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The Mystery of Abdominal Migraines: Why Do Kids Experiencing Such Severe Abdominal Pain?
In many families, children often complain of abdominal pain, which may be beyond the scope of ordinary abdominal pain. Abdominal migraine is one of them, which is a common functional disorder in children and adolescents. However, there is a lack of clear pathological mechanisms or biochemical abnormalities.
Abdominal migraine is characterized by sudden, severe mid-abdominal pain, accompanied by symptoms such as nausea, vomiting, severe headache, and paleness.
According to statistics, the incidence of abdominal migraine in children ranges from 0.4% to 4%, mainly affecting children aged 3 to 10 years old, and is more common in women. The disease often relapses over a short period of time, severely affecting children's daily lives.
Symptoms and attack characteristics
The main feature of abdominal migraine is midline abdominal pain. This pain is usually intermittent and worsens suddenly. The average attack time is 17 hours, and the shortest can be from two hours to 72 hours. No wait. Most patients experience loss of appetite (91%), nausea (73%-91%), vomiting (35%-50%), and marked pallor (93%-100%). Often these attacks end suddenly and affect the patient's life, with an average of 14 attacks per year.
Potential causes and triggers
The specific cause of abdominal migraine is still unclear, but research shows that it is related to changes in the gut-brain axis, abnormal vascular regulation, changes in the central nervous system, and genetic factors. Psychological factors are also risk factors for abdominal migraines, such as abuse and stressful events. Additionally, these children are more likely to develop mental health problems such as anxiety and depression than children with other functional gastrointestinal disorders.
Triggers for abdominal migraines include, but are not limited to, stress in family and work life, irregular sleep patterns, prolonged fasting, dehydration, high-amine foods, etc.
Diagnosis and differential diagnosis
When diagnosing abdominal migraine, other physiological diseases that may cause symptoms need to be ruled out. According to the Rome IV Criteria, a diagnosis of abdominal migraine may be considered if there are at least two typical episodes of abdominal pain within six months, with a symptom-free period of weeks or months between episodes. Because this condition has many similar conditions, such as irritable bowel syndrome or gastroesophageal reflux, differential diagnosis is crucial.
Treatment methods
There are currently no clear treatment recommendations for abdominal migraine due to extremely limited studies in the literature. Most treatments are still based on accumulated experience with small samples. In order to better manage this disease, doctors can refer to the STRESS mnemonic, which includes: stress management, travel precautions, rest, attention to emergency symptoms, avoiding flashing lights and providing appropriate snacks.
For those with frequent attacks, it is recommended to consider biofeedback and psychological counseling, which may be helpful for migraines triggered by emotional stress. It is worth noting that children with nausea and vomiting can consider using nasal sprays or suppositories, and some cases can also be relieved by oral or intravenous administration.
Prognosis and Epidemiology
Abdominal migraines have a significant impact on children's daily lives, often requiring them to miss school or other activities, but most patients experience less symptoms as they age. Abdominal migraines are rare in adults, but children who have been diagnosed with the condition may develop migraine symptoms as adults, affecting their quality of life.
The medical community’s understanding of abdominal migraine continues to improve, however, many questions remain unanswered, including how to better manage the condition and its potential future impact on patients. What impact will the pain experienced by children during their growth have on them?
