Children’s pain could be abdominal migraine says Dr Miriam Stoppard

One of my grandsons suffered with abdominal migraine for a long time before it was finally diagnosed.

His mum and his teachers thought the pain was simply an excuse for not going to school and concentrated on finding reasons why this might be so.

Then some bright GP put his ­symptoms together and came up with abdominal migraine.

It often affects children and it’s not a straightforward diagnosis because, usually, there aren’t any headaches involved.

Abdominal migraine is an important, common and under-reco­gnised cause of recurrent ­abdominal pain in ­children, according to the British Medical Journal.

It’s a vital diagnosis because it avoids unnecessary investigations and incorrect treatments.

Preventive ­measures are available, important because abdominal migraine is a predictor for adult migraine.

There’s no test but doctors usually make the diagnosis from the pattern of symptoms.

Children complain of intermittent central abdominal pain that’s severe enough to stop normal activity.

They also have symptoms commonly seen in adult migraine like sensitivity to light and sound, nausea, vomiting and limb pain.

Crucially, the children are totally well between bouts of pain with normal development and weight, while hitting expected milestones.

In two British studies of children, the prevalence of abdominal migraine was four in 100 and just over two in 100.

In a US study, however, prevalence was nine in 100 when the mothers of 949 children were ­questioned.

The age when abdominal migraine appears is interesting too.

A study of British schoolchildren revealed it peaks at six-12 years, the highest being 9% at 12 years, and falling to 1% at 14.

It’s more common in girls too with a female to male ratio of 1.6:1.

The triggers in children with ­abdominal migraine are the same as for adult migraine sufferers – stress, tiredness, travel, missed meals and routine change.

Sometimes, triggers may be confused with symptoms preceding or forewarning of a migraine episode.

For example, bright light or moodiness may seem to trigger an episode when, in fact, photophobia and mood change are well-known warning symptoms.

If your child or grandchild is having periodic attacks of tummy pain, what should you do? First and foremost

get your doctor to check them out and ask your GP whether this could be abdominal migraine.

If it turns out it is, what can you do? Well, the things that help adult migraine also help children.

The research shows rest (in 88% of patients), sleep (in 64%), and analgesia (in 38%) can work.

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