Chapter 1, Episode 10: What is Abdominal Migraine?


This content has been medically reviewed by Dr. Dan Henry.

Abdominal migraine is a form of migraine that occurs mostly in children aged 3-10. Approximately 3% of children experience abdominal migraine but it is often misdiagnosed. Adults can also be affected by abdominal migraine but generally migraine in adults presents with more typical symptoms like head pain.

To receive a diagnosis of abdominal migraine a person must have had at least five recurrent episodes of moderate to severe pain in the abdomen usually around the midsection or belly button. 

The person must also have at least two of the following: nausea, vomiting, paleness, or loss of appetite. A headache may or may not be present. An aura may occur before the abdominal symptoms. 

Each attack generally lasts from 1 hour to 3 days. A person with abdominal migraine may have complete freedom of symptoms between attacks, meaning that these symptoms do not linger. 

Children with a family history of migraine are more susceptible to this condition. Abdominal migraine may spontaneously resolve for some but unfortunately a large number of those with abdominal migraine will develop another form of migraine later in life. A person with abdominal migraine may also have another form of migraine concurrently.

Abdominal migraine is diagnosed based on a thorough history of both the patient and family, symptoms and exclusion of other causes. It is helpful to let a healthcare provider know if the patient has an aura prior to an attack.

Abdominal migraine can be diagnosed and treated by primary care clinicians or neurologists but they may also consult with gastrointestinal specialists. Lab tests, CT scans and/or an abdominal ultrasound may be ordered to rule out other possible diagnoses.

Cognitive behavioral therapy may be a helpful treatment option in children. 

Stress management, proper hydration and regular sleep patterns can all be helpful for managing abdominal migraine, especially in children. 

Increasing fiber has been shown to reduce the number of attacks of abdominal pain. 

Avoiding common food triggers such as chocolate, MSG, caffeine and cheese may be beneficial.

NSAIDS and acetaminophen are commonly used over-the-counter treatments. Zolmitriptan is an abortive prescription option that is approved for pediatric and adult use. Another option is nasal sumatriptan. It is not approved for pediatric use however some doctors may still prescribe it after assessing the patient. Anti-nausea medications are commonly a part of the treatment plan due to the high prevalence of nausea and vomiting. 

Neuromodulation devices may be an effective treatment option for both children and adults. 

Propranolol, topiramate, cyproheptadine, pizotifen and flunarizine are preventive medications that may be prescribed for abdominal migraine in adults.

This video is sponsored in part by Amgen, Abbvie and Teva Pharmaceuticals.

*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.