Abdominal migraine in children: causes, symptoms and treatments

Abdominal migraine in children is a clinical event that characterized by episodes of severe abdominal pain, accompanied by nausea, vomiting, loss of appetite and paleness. Chronic abdominal pain in childhood corresponds to 2-4% of visits to the pediatrician.

Certain gastric, urogenital and metabolic conditions can mimic the symptoms of an abdominal migraine, so its appearance should never be ignored. If you want to know more about this complex and diffuse clinical entity, keep reading.

What is abdominal migraine (AM) in children?

Scientific publications collect the most appropriate definitions for this clinical event. Abdominal migraine in children (MA) these are severe episodes of abdominal pain —Generally diffuse— lasting an hour or more. These episodes are separated by intervals of weeks or months and, in addition, there are a series of patterns in each patient.

At the epidemiological level, it should be noted that 10-15% of children and adolescents suffer from chronic abdominal pain at some point. The maximum incidence is at 7 years of age, with a mean between 4 and 15 years. The absolute prevalence is estimated to be 1% to 9%, depending on the studies consulted.

As indicated by the American Migraine Foundation, children with MA are more likely to develop typical head migraines in his adulthood. In any case, there is still much to learn about this pathology.

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Symptoms of abdominal migraine

As we have already said, abdominal migraine in children manifests as very noticeable pain of a diffuse nature in the abdominal area. It can last from 1 to 72 hours, but when the symptoms disappear, the infant does not present any associated discomfort.

Among the most obvious signs we find the following:

• Nausea, vomiting, and loss of appetite. Gastrointestinal symptoms are typical during this condition.
• Pale skin tone.
• Sensory disturbances.
• Lack of energy and dizziness.

As we have said, the majority of children with this clinical picture are between 3 and 10 years of age. In any case, this entity is being studied in adults, estimating that up to 1% of them may also suffer from abdominal migraines.

What are the causes of abdominal migraine in children?

According to the medical website of Yale Medicine, A specific cause of AM in infants has not yet been detected. In any case, a series of hypotheses are being considered that could explain this very diffuse clinical entity. We will tell you briefly.

1. Visceral hyperalgesia

Visceral hyperalgesia is defined as increased nerve sensitivity in internal organs. Patients who present it notice much more the sensations inside and, in addition, the pain they suffer is much greater.

Children with abdominal migraine have a low tolerance for intestinal pain, which could indicate visceral hyperalgesia. This can find its origin in genetic, metabolic, environmental and psychosocial factors.

2. Alteration in intestinal motility

Children with MA may have atypical intestinal motility. The distension of the abdominal muscles and the exaggerated gastric contractions could promote the appearance of this characteristic and transitory pain.

3. Intestinal permeability

The permeability of the intestinal mucosa is an indirect indication of gastric health. A too leaky gut is not good, as it can promote the integration of substances into the bloodstream that would be excreted with the stool.

Based on this premise, studies have shown that the more intestinal permeability decreases in patients with AM, the greater the degree of improvement in their symptoms.

4. Allergies and intolerances

Diet and immune activity could also play a key role in the development of abdominal migraines in children. For example, cephalic migraine is sometimes associated with atopy and other allergic disorders.

Diagnostic tests

The diagnosis of abdominal migraine in children is based on dismissal. It cannot be proven that this episode is present for one reason or another, but it is possible to rule out the existence of other pathologies that cause abdominal pain.

Some of the diseases that should be neglected are the following:

• Urogenital disorders: as their name suggests, they are pathologies that affect the urogenital tract. For example, kidney stones (kidney stones), which can manifest with vomiting, severe pain, nausea, and other similar symptoms.
• Peptic ulcers: ulcers cause severe pain in the abdominal area.
• Intestinal obstruction: colicky abdominal pain and bloating are very common during intestinal obstructions.
• Other chronic gastric diseases: examples of this are irritable bowel syndrome (IBS) and Crohn's disease.

Available Treatments for Abdominal Migraine in Children

Studies explore possible treatments for patients with abdominal migraines, both at the gastric and neurological level. First, cyproheptadine, sumatriptan, promethazine, and amitriptyline are often prescribed to address acute pain episodes. These drugs have anesthetic and anticholinergic properties.

On the other hand, you can also resort to fluid therapy for fluid replacement, in case the child has vomited excessively. Antiemetic drugs can help on this front, as they suppress or relieve vomiting and the feeling of nausea that occurs during the condition.

Finally, if abdominal migraines are frequent in a specific patient, also long-term drug administration can be explored. Some of those used are also prescribed for the control of cephalic migraines, such as over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs).

Prevention and recommendations

Unfortunately, tips for managing these clinical events from home are conspicuous by their absence. The use of prebiotics, probiotics and controlled diets is advocated, But the correlation of the gut microbiome with the appearance of abdominal migraines is still far from clear.

The only advice we can offer a parent of a child with AM is not to take an infant's abdominal pain lightly. You may have abdominal migraines, but you most likely have another gastrointestinal condition with similar symptoms. Going to a specialist is essential.

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Abdominal migraine in children is still mysterious

Abdominal migraine in children (and adults) it is a very little explored condition. There are certain hypotheses that try to explain its appearance, although none of them have been confirmed. What has been recorded, for example, is that a family history can lead to a child suffering from AM.

In short, rather than speculating and trying to find explanations on your own, the wisest thing to do will always be to go with an infant to a medical center. The professional will rule out other possible pathologies and, if all is well, will attribute the abdominal pain to this type of migraine.