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Abdominal migraine – Rome IV — RACP Paediatrics MCQ

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ModerateGIAbdominal migraine – Rome IVRACP Paediatrics

A 10-year-old has episodic periumbilical abdominal pain lasting 1-72 hours occurring 2-3 times per month. During episodes she is pale, anorectic, and nauseated but does not vomit. Between episodes she is completely well. There is a family history of migraine. Growth and investigations are normal. What is the Rome IV diagnosis?

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Correct answer: A — Rome IV – abdominal migraine

Episodic midline abdominal pain lasting hours with associated vasomotor symptoms (pallor, anorexia, nausea), complete wellness between episodes, and family history of migraine meets Rome IV criteria for abdominal migraine. Treatment of acute episodes is with ibuprofen or triptans. Prophylaxis (pizotifen, cyproheptadine, propranolol) is considered if episodes are frequent.

Reference: RCH Melbourne – 2023 – Functional GI CPG; RACP Paediatric Curriculum – GI