Abdominal migraines and pizotifen

[Candlestickchic]

My pre-teen dd has been suffering with painful abdominal cramps and nausea all her life, but it has been much worse since starting secondary school. It is causing massive issues now with her attendance. It’s definitely worse when she’s anxious, but I’m not convinced it’s all anxiety as it has been an issue for so many years. She has been tested for celiac, inflammatory bowel conditions and so on. GP has suggested a trial of pizotifen as it might be abdominal migraine, but I am worried about the potential weight gain side effect as she would hate this. Dr said this only affects around 20% but a quick google is a bit scary. Has anyone had any experience of pizotifen for stomach migraines, or indeed have any other advice?

DS had pizotifen in year 7 ... his cyclical vomiting syndrome (similar to abdominal migraine) meant it was three months before he could manage a full week in school (his CVS at that time was triggered by anxiety and fatigue). It definitely helped him settle and he only took it for a few months. Over the years, his CVS reduced and he's now at Uni and doing well.
He did gain some weight while on Pizotifen but I never linked it to that ... he was very thin from throwing up so much that it was a relief to see some weight go back on. It wasn't a huge weight gain and no one else really noticed (just family).

I appreciate this is an old post however I'd love to know if anything has worked for your DD?

I could have written your post myself. My DD has been getting episodes of what I put down to abdominal migraines for several years now. She's in year 9 now and they seem to have suddenly ramped up!

Like you I have associated it with anxiety but I don't believe that it's all entirely down to this. I really don't know what triggers them. She's a happy girl generally with a lovely group of friends. She dances and doesn't have any issues at school.

I've never pursued this with a GP but feel this should be our next plan of action as these episodes are debilitating for her and her attendance at school is becoming a slight concern (for the school).

Hi, sorry I have only just seen your message. No I’m afraid nothing has really changed or helped. The pizotifen didn’t seem to help so she stopped after 6 months or so. She is now out of school and has an ASC diagnosis, and the tummy pains are significantly worse before any activity that causes her stress. Tummy issues can be linked with neurodivergence, but it sounds like your daughter is having a much smoother time at school than mine so that is probably a red herring. I do think it must be IBS, though I’m sure there are a myriad underpinning reasons for those symptoms; they just don’t know what they are yet.
Her tummy is a huge issue though, because even when she’s feeling more confident she doesn’t think going to college or something when she’s 16 will be possible due to the pain she’d be in.
I have thought about paying to see a gastro expert privately, however she is terrified of needles so I think wouldn't manage the tests they would want to do.
A paediatrician we saw about her EHCP said they usually suggest CBT for anxiety-related pain, or failing that amitriptyline. I haven’t looked into that a great deal yet.
sorry to hear your daughter suffers too. If you make any breakthroughs then please let me know!