Your Child’s Stomach Hurts — Is it a Migraine?

Abdominal migraine is a common diagnosis in Europe and the U.K., but it’s not made in the U.S. very often and many health care providers don’t know that such a syndrome exists. A recent study in the journal Headache set out to evaluate whether kids who suffer from severe and unexplained abdominal pain were perhaps instead suffering from abdominal migraines. The authors of the study investigated why, despite recognition by both stomach and headache medical groups, abdominal migraine remains under-recognized and under-diagnosed as a cause of recurring abdominal pain in children living in the U.S.

Ongoing and recurring abdominal pain occurs in 9-15% of all children and adolescents. After excluding other causes of pain such as that caused by anatomical problems, infection, inflammation or other causes, “functional abdominal pain” is the most common diagnosis of chronic, naturally occurring, abdominal pain in childhood. Functional abdominal pain is typically categorized into one, or a combination disorders including abdominal migraine which has been and which consists of painful attacks of mid-section of the stomach area, moderate to severe abdominal pain lasting 1-72 hours along with nausea, vomiting and other motor symptoms.

In the study, the authors conducted a review of medical charts for children that were referred to a pediatric gastroenterology practice and who were suffering from ongoing abdominal pain. 458 patients met the standards for inclusion in the study and a total of 1824 total patient office visits were reviewed. 84.6% of the children did not meet the standards for the diagnosis of abdominal migraine but 4.4% did and another 11% had symptoms that were almost consistent with the diagnosis. Notably, however, none of the children were ever given the diagnosis of abdominal migraine after their visit.

The authors concluded that among children with chronic, naturally occurring, recurrent abdominal pain, abdominal migraine represents about 4-15% of the incidence. Given the variety of treatment options available for pediatric migraine, raising awareness about this syndrome will hopefully improve the appropriate diagnosis of children who exhibit these symptoms. Until an evaluation is done and a diagnosis is made, it may be advisable for parents to practice common migraine prevention techniques including the limiting certain foods or activities that might be a precipitating factor for the development of migraine.

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