Abdominal migraine is a cause of recurrent episodes of central abdominal pain. It tends to affect children but can also affect adults. They most often occur in children aged 3-10 years and are more common in girls. Children with abdominal migraine are more likely to develop traditional migraine headaches as adults.
No underlying physical pathology will be present on examination or investigations.
The episodes may have triggers, such as stress, lack of sleep, dehydration, certain foods and bright lights.
Presentation
Abdominal migraine presents with episodes of periumbilical abdominal pain lasting between one hour and three days.
There may be associated:
- Nausea and vomiting
- Anorexia (loss of appetite)
- Pallor
- Headache
- Photophobia
- Aura (e.g., visual changes or a tingling sensation in the hands)
Management
Management is similar to traditional migraine. Adequate explanation and education are essential.
Treating the acute attack may involve:
- Low stimulus environment (e.g., a quiet dark room)
- Paracetamol
- Ibuprofen
- Triptans (e.g., sumatriptan)
Longer-term preventative medications include:
- Pizotifen (serotonin antagonist)
- Propranolol (non-selective beta blocker)
Pizotifen needs to be withdrawn slowly when stopping as it is associated with withdrawal symptoms of depression, anxiety, poor sleep and tremors.
Last updated February 2025
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