Diagnosis and Management of Abdominal Migraine

Abdominal migraine attacks typically cause severe pain to the belly, but so do many other conditions. Because of the relative rarity of this condition, it becomes very easy to confuse the migraine attacks with other gastrointestinal conditions like Irritable Bowel Syndrome for example, which is a gastrointestinal condition that causes serious stomachaches.

 

Diagnosing Abdominal Migraine

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A correct diagnosis of the condition by your doctor is essential in enabling them to know the type of drugs to administer and propose other treatment plans.

Unfortunately, the diagnosis of abdominal migraine may not be as straightforward since there is no one exact test to confirm whether or not one is experiencing abdominal migraine attacks. However, there are several ways that can help doctors determine a diagnosis.

In the case of abdominal migraine in children, the medical history of the child and the child’s family history is important because “children with abdominal migraine often have a family or personal history of migraine headaches, find relief with migraine medications, and share similar triggers and symptoms” [1].

In Migraine Buddy, the statistics regarding this topic seems mixed as half of the respondents from our previous survey shared that either one or both of their parents have migraine

 
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According to the International Headache Society, these are the diagnostic criteria that have to be met before a conclusion can be reached [2]:

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1. There must have been a minimum of five attacks. Each attack should have lasted between two hours to three days when not treated or when treatment did not work.

2. Pain that is characterized by at least two of the following:

  • midline location, periumbilical or poorly localized

  • dull or “just sore” quality

  • moderate or severe intensity

3. Presenting a minimum of two of the following associated symptoms:

  • anorexia

  • nausea

  • vomiting

  • pallor

4. In between attacks, there should be “complete freedom from symptoms.”

5. Other gastrointestinal conditions should be ruled out such as “urogenital disorders, kidney disorders, peptic ulcer, cholecystitis (gall bladder), bowel obstruction, gastroesophageal reflux, Crohn’s disease, and irritable bowel syndrome” [3].

Indeed, Migraine Buddy users’ anecdotal experiences support the notion that getting a diagnosis for abdominal migraine can be challenging:

"It took me a couple dozen doctors and years of appointments to figure out what an abdominal migraine was. Only one doctor has mentioned it to me in connection with my other migraine symptoms. My tricyclic antidepressant treats both my chronic migraine and abdominal ones but does not fully get rid of the symptoms. I would LOVE more research and awareness about abdominal migraine."

“Have experienced it for years but was always passed off by doctors. Learned about abdominal migraine by doing my own research.”

“Doctors did not know what was wrong for years. It wasn't until I was in my 20s, a decade after I developed traditional migraine, that my mom heard about abdominal migraine and realized that's what I had been experiencing as a child.”

“Not every medical professional recognized it. It was recognized by my gynecologist who treated it with hormone replacement which worked—it went away or changed and then was IBS for which I was treated.”

 
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There is definitely more word to be spread about abdominal migraine as it seems that not many healthcare professionals have explained it clearly to their patients. Only a mere 19% of the Migraine Buddy community who answered our survey said that they received such explanations. 

 

Managing Abdominal Migraine

If you’ve been able to receive a diagnosis for your abdominal migraine, you may be wondering about the next steps to deal with this particular type of migraine. Aside from the treatment plans that your physician recommends, below are some of the community’s experiences to manage their abdominal migraine:

 
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Yohanna: “I began Botox treatments this June and the abdominal pain began to lessen as the Botox began to help the headaches. Wow!! Now, the first treatment is wearing off and the abdominal pain has returned with the intense headaches I had before the Botox. My next Botox treatment is early September. I hope I have more to share then.”

Lisa: “Abdominal migraine [...] are extremely common in children and they can grow out of them as they get older. My daughter was given Propanol & Sumatriptan [and] they worked ?? our daughter is 18yrs old now and since being 12 has suffered from cluster migraine & hormonal migraines. But under control now.”

Walker: “My grandson is 10 years old and has been on amitriptyline for about 4 months. The headaches are less frequent and not as bad. Keeping my fingers crossed this will continue.”

Lis: “The only thing that’s helped me at the onset is sumatriptan. I was given a nasal spray of sumatriptan that didn’t help, but was later told they gave me a child’s dose, so that might be worth looking at. I’m now taking migraine preventative medications, and my abdominal migraine have reduced a lot too.”

Betsy: “I recently went thru the most severe abdominal migraine of my life. Went off gluten and dairy and am SO much better. Still getting them, no longer vomiting. Still very nauseous. I was making things worse w/ the gluten (toast, crackers etc). Maybe try to see if there are some diet changes that will help. Vomiting is normal for migrainers! You aren’t alone! Inhaler is awesome. Peppermint great too.”

Cindy: “My brother and I have both had abdominal migraines. I’m 37 and I will still get them. Sumatriptan is the only medicine that relieves them for me.”


Above all, knowing what you are experiencing may allow you to speak more confidently with your doctor or healthcare provider to ensure you get diagnosed and treated. What are your management strategies to combat abdominal migraine? Let us know in the chat group below!