In this blog, we answer common questions about abdominal migraine that we hear on The Migraine Trust helpline.

What is abdominal migraine?

Abdominal migraine is thought to affect around four percent of children and a small number of adults. The main symptoms of abdominal migraine include:

• Regular attacks of moderate to severe stomach pain that last from 2-72 hours (for most people the symptoms should resolve between attacks)
• Feeling sick and vomiting during attacks
• Loss of appetite and paleness
• No headache during attacks
• Feeling normal between attacks

Most children who experience abdominal migraine grow out of it by their teens, but often go on to develop migraine headaches. It can often be mistaken for other conditions, and isn’t very well known or understood. Unfortunately, we don’t know why some people get abdominal migraine.

There is very little information on abdominal migraine in adults. Some people experience other migraine symptoms with the stomach pain such as sensitivity to light, sound and smell, fatigue and headache.

What causes abdominal migraine?

Abdominal migraine is an idiopathic disorder, meaning it is not understood why people get it.

There are possible associations with other conditions such as cyclical vomiting syndrome, and migraine limb pain, as well as benign paroxysmal vertigo, infantile colic, Raynaud’s disease and hypermobility syndrome.

Abdominal migraine and cyclical vomiting syndrome can have similar symptoms, however, cyclical vomiting syndrome has severe and constant vomiting, up to five or six times an hour. You can find out more about cyclical vomiting syndrome from CVSA UK. If you are not sure which condition you or your child may have, your GP can review your symptoms and provide an appropriate diagnosis and treatment plan.

How is abdominal migraine treated?

There are treatments that can be tried to help relieve the symptoms but some may not be suitable, it will depend on age, symptoms and medical history. Treatment usually falls into either acute treatment, with the aim of stopping or shortening an attack; or preventive treatment, which is taken daily to reduce how often someone has attacks and how bad they are.

Acute treatment options often include anti-sickness medication, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and focusing on hydration. For some people a triptan (a migraine-specific painkiller) can be used but this will depend on the symptoms and whether the doctor thinks it’s appropriate.

Preventive treatment is often used when someone is having more than four attacks a month, or their attacks are very severe. There is no standard preventive and often the doctor will suggest a treatment based on symptoms, medical history and personal preference. Some standard preventives include beta-blockers, tricyclic antidepressants or anti-epileptics (but suitability varies according to age). If these are tried and are unsuccessful then the doctor may look at other treatment options to help, or referral to a specialist.

What else can help?

In general, migraine (of any type) does better with consistency and balance in activities and can be triggered by several factors. Knowing what these triggers are can help to reduce the likelihood of an attack, although not all triggers will be preventable. It is often unlikely that any one thing will trigger migraine on its own and it is usually a combination of factors. Attacks might be triggered by changes in routine, so it is best to strive for regularity where possible such as eating regularly, staying well hydrated, reducing stress, sleeping at regular times. For children, bright light, travel and hunger can also act as ‘triggers’ for migraine attacks.

Keeping a headache diary is useful. You can note down when an attack happens, the symptoms and what treatments have been tried. This can help the doctor make a diagnosis and identify if there are any patterns to the attacks.

For more information about abdominal migraine, click here. For information about how to help a child or young person with migraine, click here.

If you or a loved one has questions about migraine or is in need of support, you can contact us via our free helpline on 0808 802 0066 or visit migrainetrust.org/contact-us. You can also chat to us online through our new live chat service at migrainetrust.org.