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Repeated episodes of stomach pain, nausea or vomiting often are related to the digestive system, but for some children, they are symptoms of abdominal migraine. Like migraine attacks that cause head pain, abdominal migraine is a neurological condition that is felt in the stomach area.
Abdominal migraine causes recurring attacks of moderate to severe abdominal pain, often around the belly button, along with symptoms such as nausea, vomiting and loss of appetite. The attacks can interfere with school, activities and everyday life.
Abdominal migraine is most common in children, particularly younger children. With an accurate diagnosis and individualized treatment, most children can learn to manage their symptoms and return to their normal activities.
Abdominal migraine is a type of migraine that causes episodes of significant abdominal pain instead of the typical migraine head pain.
During an abdominal migraine attack, a child may have:
A child with abdominal migraine usually does not have head pain during an attack, although some children may experience a headache along with their abdominal symptoms.
One of the most important characteristics of abdominal migraine is the pattern of the attacks. Symptoms come and go, and a child generally feels completely well between episodes. Attacks may occur weeks or months apart.
Abdominal migraine most often is diagnosed in children between ages 3 and 10, although it can occur in older children and, rarely, adults.
Abdominal migraine symptoms can be difficult for a child to describe, particularly when the child is young.
A child may describe the pain as a stomachache, belly pain, cramping or soreness. The pain often occurs in the middle of the abdomen or around the belly button and can be severe enough to stop normal activities.
During an abdominal migraine attack, the child may:
You may notice that the child seems completely healthy after the attack ends. This pattern of recurring attacks followed by periods of normal health is an important clue when evaluating abdominal migraine.
The most common abdominal migraine symptoms include:
Abdominal pain is the primary symptom of abdominal migraine. It usually is moderate to severe and occurs in the middle of the abdomen, often around the belly button.
The pain can be dull, aching or cramping and may be severe enough to interfere with school, play, sports, eating or sleep.
Nausea and vomiting commonly occur during an abdominal migraine attack. Some children may have significant vomiting, while others primarily experience nausea.
The child may not want to eat during an abdominal migraine attack. This loss of appetite usually improves when the episode ends.
The child may look paler than usual during an attack. On lighter skin, you may notice the skin looks less pink or red than usual. On darker skin, the change may be easier to see in the palms, inside the lower eyelids or inside the mouth, which may look lighter than usual or grayish.
Some children with abdominal migraine become sensitive to bright lights or loud sounds and may want to rest in a quiet, dark room.
Head pain is not usually the main symptom of abdominal migraine. However, some children may experience headache during an abdominal migraine episode, and children who have abdominal migraine may experience typical migraine as they get older.
An abdominal migraine attack can last from about two hours to 72 hours, or up to three days.
Attacks can occur weeks or months apart. Between attacks, most children return to their usual health and do not have ongoing abdominal symptoms.
The recurring pattern can help distinguish abdominal migraine from conditions that cause continuous or progressively worsening abdominal pain.
The exact cause of abdominal migraine is not known. Like other types of migraine, it is thought to involve changes in the nervous system and the way the body processes pain and other sensory signals.
A family history of migraine may increase a child’s likelihood of experiencing abdominal migraine.
Certain factors also may trigger an abdominal migraine attack. Common migraine triggers can include:
Some children may notice that certain foods or food additives trigger their symptoms. Triggers vary from child to child, so keeping a symptom diary can be more useful than automatically eliminating foods from the child’s diet.
The brain and digestive system communicate constantly through what is sometimes called the gut-brain axis. This two-way connection can influence digestion, nausea, pain and other sensations in the abdomen. With abdominal migraine, changes in the nervous system involved in migraine may affect this connection, causing significant abdominal symptoms even when there is not an underlying problem with the stomach or intestines.
There is no single test that confirms abdominal migraine. Instead, the child’s healthcare provider looks at the pattern of symptoms, medical history and physical examination.
During an evaluation, the pediatrician or pediatric neurologist may ask:
The pediatrician also may perform a physical and neurological examination.
Additional testing may be recommended when symptoms suggest another possible cause of abdominal pain. The goal is to make sure conditions affecting the digestive system or other parts of the body are not responsible for the symptoms.
Abdominal migraine is diagnosed based on the overall pattern of symptoms rather than a blood test, scan or other single diagnostic test.
Both abdominal migraine and cyclic vomiting syndrome are conditions associated with migraine and can cause recurring episodes in children. The main difference is the primary symptom.
With abdominal migraine, abdominal pain is the main symptom. Nausea, vomiting and other migraine symptoms may also occur.
With cyclic vomiting syndrome, repeated nausea and vomiting are the main symptoms. Episodes can be severe and may lead to dehydration.
