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The tummy monster

The tummy monster

Abdominal migraine is a type of migraine most often seen in children. It does not involve headache symptoms. Instead, the pain is located in the belly. Small children will complain of “tummy aches”, refuse food or drink, and usually vomit before the attack is over. Other associated symptoms such as hypersensitivity to sensory stimuli, nausea, and vomiting are common.

Diagnosis

The attacks last at least 2 hours and can be as long as 72 hours. As with other forms of Migraine, this one is a diagnosis of exclusion. In the absence of kidney, liver, gallbladder, or gastrointestinal disease, Abdominal Migraine is considered. This is especially true if one more family member has already been diagnosed with migraine. A diagnosis is confirmed when 5 or more attacks occur, absent headache, with 2 or more associated symptoms (anorexia, nausea, vomiting, or pallor). If a headache is present, then the more accurate diagnosis is Migraine without Aura.

Symptoms

The pain of Abdominal Migraine is in the middle of the abdomen, usually around the belly button, but may be diffuse. The pain quality is dull, rather than the characteristic throbbing of an acute headache phase. It can feel just as intense as the headache phase of a Migraine attack. Nausea and vomiting are common. In fact, recurrent complaints of belly pain followed by vomiting are often the first clues that your child is experiencing Abdominal Migraine. Lack of appetite (anorexia) is also possible. The skin may appear pale (pallor) and feel cold and clammy to the touch. There may be dark shadows under the eyes. Occasionally, a child will experience flushing of the skin instead.

Kids often complain of vague belly pain, so it is important to note that the symptoms of Abdominal Migraine are severe enough to interfere with even play time. A child who is experiencing an Abdominal Migraine attack will be very sick, unwilling or unable to eat, may cry or whine, and frequently vomits. Most of the time Abdominal Migraine is a predictive of developing Migraine with Aura or Migraine without Aura later in life.

Treatment

The treatment for Abdominal Migraine is very similar to the treatment of other Migraine disorders and depends greatly on the age of the child. Anti-nausea medications are used in addition to NSAIDs or triptans. If the attacks are frequent, preventives may be indicated, too.

My family’s experience with the Tummy Monster      

My oldest child started having symptoms of Abdominal Migraine just after her second birthday. Whenever she was exposed to bright lights, loud noises, strong smells, irregular bedtimes, or irregular mealtimes an attack would hit. She would become irritable, whining at everything, refusing food and drink. Within an hour, all the color would drain from her face and she would get very cold. With her tiny arms wrapped around her tummy, she would curl up in my arms for comfort. Then just before she dozed off to sleep from exhaustion, the projectile vomiting would start. For hours afterward she lay limp in my arms staring blankly from swollen eyes highlighted in dark circles — symptoms we now recognize as a “migraine hangover.”

I didn’t know about Abdominal Migraine back then, but suspected that somehow Migraine was to blame. She would have these episodes a few times every month. Then when she was four years old, she started complaining of head pain in addition to the other symptoms. Her symptoms had transformed into Migraine without Aura. Our local general practitioners and pediatricians were reluctant to diagnose headache disorders in children younger than five years old. Not a single doctor we consulted had any knowledge that Abdominal Migraine was even possible. It took a lot of “Momma Bear Advocacy” to get a referral to a pediatric neurologist. Thankfully, we found a good one who recognized the symptoms, made an accurate diagnosis, and prescribed Periactin syrup as a preventive.

Get help

If you have a child who is exhibiting these symptoms, don’t hesitate to fight for excellent care. Small children can and do get headache disorders. As with adult migraineurs, children are best diagnosed and treated by a headache specialist. The Migraine Research Foundation has a list of pediatric headache specialists. They deserve competent, compassionate care just like the rest of us. Early intervention increases the odds of good migraine control for a lifetime.

p.s. Grown-ups can get Abdominal Migraines, too!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Jojiieme
    3 years ago

