ABDOMINAL MIGRAINE IN CHILDREN: ALL YOU NEED TO KNOW
Written by Marina Medved-Lentini and medically reviewed by Dan Henry, M.D.
Abdominal migraine is a type of migraine that mostly affects children, showing up as stomach pain instead of the usual head pain we think of with migraine. Diagnosing abdominal migraine in children can be difficult and stressful for the whole family. However, getting the right diagnosis is very important. It’s the first step towards finding effective treatment and helping your child feel better. In addition, by educating yourself about this neurological disorder, believing your child’s experiences, and seeking support for both yourself and your child, we hope you can empower them to manage this disorder effectively and live more comfortably.
WHAT IS ABDOMINAL MIGRAINE? CAUSES, SYMPTOMS, AND MORE
The exact cause of abdominal migraine is unknown. However, researchers think it’s linked to an overly sensitive nervous system, influenced by a mix of genetics, social, and environmental factors. [1] Abdominal migraine involves episodes of intense stomach pain, often accompanied by symptoms of paleness, nausea, vomiting, anorexia, headache, and sensitivity to light, which can last anywhere from 2 to 72 hours. [3]
WHO GETS ABDOMINAL MIGRAINE?
Abdominal migraine is most common in children aged 3-10 but can also occur in teens and, less frequently, in adults. [3] Interestingly, it is more common in girls than boys. [2]
Children with abdominal migraine often endure intense episodes of abdominal pain that disrupt their daily routines, including school and extracurricular activities, often leaving both children and parents searching for answers and relief.
Danielle Byron Henry’s Story
Danielle's journey with migraine began at age 8 when she was diagnosed with abdominal migraine. Despite the challenges, Danielle faced this neurological disorder with courage. However, as migraine persisted and got worse over the years, the toll on her body and mental health became overwhelming. Tragically, Danielle died by suicide at the age of 17.
Danielle is the inspiration behind Danielle Byron Henry Migraine Foundation. At the heart of the Foundation's work is the Migraine at School initiative, designed to increase awareness and provide support for children and adolescents living with migraine. Danielle's story serves as a powerful reminder of the need for education, awareness and support for children and adolescents affected by migraine.
TRANSITION FROM ABDOMINAL MIGRAINE TO MIGRAINE WITH HEAD PAIN
The good news is that most children tend to outgrow this disorder by their teen years. [4] “Children with abdominal migraine usually start to outgrow the abdominal pain symptoms sometime around puberty. About 60% of children with this disease no longer have episodes … by their late teenage years.” said Kaitlin Greene, a pediatric neurologist and director of the Child and Adolescent Headache Program at Doernbecher Children’s Hospital at Oregon Health & Science University in Portland, Oregon. [2]
From Abdominal Migraine to Chronic Migraine: Maddy’s Story
Up to 70% of children with abdominal migraine go on to develop migraine with head pain later in life. [2] For instance, Maddy’s journey with migraine began at only 4 years old when she started to experience abdominal migraine symptoms. Like most children, she eventually outgrew them, but by 13 she was suffering from chronic migraine. It was not until she was 20 that she finally received a proper diagnosis from a migraine specialist.
From Abdominal Migraine to Vestibular Migraine: Lacy’s Story
Our reader, Lacy, shared a similar experience. Although Lacy’s first abdominal migraine attack occurred when she was a toddler, she was not diagnosed until she was 12 years old. “It consumed most of my childhood,” Lacy shared, noting that schools at the time viewed her attacks as a “behavioral issue” or “attention seeking.” Lacy was allowed to bring Gatorade to hydrate after a migraine attack, highlighting the importance of school accommodations for children with migraine today. Thankfully, Lacy’s abdominal migraine attacks stopped in college, but her migraine journey wasn’t over. As is often the case with abdominal migraine, for Lacy, it transformed into vestibular migraine and migraine without aura.
CAN ADULTS GET ABDOMINAL MIGRAINE?
Although abdominal migraine is rare in adults, a small percentage of patients carry their symptoms into adulthood. [4]
Sarah, a Migraine at School Outreach Coordinator shared her experience of living with migraine, stating that she had “abdominal migraine as a child and continues to experience symptoms to this day as an adult.” Other readers in our migraine communities have shared similar stories, showing that while rare in adults, the unpredictable nature of abdominal migraine and its impact on daily life can lead to feelings of frustration, isolation, and guilt.
