other possible treatments include tricyclic antidepressants Valproic acid, an antiseizure medication and ergotamine medications, which doctors also prescribe for adult migraines.

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Triggers Of Abdominal Migraines

Doctors offer several hypotheses regarding triggers of abdominal migraines in children. Some say it may be due to food allergies, abnormal catabolism of certain hormones, and/or stress affecting the central nervous system and gastrointestinal tract. However, none of these theories have yet been verified as causes of abdominal migraines.

Treatment Options For Abdominal Migraines

Anti-nausea medications and NSAIDS are typically prescribed to treat abdominal migraines. Medication choices differ according to the age of the child. Although some children experience spontaneous resolution of an abdominal migraine before age 11, many go on to suffer migraines in adulthood because the root cause of their abdominal migraine was never addressed properly.

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Symptoms Of An Abdominal Migraine In Children

The International Headache Society offers the following diagnostic criteria for an abdominal migraine:

• Abdominal pain lasting at least one hour and up to 72 hours
• Poorly localized pain of moderate to severe intensity
• Abdominal pain accompanied by vomiting, nausea, lack of appetite and pallor

Abdominal migraine pain can be diagnosed correctly when new or existing renal or gastrointestinal disorders are ruled out. Pain should be severe enough to restrict children from engaging in normal activities. In addition, some children develop dark circles under their eyes, while others may show signs of flushing or reddening of the face.

Abdominal Migraine In Adults

Abdominal migraine occurs most often in children and is rare in adults. But if you experience chronic, recurrent abdominal pain and your doctor has ruled out other conditions, abdominal migraine could be the cause. Also, having a family history of migraines or getting migraine headaches may mean youre having abdominal migraine. Adults with abdominal migraine are treated the same as children.

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What Treatments Are Available For Abdominal Migraines

Children receive treatments based on their symptoms, and the causes and triggers for their abdominal migraines.

Once your care team determines the stress, event or food that triggers the abdominal migraine, they will work to remove that source of stress and reduce your child’s pain. Your doctor might suggest medications to relieve pain or medications used to treat migraines. It is important to know that some medicines may not work for your child, so talk to your doctor about options.

“Remember that the medicines stop an attack, but they do not prevent one,” says Dr. Sanghavi. To prevent an abdominal migraine, work with your child to monitor and reduce stress and avoid eating trigger foods.

Other treatments include:

• Cognitive behavioral therapy

“Stress cannot always be controlled, but we can teach a child how to control their body’s response to stress,” says Dr. Sanghavi. “We recognize that some children need help relaxing.”

Children likely outgrow abdominal migraines, but may develop migraine headaches during adolescence or adulthood. “Managing migraines is not a sprint, but a marathon,” says Dr. Sanghavi. “We help families make lifestyle changes now that will last for life.”

What Is An Abdominal Migraine

Much like their name indicates, abdominal migraines create recurring episodes of gastrointestinal symptoms, according to Morgan Sendzischew Shane, M.D., M.S.C.T.I., gastroenterologist and assistant clinical professor, division of digestive health and liver diseases at the University of Miami Health System. While they are most likely to occur in patients who already suffer from migraines, some people may experience abdominal migraines without any history of migraine symptomsand sometimes without even the tell-tale headache that normally accompanies a migraine. According to the American Migraine Foundation, attacks can last from two to 72 hours, and a person often has no symptoms between attacks. And, interestingly, the disease is mostly seen in children.

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How Is An Abdominal Migraine Diagnosed

Even though abdominal migraine is more common in children, it is still a rare condition. It is important to see a pediatric gastroenterologist who can rule out other causes of abdominal pain first, such as:

Because a diagnostic test is not available to diagnose abdominal migraine, Dr. Sanghavi explains that doctors oftentimes make a diagnosis of exclusion, ruling out other conditions to arrive at a diagnosis.

What Parents Need To Know About Abdominal Migraine

One of the biggest concerns of parents who have children with abdominal migraines is the severe pain that the condition inflicts during an attack. Sometimes they are hesitant to take the child to the doctor, thinking that it is a stomach flu or just a little stomach bug. However, if your child is experiencing severe abdominal pain, especially if it happens more than once, they should see a doctor to rule out other, more serious problems.

