Diagnostic criteria for abdominal migraine, a functional gastrointestinal disorder of recurrent paroxysmal abdominal pain.

Criteria

1) Paroxysmal episodes of intense, acute periumbilical, midline, or diffuse abdominal pain lasting ≥1 hour (should be the most severe and distressing symptom)
2) Episodes are separated by weeks to months
3) The pain is incapacitating and interferes with normal activities
4) Stereotypical pattern and symptoms in the individual patient
5) The pain is associated with ≥2 of the following: Anorexia, nausea, vomiting, headache, photophobia, or pallor
6) After appropriate evaluation, the symptoms cannot be fully explained by another medical condition

Alarm Features

Patients with any of the following alarm features must be evaluated clinically for other diagnoses even though abdominal migraines may be present: 1) Persistent right upper or right lower quadrant pain. 2) Pain radiating to the back. 3) Dysphagia. 4) Odynophagia. 5) Persistent or bilious vomiting. 6) Gastrointestinal blood loss. 7) Nocturnal diarrhea or diarrhea. 8) Arthritis. 9) Perirectal disease. 10) Involuntary weight loss. 11) Deceleration of linear growth. 12) Delayed puberty. 13) Chronic and unexplained diarrhea. 14) Recurrent or unexplained fever. 15) Dysuria or Hematuria. 16) Family history of inflammatory bowel disease, celiac disease, or peptic ulcer disease.