Q: I am a marriage and family therapist and was just contacted by a client’s mother that her 17-year-old daughter has had severe abdominal pains for nine months. One of her doctors has mentioned her problems as migraines. Please send me any information you may have regarding abdominal migraines.
A: An abdominal migraine is a variant of a migraine headache that presents in the abdomen with nausea, vomiting and pain in varying degrees of intensity. Strangely, they are most prevalent in individuals between the ages of 5 and 9 but can appear at any age. According to a study published in Pediatric Neurology, approximately one in five children diagnosed with migraines suffer from abdominal migraines.
While the exact cause of this condition has yet to be discovered, one theory is that they are caused by changes in two chemicals that occur naturally in the body – histamine and serotonin. It is believed that anxiety and stress can cause these particular chemicals to fluctuate. Yet another theory is that chocolate, MSG (monosodium glutamate), and meats that contain nitrites may also be to blame. While some individuals will not have triggers, those that do and exhibit symptoms following the ingestion of offending products may be helped. For example, individuals so diagnosed can become better educated in determining what triggers both an event and the side effects that follow. Foods with MSG or other flavor enhancers or preservatives might be found to be the culprit, as can a chocolate bar or cup of hot chocolate before bedtime. By learning what to avoid, if indeed there are any such products and eliminating them from a person’s diet, the issue may be resolved. It will be necessary to keep a diary for a period of time to determine if particular foods, additives, or stress play a role. Over-the-counter remedies such as aspirin, Motrin or Advil are often considered for control; however, they can actually cause abdominal pain and bleeding, particularly when taken for extended periods of time. Prescription tricyclic antidepressants, triptans, or serotonin blockers might prove useful.
Symptoms of abdominal migraines can include mild to extreme abdominal pain with the patient lying in a fetal position, nausea, vomiting, and an inability to eat. The pain can be as brief (and I use this word lightly), as one hour or as long as 72 hours. A difference between a migraine headache and an abdominal migraine is that the patient with a headache is often “warned” by an aura that indicates it is coming on, while the abdominal form is often rapid in appearance and severity.
Diagnosis by a physician can be difficult since abdominal pain can result from many causes. Therefore, the initial steps will include a personal history, family history, examination and possible laboratory and/or X-rays so that other possibilities may be ruled out. Sadly, this can take an inordinate amount of time because of the possibility of irritable bowel syndrome, an ulcer, or other cause which must be ruled out. Should a physician suspect abdominal migraines, the patient would report severe pain lasting from between one and 72 hours, anorexia, vomiting, nausea, headache and several other symptoms. Regardless of the intensity, symptoms will commonly disappear as quickly as they present; there will be no symptoms between attacks and the patient will be left wondering when the next bout will occur.
Readers who would like related information can order Dr. Gott’s Health Report “Headaches” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order made payable to Dr. Gott’s Health Reports”, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from our website www.AskDrGottMD.com.
