Abdominal Migraine and the Gut-Brain Axis

Abdominal migraine, as the name suggests, is a type of migraine that affects the abdominal region. Severe and intense headaches characterize most migraine attacks, but during an abdominal migraine, pain is actually located in the stomach rather than the head.

This type of migraine attack is usually experienced by children, although adults may also experience them. Abdominal migraine is most studied in children and there are currently very few studies on abdominal migraine in adults. Children affected by abdominal migraine are traditionally between the ages of five to nine.

According to Dr. Vander Pluym, a pediatric neurologist at the Mayo Clinic, “Abdominal migraine resolves in about 66% of patients by their late teens and 50-70% will go on to develop migraine attacks associated with head pain” [1]. Because its symptoms are not felt in the head as with a typical migraine, it is sometimes hard to link them together.

Within the Migraine Buddy community, almost 900 users have recorded experiencing abdominal migraine. A survey that we conducted earlier this year revealed that among those who have experienced abdominal migraine, 44% experienced it during adulthood while 39% during both adulthood and childhood! If anything, these numbers tell us that more work needs to be done to study abdominal migraine further especially in adults.

Symptoms of Abdominal Migraine

The symptoms that accompany this type of migraine resemble those that accompany a host of other gastrointestinal conditions. They include:

• Pain in the center of the stomach, usually around the navel region. The pain can be intense or moderate. It also does not affect the sides of the stomach.

• Nausea

• Loss of appetite

• Paleness

• Lightheadedness

• Fatigue

Indeed, the most common abdominal migraine symptoms experienced by the Migraine Buddy community are nausea (89%) and abdominal pain (85%). Abdominal migraine attacks usually stretch from 2 to 72 hours and “in between attacks there should be complete symptom freedom” [2].

The Gut-Brain Axis

Abdominal migraine attacks cause pain to the stomach, as well as being associated with other symptoms like nausea and vomiting. It only becomes natural to wonder whether there is a link between migraine attacks and the health of the gut. Let’s dive deeper into this!

Commonly known as the gut-brain axis, researchers have been studying this “bidirectional relationship between the GI system and the central nervous system (CNS)” in an attempt to understand how gut imbalance can be linked to chronic diseases such as celiac disease (CD), inflammatory bowel disease (IBD), or migraine [3-5]. 

The human gut is the host to trillions of microorganisms and it is always in communication with the brain. There are two main ways in which communication is postulated to occur between the gut and the brain [6]:

1. Neurotransmitters – microorganisms in the gut produce some neurotransmitters that are transported to the brain using the blood. Neurotransmitters can affect brain function significantly. When too much or too little of them are present, problems arise. The same happens when the wrong neurotransmitters are present at any given time.  

2. The vagus nerve – this nerve is the primary nerve connecting the gut and the brain. It plays a vital role in the way specific brain receptors are expressed.

Although the gut-brain axis remains to be explored deeper specifically for conditions like abdominal migraine, various studies have theorized on the possibilities of using probiotics to improve gut health, and in turn, reducing migraine days [3].

In a 2019 study, a probiotic supplement was given to 50 individuals experiencing either chronic or episodic migraine [7]. The probiotic contained 14 strains of bacteria that were dubbed ‘friendly’ to the gut. After eight to ten weeks, it was observed that migraine attacks had decreased in both frequency and intensity for those who took the probiotic. Among participants with chronic migraine, the frequency and intensity had dropped by 45% and 31% respectively while participants with episodic migraine experienced a corresponding decrease of 40% and 29% [6]. 

Do you know of anyone who has experienced abdominal migraine, or perhaps you’ve just learned about this term today? Feel free to share your thoughts and comments in the community chat group linked below! We would love to hear more about how you cope with this type of migraine. ?

References

[1] https://americanmigrainefoundation.org/resource-library/what-is-abdominal-migraine/

[2] https://americanmigrainefoundation.org/resource-library/abdominal-migraine/

[3] https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-1078-9

[4] https://pubmed.ncbi.nlm.nih.gov/27472486/

[5] https://pubmed.ncbi.nlm.nih.gov/27688656/

[6] https://www.news-medical.net/health/-Is-There-a-Link-Between-Migraine-and-The-Gut-Microbiome.aspx

[7] https://journals.sagepub.com/doi/full/10.1177/0333102418820102