Many parents are often concerned that even though the pain comes and goes, during an attack it is so severe that is often interferes with the childs daily activities which includes school. Several abdominal migraine episodes during one school year could result in the child missing a lot of school.

For parents who suspect their children may have abdominal migraines, Dr. Caminez has this advice, I recommend they always start with the childs pediatrician who can then be a referral source to a headache specialist. I find that abdominal migraines, like migraines in adults can be very confusing to diagnose. He continues, I have seen children as well as adults with migraines dismissed by doctors who just feel the condition is in their head. I always remind parents and patients that their doctor is there to give their expert opinion and treatment but if the parent is not satisfied with the care, it is never a bad idea to get a second opinion.

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Causes Of Abdominal Migraine In Adults

Like migraines, abdominal migraines are thought to be caused by neurological problems. There is a well-established relationship between the brain and the gut known as the brain-gut connection. Doctors dont fully understand what causes migraines or abdominal migraines, but they do know that there is a neurological component that affects the head and gut.

Often, abdominal migraines can have the same triggers as migraines. These may include stress, weather changes, certain foods, or lack of sleep. If you think you have abdominal migraines, keep a journal to help identify which triggers may have caused your attacks.

A Healthier Alternative To Treating Abdominal Migraines

An ear, nose and throat specialist and board-certified facial plastic surgeon, Dr. Smith offers an innovative and research-based technique for treating abdominal migraines involving repair of deviated septums and/or bone spurs.

In his research on migraine patients, Dr. Smith discovered that people undergoing rhinoplasty frequently remarked they no longer suffered migraines after surgery. This led him to investigate a possible relationship between deviated septums and migraine pain. He ultimately concluded that people with deviated septums crooked, bent or abnormally shaped due to trauma often experienced symptoms nearly identical to migraine headaches. Restoring normal structure to deviated septums therefore brought migraine pain relief to his patients.

You can learn more about Dr. Smiths treatment for abdominal migraines by calling Smith Center today at 795-0600.

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Treatment Of Abdominal Migraines

Once an abdominal migraine has started, you can treat it the same way that you would treat a migraine headache. The use of NSAIDs like Advil can help control the pain. Triptans can be used to stop the attack before it gets worse. In addition, your doctor might recommend anti-nausea medications and rehydration, particularly if your abdominal migraines include severe vomiting.

How Is Abdominal Migraine Treated

Once a child is diagnosed with abdominal migraine, treatment generally falls into two categories: relieving symptoms during an episode and preventing future episodes.

While there are few studies on the treatment and management of abdominal migraine, doctors may prescribe the following medications, based on their usefulness in treating migraines:

• NSAIDs or acetaminophen to relieve the pain.
• Triptans. This family of drugs is commonly used to treat migraine headaches and, if taken as soon as a migraine starts, can prevent symptoms from progressing.
• Anti-nausea medication. Anti-nausea drugs act by blocking chemicals in the brain that trigger vomiting.

Some studies have shown evidence to support the use of the following medications in preventing abdominal migraine:

• Pizotifen, a benzocycloheptene-based drug.

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What Are The Symptoms Of Abdominal Migraines

It can be hard to know if you or your child has abdominal migraines. Theyre not a well-known diagnosis, and they can lead to symptoms that many things can cause. There are several symptoms providers use to diagnose abdominal migraines that can help you figure out if theyre happening to you.

The symptoms and characteristics of abdominal migraines include:

• Abdominal pain: This can range from dull pain around the belly button to cramping pain all over the abdomen. Its generally severe enough to keep children from doing their daily activities.

• Episodic: Theres usually a sudden start to the abdominal pain, which then goes away between episodes. Each episode generally lasts between 2 hours and 72 hours.

• Recurrent: This means the episodes of abdominal pain keep repeating themselves. Episodes are usually separated by weeks to months.

• Pallor: More than 90% of children are pale during episodes of pain.