Overall, the symptoms, triggers, and treatment for abdominal migraine in adults are similar to those in children. However, the prevalence of other migraine types in adults may make it more challenging to diagnose.
SYMPTOMS OF ABDOMINAL MIGRAINE IN CHILDREN: WHAT TO LOOK FOR
Abdominal migraine can go undiagnosed for years, leaving children and their families without answers despite ongoing symptoms. Therefore, recognizing the symptoms of abdominal migraine is the first step to getting the correct diagnosis. The main symptom of abdominal migraine in children is recurrent abdominal pain that is not caused by other gastrointestinal issues. For instance, abdominal pain may present as a dull ache or soreness, often in the middle of the stomach, near the belly button. Moreover, its intensity can range from moderate to severe. [3] Typically, the end of the abdominal migraine attack occurs abruptly. [3]
In contrast to typical migraine attacks, an abdominal migraine attack does not usually include head pain as a symptom. However, it is possible for a person to experience an abdominal migraine and a typical migraine attack with head pain at the same time. [1]
Abdominal migraine symptoms may include abdominal pain as well as any of the following:
Nausea
Vomiting
Loss of appetite
Pale skin
Fatigue
Dark circles under the eyes
Sensitivity to light or sound
These symptoms can last anywhere between 2 and 72 hours, can be disruptive to a child's daily life, and may lead to missed school days and social activities.
Keeping a migraine diary to document your child’s symptoms and scheduling an appointment with their pediatrician, a neurologist, or a headache specialist are the first steps towards an accurate diagnosis.
ABDOMINAL MIGRAINE TRIGGERS IN CHILDREN: WHAT TO KNOW
Just like with other types of migraine, abdominal migraine in children can be triggered by various factors. Knowing these triggers can help the diagnosis and management of abdominal migraine.
Common Abdominal Migraine Triggers Include: [3]
Stress from school and family life
Poor sleep and irregular sleep habits
Prolonged fasting and food deprivation
Dehydration
Travel
Exercise
High-amine foods, foods with additive flavoring, coloring, and MSG
Flashing lights
Everyone's migraine triggers are different. Keeping a migraine diary and working with a health care provider can help identify potential migraine triggers and develop strategies for avoiding them.
HOW TO DIAGNOSE ABDOMINAL MIGRAINE IN CHILDREN?
“I had undiagnosed abdominal migraine - but was told I was making it up for attention…it is discouraging how often I was told I was faking instead of people taking some extra time and investigating what could have been the source,” shared Nikki, a Migraine at School Ambassador.
Unfortunately, Nikki’s experience is common because abdominal migraine in children is frequently misdiagnosed, largely because it doesn’t involve the typical head pain associated with migraine. It's even harder to diagnose in young kids who struggle to describe their symptoms.
Is There a Test for Abdominal Migraine?
As with other types of migraine, abdominal migraine is not diagnosed using diagnostic tests, like blood tests or imaging studies. Instead, doctors focus on the child’s symptoms and medical history. Furthermore, they rule out other conditions with similar symptoms to ensure the diagnosis is correct.
Learning about abdominal migraine is important for advocating for your child. Keeping a detailed migraine diary can be incredibly helpful. Document your child’s symptoms, the date of their occurrence, and any potential triggers. Ultimately, this valuable information can help their health care provider make an accurate diagnosis and treatment.
Download our free migraine diary to document migraine symptoms here.
ABDOMINAL MIGRAINE TREATMENT OPTIONS
There is no cure for abdominal migraine yet. However, the goal is to find treatment options to reduce the frequency and severity of abdominal migraine attacks. This can involve a combination of lifestyle changes, medication, and alternative therapies.
1. Lifestyle Changes to Manage Abdominal Migraine
Making certain lifestyle adjustments can significantly impact the frequency and severity of abdominal migraine in children. These may include:
Consistent routine: regular sleep schedule and balanced regular meals.
Stress management: relaxation techniques such as mindfulness, deep breathing, or yoga.
Dietary adjustments: a whole foods diet, limiting processed foods, and adequate hydration.
