Posts Tagged ‘Abdominal Migraine’

Abdominal Pain in Children

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Abdominal pain is a common problem in children. Although most children with acute abdominal pain have self-limited conditions, the pain may herald a surgical or medical emergency. The most difficult challenge is making a timely diagnosis so that treatment can be initiated and morbidity prevented. This article provides a comprehensive clinical guideline for the evaluation of the child with acute abdominal pain.

The term “recurrent abdominal pain” as currently used clinically and in the literature should be retired. Functional abdominal pain is the most common cause of chronic abdominal pain. It is a specific diagnosis that needs to be distinguished from anatomic, infectious, inflammatory, or metabolic causes of abdominal pain. Functional abdominal pain may be categorized as one or a combination of: functional dyspepsia, irritable bowel syndrome, abdominal migraine, or functional abdominal pain syndrome (see table below titled “Recommended Clinical Definitions of Long-Lasting Intermittent or Constant Abdominal Pain in Children”).

The most common medical cause is gastroenteritis, and the most common surgical cause is appendicitis. In most instances, abdominal pain can be diagnosed through the history and physical examination. Age is a key factor in evaluating the cause; the incidence and symptoms of different conditions vary greatly over the pediatric age spectrum. In the acute surgical abdomen, pain generally precedes vomiting, while the reverse is true in medical conditions.

Abdominal pain and gastrointestinal (GI) symptoms, such as vomiting or diarrhea, are common chief complaints in young children presenting in emergency departments (ED). It is the emergency physician’s role to differentiate between a self-limited process such as viral gastroenteritis or constipation and more lifethreatening surgical emergencies. Extra-abdominal conditions such as pneumonia or pharyngitis caused by streptococcal infection also can present with abdominal pain and must be considered.

Abdominal pain is one of the most common reasons for a parent to bring his or her child to medical attention. The evaluation of a “tummy ache” can challenge both parents and the physician.

Possible causes for a child’s abdominal pain range from trivial to life threatening, with little difference in the child’s complaints. Fortunately, abdominal pain in a child most often improves quickly. The difficulty for a parent or caregiver lies in deciding which complaints need emergency care and which do not.

Bacteria and viruses are responsible in case of abdominal pain due to infections. Gastroenteritis and stomach flu are some of the examples of infections that can cause stomach aches. Gastroenteritis is the inflammation and irritation of stomach and the gastrointestinal passage. Extra care must be taken by travelers, as the food and drinks can be contaminated at new locations and can lead to traveler’s getting diarrhea.

Abdominal pain in children may be mild or serious. It can be termed serious, if it is accompanied by diarrhoea and sickness or if it has lasted continuously for more than three hours or if it is accompanied by fever and the child’s neck glands are found swollen and his throat red or if the pain persists for several days.

The character of abdominal pain vary according to the site of the pain and the underlying cause. Thus in case of colic, a frequent cause of this problem, the pain may be sudden and spasmodic. There may be faintness, nausea and perhaps vomiting. The patient lies on his back and folds the legs and presses them over the abdomen to put pressure on it, which gives a sense of relief.



Taking Fioricet

Protecting Kids From Abdominal Migraine


Abdominal migraine is the pain in the abdomen even when there is no headache and it occurs often in children but rarely in adults. It is common in children aging five to nine years old. Abdominal migraine consists primarily of abdominal pain, nausea and vomiting and the patient may become flushed or pale. Typically, the pain lasts anywhere from one to six hours.

The most frustrating part of abdominal migraine is the diagnosis because young children have difficulty in trying to explain how they feel. Since migraine is believed to be genetically based, it is quite certain that there is a member in the family who also has a migraine. Besides medical history and family history, diagnosis usually involves a physical examination, blood and urine tests and tests such as sonography. Non-drug treatment like bio feed back is helpful in both children and adults and beta-blockers can be a preventive medication.

In most of the cases, a child with abdominal migraine would still have migraine as an adult, though the symptoms may change. It has been studied that migraines can do permanent damage and so, the sooner the treatment, the better. The children who experience abdominal migraine eventually develop migraine with or without aura. An abdominal migraine can be diagnosed through attacks of abdominal pain lasting 1 to 72 hours and characteristically, pain in midline location and periumbilical part, and of dull or just sore quality with moderate or severe intensity.

A child suffering from abdominal pain may have either one or any two of anorexia, nausea, vomiting and pallor (dark shadows under the eyes). The child suffering from abdominal migraine experiences pain, which is severe enough to interfere with normal routine activities. Most children with abdominal migraine are certain to develop migraine head ache in their later life. The attacks are self-limiting and resolve almost spontaneously and the patients have no symptoms between attacks.

The abdominal pain usually occurs in the morning, though it may also occur at any time of the day. The other symptoms are photophobia, phono phobia and dizziness. Since there is no diagnostic test to confirm abdominal migraine, it is achieved only through patient’s medical history and family history, evaluating the symptoms and ruling out other causes of symptoms.

If the abdominal migraine is of serious nature, the patient can be allowed to take rest and the condition usually improves with sleep and he or she should be allowed to lie down in a quiet and dark room, undisturbed.

If the abdominal migraine is not frequent, medications used for other types of migraine are given and when they are frequent, preventive therapies used for migraines can be given. But fundamentally, the choice of medication largely depends upon the age of the patient.



Butalbital

This page is provided for educational and informational purposes only and is not intended as a substitute for the advice of a medical doctor, nurse, nurse practitioner or other qualified health professional.