Children often complain about pain in the stomach and usually find it difficult to describe the symptoms. This lack of a clear explanation confuses parents and caretakers if the pain is actual, or whether the child is making up excuses to skip school for a day or two. However, a dull abdominal pain could be an indicator of abdominal migraines, commonly seen in children. And this pain is different from the regular tummy ache.
Difference between stomach pain and abdominal migraines
Stomach pain is often triggered by food intake or indigestion, which can result in colic pain in the abdomen. The pain is usually inconsistent, unlike abdominal migraine.
“In cases of abdominal migraine, there might not be any provoking factor for the pain. The pain can suddenly come and last anywhere between one hour to three days,” says Dr Ganesh Shenoy, GI and bariatric surgery, Fortis Hospital, Bengaluru.
“The person can experience dull or agonizing pain. On clinical examination, the abdomen will not be tender,” adds Dr Vipulroy Rathod, director of gastroenterology, Fortis Hospital Mumbai.
Other symptoms include abdominal pain, vomiting and nausea.
“Abdominal migraines can be related to migraine headaches, since at least 25 percent of people with abdominal migraines will have migraine headaches at some point in their life,” adds Dr Shenoy.
How abdominal migraines occur
For reasons unknown, abdominal migraines are commonly seen in children compared to adults and in women compared to men.
Dr Rathod, with over three decades of experience in gastroenterology opines that, “In children, the most common factor for the occurrence of abdominal migraines could be genetic. Other reasons could be allergic reactions to certain foods or even gut infections.”
“Whereas in women, the hormonal shifts and cyclic changes can affect the motility of the gut, which can cause severe spasms leading to these abdominal migraines,” he adds.
Even adults can experience abdominal migraines but not as frequently as children do.
Other causes for abdominal migraines
Intake of certain food items, environmental factors, genetics and even some emotional factors such as extreme stress can cause abdominal migraines. Identifying the trigger factors helps prevent it.
“Multiple factors are at play in an individual. If one is having chronic deprivation of sleep, constant headaches, digestive issues in the form of gastrointestinal infections, and long-standing emotional trauma, then they are likely to experience abdominal migraine,” says Dr Rathod.
In some people, consuming chocolates, coffee, citrus fruits, or any other food that they might be allergic to, can also cause it.
“Low vitamin B12 and vitamin D3 levels are also causes of the migraine,” adds Dr Rathod.
“The triggering factors vary from person to person. For some it could be artificial flavoring agents in the food. Whereas for some others, it could be light of high intensity,” adds Dr Shenoy.
Stress, a major culprit for many health conditions, is also a factor that can cause or worsen abdominal migraines.
“The gut-brain axis, a communication system that links the central nervous system with the gut, influences how mental health can affect gut health and vice-versa,” adds Dr Rathod.
Diagnosis and treatment
A systematic approach is required in the diagnosis for abdominal migraines since it is normally confused with common stomach aches.
“Diagnosis involves ruling out symptoms of acute abdomen [abdominal tenderness and pain that calls for an emergency], some basic blood tests, including checking the vitamin B12 and vitamin D 3 levels. An abdominal ultrasound helps rule out gallstones, inflammation of bowel, liver or even pancreatic stones,” says Dr Rathod.
In the initial couple of weeks, treatment based on the symptoms is prescribed.
“For example, if it’s stress then counseling and psychotherapy are required. In cases of disturbed sleep, getting quality sleep helps,” says Dr Shenoy. “In some people for whom the trigger is visual, flashing lights should be avoided. Since food is also a major trigger, maintaining a food diary and avoiding food that can trigger abdominal migraines is necessary.”
“Beyond two weeks, if the person still struggles with recurring symptoms, then an endoscopy is suggested,” adds Dr Rathod.
Takeaways
- Abdominal migraine is a dull or agonizing pain felt in the abdominal region and has multiple triggers.
- Causes include certain types of foods like caffeine, citrus fruits, etc. Genetics, bacterial gut infection and psychological conditions like extreme stress contribute to abdominal migraine.
- Since treatment is based on the symptoms, diagnosis must be accurate to rule out any other possible reasons for the spasms or pain.