    Meaghan and Jan, I’m so lucky: no trace of IBS or Crohns although both run in the family, on both sides, as does PCOS. I’m intolerant of caseinate, which loads of people like to tell me means I shouldn’t go near lactose… (I’m sitting here shaking my head), and I have a gluten sensitivity (too much, and I swell; in fact the insides of my ears actually peel!). So I use FODMAPS as a guiding food principle, since the 1980s.
    But I hadn’t put the other bits together, the nasty cramps with that particular kind of compulsive unstoppable evacuation, and the stuff going on with brain and eyes and coordination… Not until a couple of years ago. So when nearly every reference you read says ‘abdominal migraine is a child’s syndrome. The child will grow out of it’, it’s very very disheartening.
    I just am so grateful for this resource, the community and the information. There really is strength and comfort in reaching & hearing each other, isn’t there?

  • Jojiieme
    3 years ago

    OK. I’ve read the links: thanks!
    For me, I’m not strictly FODMAPS (which helps with sanity *grin*) but more low salicylates and amines. So there’s more variety and ease, less stress.
    And also, as I’ve mentioned elsewhere, I’ve done Feldenkrais classes, so I’ve learnt some exercises to help relax tense or painful muscles. When I’m ‘together’, it helps. I really recommend the Pelvic Floor workshops!
    I’ve also done some bellydance about a thousand years ago. Again, using those muscles can be really soothing and helpful if you’re trying to avoid meds.
    BUT a time inevitably comes when only the loo will do! 🙂 I can’t number the pairs of panties I’ve had to discretely throw away in order to make a dignified exit from the Ladies and get safely home to my shower. Luckily I might only have 6 or 8 of these a year.

  • JP Summers
    3 years ago

    As always, another great article! Thank you Tammy for explaining what it is like to have abdominal migraines and even sharing your own personal experiences. Colton’s checks often gets flushed and he’s hunched over when an abdominal migraine episode begins. Although I was never diagnosed with abdominal migraines,my mom truly believes all of the times I ended up in the ER with unexplained stomach pain then uncontrollable vomiting a few hours later was me experiencing them at least a year before I developed episode, migraines with aura. I’ll definitely reference back to this article when I’m trying to better educate others about Colton’s neurological condition.

  • Jojiieme
    3 years ago

    Who’s another adult who still gets these? No-one really knew what they were when I was young; they called them “growing pains” or told me to stop pretending, and then I started menstruating early so everything was just put down to hormones. But now I’m 59, still with periods, still experiencing cramps worse than period pains at least once every couple of months, and those cramps aren’t related to my periods. On the days I have those cramps, sometimes I can barely stand … There’s explosive uncontrollable diarrhoea, and if it goes on too long, a sense that I don’t know how to hold myself together. On Monday someone told me at work I looked terrible (she said this after I started feeling better, noting she could the difference).

  • Jan
    3 years ago

    Oh, JOJ, you can count me in as an adult with abdominal migraine, unfortunately. I’m 54 and have had these since I was a tween. Most doctors call it Irritable Bowel Syndrome, but I’ve decided they are incorrect. I have terrible cramping and vomiting and like you, it’s not related to my menstrual cycle at all. I’m so sorry you go through this, too.

  • Meaghan Coneys moderator
    3 years ago

    Hi JOJ,

    Thank you for your comment. We are so happy you are a part of our community here at Migraine.com! And we love hearing from you! Your experience with abdominal migraine attacks sound quite debilitating. I am sorry to hear you experience such pain. While I’m sure other members of the community will provide a more personal account with abdominal migraines, I thought you would find this article helpful – https://migraine.com/migraine-types/abdominal-migraine/. It provides more information about abdominal migraine attacks, and has a section on its manifestation in adults. Also, you mention experiencing diarrhea, which you are not alone in experiencing as an accompaniment to a migraine attack. The following article discusses diarrhea and IBS – https://migraine.com/blog/the-ugly-truth-poop-issues-and-migraine-disease/. Furthermore there are many community member comments, which you may find helpful. Please continue to reach out to us here at Migraine.com whenever you need. Wishing you all the best.

    Warmly,

    Meaghan (Migraine.com Team)

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