Abdominal Migraine

What it is and how to treat it?

Abdominal Migraines or tummy migraines are most commonly seen in children between the ages of 3 and 10 years of age.  

Symptoms include abdominal pain - felt at a point around the belly button. The pain is often described as dull but can be moderate to severe in some cases. Children can also present with pallor (a pale complexion), loss of appetite, nausea and vomiting. 

Headaches are uncommon with Abdominal Migraines, however if a headache is present, and it is associated with neck stiffness, or the pain alternates or moves, then the neck structures must be assessed as a potential cause.

Diagnosis of Abdominal Migraines

Diagnosis of Abdominal Migraines is made through elimination- ruling out other causes of stomach ailments, such as celiac disease.

Treatment for Abdominal Migraines

Treatment for Abdominal Migraines is largely unresearched but is similar to that used for Migraines. This is because many children who develop Abdominal Migraines will develop Migraines with head pain around the ages of 10-14 years of age.

It has been assumed that both conditions share a similar pathway - a sensitised brainstem, therefore medications used for Abdominal Migraines are similar to those used for Migraines. 

Theories as to why children develop stomach pain with Abdominal Migraines are vast but one likely suspect is the Vagus nerve. The Vagus nerve is a key player in the gut brain pathway. It is a cranial nerve which originates at the base of the skull in the brainstem and innervates various structures in the thoracic and abdominal cavity. 

It is a motor and sensory nerve and can transmit signals both ways between the stomach and brain.  Normal signals from the gut can be misinterpreted in a sensitised brainstem and result in stomach pain when the gut itself is normal.

Due to the close relationship to the brainstem, the upper cervical spine is a potential source of the sensitised brainstem and should be examined by a skilled practitioner who can assess this area and rule in or out an underlying neck disorder.