An Approach to the Patient With Abdominal Migraine
By SEYMOUR DIAMOND, MD |
September 1, 2002
Diamond Headache Clinic, Chicago
Dr Diamond is founder and director of the Diamond Headache Clinic and director of the Diamond Inpatient Headache Unit at St Joseph
Hospital, both in Chicago. He is also adjunct professor of cellular and molecular pharmacology and clinical professor of family medicine at
Finch University of Health Sciences/The Chicago Medical School in North Chicago.
A bright, active 10-year-old boy has been experiencing recurrent bouts of
abdominal pain with nausea and occasional vomiting for 3 years. Although he
has had 1 or 2 attacks at school, the pain usually occurs at home—frequently
on weekends. His mother has been unable to correlate these episodes with particular
foods or activities. She notes that her son has experienced motion sickness
during long auto trips and during a family holiday in the mountains of
In infancy and until the age of 3 years, the child had multiple episodes of
vomiting. When he was about 5 years old, he complained of nausea and dizziness
after swinging as well as after a trip to an amusement park.
The mother has tried to ascertain whether the pain might be stress-related. Her son has had attacks at times that might be considered stressful, such as before
a soccer game or birthday party; however, he also has them at home. The
mother reports that when her son has an episode, he stops what he is doing and
lies down in a darkened room. On a few occasions, vomiting has relieved the
pain. The mother has migraine headaches and recalls that vomiting relieved
the attacks she had in high school.
To manage the pain, the parents have used over-the-counter remedies, such
as antacids, but the attacks usually resolve in 2 to 4 hours without treatment.
BLOG FOR CONSULTANTLIVE
Send us your blogs! Contact us for more information if you are interested in writing a post or becoming a blogger.
ABOUT OUR BLOGGERS
| || |
On Health and Mental Health
Erik R. Vanderlip, MD, is a senior fellow and acting instructor in the University of Washington Department of Psychiatry. As a dually-trained family physician and psychiatrist, Dr Vanderlip is active in national health system redesign efforts with a particular interest in newer models of the medical home. He practices family medicine in a hybrid primary care clinic within a mental health center in Seattle.
| || |
The HIV-AIDS Observer
Rodger D. MacArthur, MD, is Professor of Medicine, Wayne State University, Department of Internal Medicine, Division of Infectious Diseases and Director and Site Principal Investigator, Wayne State University HIV/AIDS Clinical Research Unit.
| || |
Speaking of Pain
Steven A. King, MD, MS, is in the private practice of pain medicine in New York, and he is Clinical Professor of Psychiatry at the New York University School of Medicine, New York.
| || |
Tales Doctors Tell
David T Nash, MD, is Clinical Professor of Medicine at Upstate Medical Center in Syracuse, New York. The author of more than 250 peer-reviewed clinical articles, Dr Nash has practiced cardiology in Syracuse for over 50 years. He is a Fellow of the National Lipid Association.
| ||Primary Care Matters |
Gregory W. Rutecki, MD, is Professor of Medicine at the University of South Alabama College of Medicine in Mobile. He is section editor of the hypertension topic center on this web site.
| ||Practice Makes Perfect |
Pamela Wible, MD, pioneered the first community-designed ideal medical clinic in America. An expert in patient-centered care, Dr Wible helps citizens design cutting-edge clinics and hospitals nationwide. Her model is taught in medical schools and featured in Harvard School of Public Health's newest edition of Renegotiating Health Care. Dr. Wible is a medical reporter for the Oregonian, has been interviewed by CNN, ABC, CBS, and is a frequent guest on NPR.