BASICS

  • Refers to pain in abdomen severe enough to interfere with normal daily activities
  • It is diagnosis of exclusion (all other serious conditions should be excluded first)
  • It’s called migraine after it was noticed to be common in families suffering from either an abdominal or a head migraine.
  • Children with an abdominal migraine have a tendency to develop a migraine (head) when adults.
  • Commonage of presentation is 5 to 10 years of age

SYMPTOMS

  • Abdominal pain- more in centre of abdomen
  • Nausea- feeling uneasy
  • Vomiting- non-green, non-blood stained, non-forceful

 

DIAGNOSIS

Rule out Other causes of abdominal pain

  • At least 5 attacks
  • Long lasting pain ( 1 to 3 days)
  • Mid tummy pain with vomiting, uninterested in food and appears pale

 

TRIGGERS

  • Stress
  • Fasting and skipping meals
  • Changes in sleep patterns
  • Exposure to flickering or bright light
  • Foods-
    • Chocolate
    • Cheese
    • Citrus fruits
    • Chinese foods, particularly if it contains  MSG

 

OTHER CAUSES OF ABDOMEN PAIN 

  • Gastritis- (Ulcers- burning in centre of abdomen, acid reflux)
  • Appendicitis- (right-sided abdomen pain)
  • Intestine obstruction( not passed stool or blood in stool, abdomen distention)
  • Stones – in kidneys, in gallbladder( blood in urine, unable to pass urine, severe pain)
  • Inflammatory diseases of intestine (IBS)( intolerance to certain food, blood in stool, abdomen distention)

 

TREATMENT

  • Sleep typically brings relief
  • Avoid triggering factors
  • Certain medications-
    • Paracetamol ( 15-20 mg/kg./dose 8 hourly ) , Ibuprofen (10mg/kg/dose 8 hourly)
    • Domperidone for vomiting
  • There are many more medications that can be used but needs to be discussed with a doctor first.

Although there is no single treatment that is known to be effective in all patients.

 

DANGER SIGNS

  • Severe vomiting and dehydration
  • Bool in vomit or stool
  • Fever, severe pallor, drowsy
  • Severe pain in abdomen

 

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