Abdominal migraine

Regular tummy aches can be migraine – it’s not always in your head!

Stomach migraine in children (abdominal migraine) is a common reason for seeking NHS care from a GP or specialist. But research suggests it can often be misdiagnosed or overlooked.

And while abdominal migraine without headache may be more common in children, it affects lots of adults too.

What is abdominal migraine?

Mostly common in children, abdominal migraine involves repeated bouts of stomach pains alongside various other migraine symptoms. Your child might complain of severe tummy pains without any headache symptoms, which can make this misunderstood and under-diagnosed condition even harder to properly identify.

Abdominal migraines in children are surprisingly common among those with regular stomach pain, especially if there is a family history of migraine – in fact, it’s one of the most common causes of functional tummy pain in children. Many of those affected will have headaches at other times too or go on to get more obvious symptoms of migraine later.

NHS GPs see a surprising number of children with stomach problems caused by migraine – although not all are correctly diagnosed. Long-term stomach pains in children account for as many as two to four per cent of all visits to GPs and 50 per cent of appointments with paediatric gastroenterologists.

Abdominal migraines in children and teenagers can continue into later life. Abdominal migraine in adults may be less common, but their impact on those affected can be just as great.

Chronic and recurrent abdominal pain is a very distressing symptom that affects quality of life as well as school or work performance.

Abdominal migraine diagnosis

Episodes of recurring abdominal pain, especially in children, that last more than an hour and are accompanied by features typical of migraine, such as light sensitivity, nausea, sensitivity to movement, may be abdominal migraine. Since abdominal migraine without headache is not uncommon, doctors may miss the migraine link.

Between attacks, those affected have no related, ongoing symptoms.

Also, bouts of abdominal pain may be accompanied by vomiting.

Abdominal migraine can lead to frequent school or work absences, inappropriate and sometimes intrusive investigations and even unnecessary surgery. One study found that up to five per cent of all children with abdominal migraine have had unnecessary operations, so an early diagnosis is important.

Abdominal migraine treatment

Treatment of abdominal migraine follows the same basic principles for treating any migraine sufferer, with regular routines of eating and sleeping being particularly important.

Eating regularly, choosing slow-release energy foods, avoiding too many carbs, and adding a bedtime snack can lead to a significant improvement. Eating and staying hydrated before and after exercise can help too.

Sleep routines and quality of sleep are also very important. Stress management with techniques like mindfulness, writing out feelings, relaxation exercises or cognitive behavioural techniques may be helpful too.

Simple painkillers and resting in a dark quiet room often will often be enough to relieve the symptoms, although medications like sumatriptan for acute attacks or pizotifen as a preventative may be needed.

A medication to improve gastric emptying, like domperidone, can reduce stomach pains, nausea and vomiting.

For more general information on managing migraine, see our factsheet here.

For specific advice on migraine in children and young people, see our factsheet here.

Get help

If you or your child has symptoms that could be abdominal migraine, speak to your GP or see a headache specialist right away. Migraine can start early, and small children can and do get headache disorders. Early diagnosis and treatment increase the chances of good migraine control for a lifetime.

Book an appointment with the experts: review the best treatment options for abdominal migraine with a leading headache specialist. Beat the misery of migraine and get back to living. Book your consultation through the National Migraine Centre now.