2. Medications For Abdominal Migraine in Kids
Preventive Treatments for Abdominal Migraine
The FDA hasn’t approved any medications specifically for abdominal migraine. However, some healthcare providers prescribe certain drugs off-label. Medications used to prevent migraine attacks can often help prevent abdominal migraine too. [1]
Acute Treatment for Migraine Attacks
If your child has an abdominal migraine attack, resting in a quiet, dark room can help ease their symptoms. Discuss treatment options with their healthcare provider, which may include:
Non-Steroidal Anti-Inflammatory drugs (NSAIDs)
Anti-nausea medications
Triptans
3. Alternative Therapies for Children with Migraine
Neuromodulation devices - The FDA has approved three noninvasive neuromodulation devices for the acute and preventive treatment of migraine in children and adolescents. They include Nerivio REN wearable, gammaCore, and SAVI Dual sTMS. The Nerivio in particular has been approved for children with migraine ages 8+.
Cognitive Behavioral Therapy (CBT) - CBT has been shown to help children develop coping strategies for managing pain and reducing anxiety about migraine attacks. This approach can be particularly effective if stress is a trigger.
Hydration Therapy - since nausea and vomiting is a common symptom of abdominal migraine, a health care provider may prescribe hydration therapy to administer fluids through an IV. [2]
SCHOOL ACCOMMODATIONS FOR CHILDREN WITH ABDOMINAL MIGRAINE
Navigating school life can be challenging for kids with abdominal migraine. The unpredictable nature of this disease can lead to missed days, difficulty concentrating, and stress about keeping up with academic work. Advocating for school accommodations can make a big difference for your child’s education.
Briana’s Story: Advocating for School Support
Briana (10) has been living with abdominal migraine since she was 8 and vestibular migraine since the age of 4. It took four long years to receive accurate diagnoses. “We jumped from doctor to doctor until we found one who would listen and help,” shared her mother, Lanie, a migraine patient advocate.
Lanie, who also lives with debilitating migraine disease, has advocated for her daughter at school. Although Briana’s school has denied them a 504 Plan multiple times, they do have a Health Plan which provides Briana with school accommodations. Under the Health Plan, Briana’s migraine medications and an anti-nausea medication are kept at the nurse’s office. Whenever she experiences migraine symptoms, she is allowed to visit the nurse, take her medication, and either rest in the nurse’s office or go home if necessary. These accommodations help Briana get the support she needs to manage her migraine at school, allowing her to return to class when she feels well enough. When Briana cannot attend school due to migraine, her absences are excused.
Examples of School Accommodations for Students with Migraine
In December, 2024, the Department of Education released new guidelines to support kids with migraine, which you can use when advocating for your child at school. Here are some examples of accommodations for children with abdominal migraine:
Access to snacks and water throughout the day
Permission to carry and use a neuromodulation device for migraine, even during class
Access to a quiet, dimly lit room for recovery
Storage for a change of clothes at the nurse’s office
Extensions for missed assignments due to migraine attacks
Permission to leave class or visit the nurse without prior explanation
How to Get School Accommodations For Your Student with Migraine
Helping your child feel understood and supported at school can reduce stress that worsens migraine symptoms. Use our step-by-step guide to request Section 504 accommodations and learn more about your child’s rights under Section 504.
BUILDING A SUPPORT NETWORK FOR PARENTS
Parenting a child with migraine or chronic pain can feel overwhelming and isolating, but you are not alone. Join our free, monthly Peer-to-Peer virtual support group to connect with other parents who truly understand your journey. Held every third Tuesday of the month, this group offers a safe and welcoming space to share experiences, learn from one another, and find the support you need.
THIS IS NOT MEDICAL ADVICE. Information provided in this blog is meant to complement and not replace any advice or information from a healthcare professional.
References:
[1] https://my.clevelandclinic.org/health/diseases/24449-abdominal-migraine
[2] https://americanmigrainefoundation.org/resource-library/abdominal-migraine/
[3] Gastroenterol Hepatol (N Y). 2020 Dec;16(12):632–639. https://pmc.ncbi.nlm.nih.gov/articles/PMC8132691/
[4] Cureus. 2023 Mar 21;15(3):e36451. 10.7759/cureus.36451