Because the symptoms can overlap, the pediatrician or pediatric neurologist can evaluate the pattern of symptoms and determine the most appropriate diagnosis and treatment.
Abdominal migraine treatment is designed to relieve symptoms during an attack and prevent or reduce future attacks.
Treatment depends on the child’s age, symptoms, how often abdominal migraine attacks occur and how much they interfere with everyday life.
The child’s healthcare provider may recommend treatments to help relieve symptoms during an abdominal migraine attack. Depending on the child’s needs, treatment may include:
Always ask your child’s healthcare provider which medicines and doses are appropriate for your child.
Preventing migraine attacks often starts with healthy routines and identifying the child’s individual triggers.
A prevention plan may include:
If abdominal migraine attacks are frequent, severe or significantly interfere with the child’s daily life, a pediatric neurologist may recommend preventive treatment.
Talk with your child’s pediatrician if your child has recurring episodes of unexplained abdominal pain, especially when the episodes also involve nausea, vomiting, loss of appetite or skin tone changes such as paleness.
It can be helpful to keep a record of your child’s symptoms before an appointment. Note:
This information can help your child’s healthcare provider recognize patterns and determine whether abdominal migraine or another condition may be causing the symptoms.
Seek prompt medical attention for severe or persistent abdominal pain, blood in vomit or stool, significant dehydration, fainting, severe weakness or unusual sleepiness.
Many children have fewer abdominal migraine attacks as they get older, and it’s uncommon for abdominal migraine to continue into adulthood.
However, children who experience abdominal migraine have an increased likelihood of developing typical migraine attacks later in life.
If your child develops recurring headaches, tell their healthcare provider about their history of abdominal migraine. This information can help the provider understand your child’s overall migraine history.
Abdominal migraine can be difficult to recognize because a child’s primary symptoms may involve the stomach rather than the head. Our pediatric headache specialists understand that migraine symptoms can look different in younger children and can help determine whether recurring abdominal symptoms fit a migraine pattern.
At Norton Children’s Neuroscience Institute, board-certified and fellowship-trained pediatric specialists care for children with migraine and other headache disorders. Treatment is tailored to each child’s symptoms, age and needs.
Our pediatric headache team can help with:
If your child’s symptoms are difficult to diagnose or require additional evaluation, Norton Children’s provides access to a broad network of pediatric specialists, including pediatric gastroenterologists.
Abdominal migraine is a type of migraine that causes recurring episodes of moderate to severe abdominal pain, often along with nausea, vomiting and loss of appetite. It is most common in children, particularly younger children. Unlike a typical migraine, abdominal migraine usually does not cause head pain during an attack.
Common symptoms include moderate to severe abdominal pain around the belly button, nausea, vomiting, loss of appetite and pale skin. Some children also experience sensitivity to light or sound. Headache can occur but is not usually the primary symptom.
An abdominal migraine attack can last from about two hours to 72 hours. Episodes may occur weeks or months apart, with children generally feeling well between attacks.
The exact cause of abdominal migraine is not known. A family history of migraine may increase a child’s risk. Common triggers can include skipped meals, dehydration, poor sleep, stress, travel, physical overexertion, and bright or flashing lights.
The gut-brain axis is the two-way communication system between the brain and digestive system. This connection can influence digestion, nausea and how the body senses and processes pain. With abdominal migraine, migraine-related changes in the nervous system may affect this connection and contribute to abdominal pain, nausea and vomiting. This helps explain why a child can have significant stomach symptoms even when there is not an underlying problem with the stomach or intestines.
There is no single test for abdominal migraine. A healthcare provider will review your child’s symptoms and medical history, perform an examination and look for the characteristic pattern of recurring abdominal pain and other migraine symptoms. Additional testing may be recommended to rule out other causes of abdominal pain.
Abdominal migraine treatment may include rest, hydration, medicine for pain or nausea and, when appropriate, migraine-specific medicine. Preventive treatment may be recommended for children who have frequent or disruptive attacks. Regular meals, adequate sleep, hydration and identifying individual triggers also can help prevent attacks.
No. An occasional stomachache is common in children, while abdominal migraine causes recurring attacks of moderate to severe abdominal pain, often with nausea, vomiting or other migraine symptoms. Children typically feel well between abdominal migraine attacks.
No. Both conditions can cause recurring episodes in children and are associated with migraine, but abdominal pain is the primary symptom of abdominal migraine, while repeated nausea and vomiting are the primary symptoms of cyclical vomiting syndrome.
Some children who have abdominal migraine later develop typical migraine attacks. This does not happen to every child. Tell your child’s healthcare provider about a history of abdominal migraine if recurring headaches develop later.
Yes, but abdominal migraine is much more common in children. Most cases occur during childhood, and continuing to have abdominal migraine into adulthood is uncommon.