• About 90% of children do not feel like eating during episodes.

• Nausea and vomiting: About 80% of children have nausea during an episode. A smaller number actually vomit.

• Aura: Similar to migraine headaches, sometimes children who have abdominal migraines will have other symptoms before their pain starts. This can include seeing flashing lights or numbness or tingling in their extremities.

The Microbiome And Abdominal Migraines

The microbiome, the good and bad bacteria in our intestines, tells the brain when the body is healthy or not healthy. “Changes in the microbiome play a key role in gut health and can lead to abdominal migraines and other conditions such as irritable bowel syndrome,” says Dr. Sanghavi.

Probiotics, the living “good” bacteria found in foods such as yogurt and cheese help maintain good bacteria in the intestines. The American diet is low in these nutrients, explains Dr. Sanghavi, preventing good bacteria from growing. Taking a lot of antibiotics can also disrupt the healthy balance in the gut and encourage the harmful bacteria to thrive.

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When To Seek Professional Treatment

If you think you have an abdominal migraine, you should consult your doctor. There are treatments to prevent and treat abdominal migraines so that the condition doesnt often interfere with your daily life. Also, since abdominal migraines can increase the risk of migraines, its best to let your healthcare provider know about the condition so they can track your progress and recommend appropriate treatment.

Diagnosis Of Abdominal Migraines In Adults

Theres no definitive test that is used to diagnose abdominal migraines, just like there is no test that can diagnose migraine headaches. Instead of relying on a test, the diagnosis of abdominal migraine is made based on a persons symptoms. In order to be diagnosed with the condition, you must:

• Have had at least five attacks of abdominal pain, characterized by a dull, moderate to severe pain around the belly button
• Have no gastrointestinal symptoms between attacks, and no other gastrointestinal conditions

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Causes Of Abdominal Migraines In Adults

Like migraine headaches, abdominal migraines are thought to be caused by neurological issues. There is a recognized relationship between the brain and the gut , known as the brain-gut connection. Doctors dont entirely understand what causes migraine headaches or abdominal migraines, but they know that there is a neurological component that affects both the head and the gut.

Oftentimes, abdominal migraines can have the same triggers as migraine headaches. These can include stress, weather changes, certain foods, or poor sleep. If you believe that youre suffering from abdominal migraines, keep a journal to help determine which triggers might be causing your attacks.

Resources For Abdominal Migraine Patients And Their Families

Although abdominal migraines are rare, there are several very good resources for patients and their families. Facebook has two very good groups and some parenting and health forums have good threads that discuss the condition.

• Patients Like Me

Sometimes it helps just to know that you are not alone in a situation. Sometimes it helps to hear from someone who has been where you are, who has gone through what you are experiencing. Look for support groups in your area as well as online. You dont have to go through it alone and you shouldnt have to.

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Diagnosis Of Abdominal Migraine

A diagnosis of abdominal migraine is what Dr. Elton calls a diagnosis of exclusion. Meaning, you cant definitively diagnose someone with it because there are no tests to confirm it exists. But, you can rule out other conditions that cause similar symptoms and, ultimately, end up at an abdominal migraine diagnosis if everything else seems in order.

The provider can start with a comprehensive medical history and physical examination it is particularly important they ask about family history of migraine or headaches. Many times, you do not need a specialist to diagnose abdominal migraine. If the provider performs a physical examination for your child, runs blood panels or other diagnostic tests, and cant find any sign of GI disease, irritable bowel syndrome , ulcers or obstructions, reflux, or gallbladder issues, thats a good sign that the problem may not be with the gut but with the brain. At that point, your child may be referred to a neurologist.

But dont jump the gun: Dr. Elton says a primary care provider or pediatrician is the best first step to take before seeing a specialist. They can rule out acute viral infection, ask you about your family history of migraine or GI illness, and decide where to refer you next, if need be.

It can be tricky to diagnose abdominal migraine, but the diagnostic criteria includes the following:

• The child has at least five attacks of abdominal pain, and include:
• Pain has at least two of the following three characteristics: