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