Abdominal Migraine

Angela is a 7-year-old Caucasian first grader who has been sick for two years. Her mother explains that Angie has vomiting spells that last as long as one hour almost every day. She also has diarrhea, complains of dizziness, and wants to be held to “make it go away.” She likes school but is afraid she’ll vomit in the classroom.

She does not appear sick. Her eyes are bright, she’s smiling, and walks around the office investigating interesting items like any normal 7-year-old. She acts as if she does not hear what her mother is saying.

I ask the child, “Do you have headaches?” She shakes her head, “Yes,” still smiling. Her mother exclaims, “It is a 6 out of a 10 every day!” I ask her mother, “Do you have migraine?” “Yes.” “Do you think Angie does too?” “I hope not.” I sense that she feels guilty about passing on this “defect.”

I look at the child and say, “A migrainous nervous system has positive things too, like being creative. I bet you like drawing or coloring or making things.” She nods her head, “Yes.” “Show me.” She draws colorful birds flying in a bright sky full of the sun and clouds.

In the meantime, the mother lists the number of physicians she has consulted about her daughter’s GI symptoms. But nothing worked. She was still vomiting often.

I described the migrainous nervous system as being hyperexcitable and that via the brain-gut axis, the gut can express what the brain is going through. “Now you gut is overly excited. We’ll have to calm down your entire system by teaching you relaxation.” She sat in a recliner.

For years, I have been teaching patients how to relax their nervous system by using the Relax Mate, which looks like sunglasses but are opaque with a small blue light in each lens that blinks to the frequency of the theta brain wave state. These glasses induce the brain to slow down to the theta brain wave state, which relaxes the entire body. For more information about the Relax Mate, go to

http://www.normshealy.com/comersus/store/comersus_viewItem.asp?idProduct=162

I instruct Angie to close her eyes and listen to a relaxing visualization CD that I play. I suggest that she pretend she is in a place that is beautiful and fun. I explain that her mother and I would be in the room next door while she relaxes her body.

Her mother and I discussed the way Angie should communicate to her teacher when she felt GI distress or a headache coming on and needed to go to the school nurse’s office to practice relaxing her body. I explained that relaxing the body would also calm her GI tract, lessening the incidence of vomiting and diarrhea. Her Mom rented the Relax Mate and she added, “If it works, I’ll buy it.”

Angie and her Mom returned one week later. “It was a healthy week,” her mother beamed. “She likes to relax and sees that it helps.” She reported no GI episodes.

The nervous system is an integrated feedback system that constantly adjusts to the environment. Along the Brain-Gut Axis, there are four interdependent systems: the central nervous system (CNS), the peripheral nervous system (PNS), the autonomic nervous system (ANS), and the enteric nervous system (ENS). In short, hypersensitivity is a whole body experience. If the ANS senses threat, the entire body responds with a survival mode of hypervigilance to defend the organism from attack. This threat can be real or imagined. To help the person identify the threat is the first step in resolving the body’s overreaction. In Angie’s case, her fear, shared by her mother, was that her body was failing. Given the opportunity to normalize the hyperexcitability was the key to reverse the body’s need to prepare for survival and showed the 7-year-old how to calm her body.

For more information about the integration of the various nervous systems to threats in the environment and the symptoms that result, go to http://www.ncbi.nlm.nih.gov/pubmed/22447132

For an interesting study about abdominal migraine, go to http://www.headachejournal.org/SpringboardWebApp/userfiles/headache/file/abdominal.pdf

Probiotics offers an important treatment option to those with GI distress. However, as the case of Angie demonstrates, because of the Brain-Gut Axis, not all GI symptoms respond to probiotics.

For a CME article about probiotics, visit: http://www.primaryissues.org/2012/11/probiotics_pi161/