The stomach pain is the key symptom. Unlike other forms of migraines, headaches are not a standout feature. In fact some, children don't have a headache at all!

Instead the biggest concern is the belly pain. It tends to be in the middle of the stomach - like around the belly button - or vague - where your child cannot point where it hurts.

Running around and doing normal kid stuff is tough, or completely impossible, on days when the pain hits. Your child may complain about going to school or their favourite play date, so you know something is off.

Attacks typically are short lived - lasting only 1 hour to 3 days. Fortunately, between attacks, children feel and look healthy. That can be weeks or months without any pain or gastrointestinal symptoms.

Triggers may include:

• Bright or flickering light
• Poor sleep / fatigue
• Prolonged fasting
• School or family stressors
• Dietary triggers: citrus food, caffeine, cheese, chocolate, carbonated drinks, colorings and flavorings
• Motion sickness

Tests for abdominal migraines

Like other forms of migraines, other reasons for the belly pain are first ruled out. This may involve your GP referring you to see a paediatrician, neurologist, gastroenterologist or other specialist. This may take months of waiting for appointments and getting results but it's important to make sure the diagnosis is correct.

With abdominal migraines, there is no pathology - there's no visible damage and no positive tests. This is great news!

But now what?

Treatments for abdominal migraines

Medication

Medication may be given to stop the pain once an attack starts. If it's really bad and consistent, then preventative medication may be given. This a is similar approach to standard migraines.

Diet

Sometimes dietary changes can help. There's some suggestion that a low FODMAP diet may help "functional gut disorders" like abdominal migraines.

Counselling

Stress may be a contributing factor to abdominal migraines. While stress is a healthy and normal part of life, it can be overwhelming, consistent or cause problems. In this case, learning to deal with everyday stresses may reduce the abdominal migraine triggers.

As with any ongoing health concerns, counselling may help to deal with the suffering - missing out on parties, falling behind at school, feel embarrassed about being sick. There's more to pain than the pain itself.

Sleep Assistance

Because fatigue and sleep deprivation can trigger attacks, addressing sleep concerns may be beneficial.

• Sympathetic / parasympathetic imbalance
• Altered gut microbiome
• Changes to the hypothalamic-pituitary axis

• Small intestinal bacterial overgrowth (SIBO)
• Acute infections with chronic consequences
• Abnormal cell functions, particularly the mitochondria