Psychosocial risk factors for headache and stomache-ache and their co-occurrence were investigated in a longitudinal study of Norwegian children aged 4-10 years at the Department of Health and Society, National Institute of Public Health, Oslo, Norway. Children with headache only were well behaved as preschoolers, high achievers, and their mothers were employed outside the home. The stomache-ache alone group had an earlier onset of symptoms than those with headache, they were well-adapted emotionally, and their mothers were less educated. Childhood emotional problems and low maternal emotional support differentiated the co-occurrence group from the headache and stomach-ache only groups. School factors were not associated with the co-occurrence syndrome. [1]

COMMENT. The co-occurrence of headache and stomach-ache in young children appears to constitute a distinct syndrome with psychosocial implications that may need to be addressed early to prevent later childhood incapacity. In the absence of central nervous or abdominal pathology, an interactive pediatric and psychological approach involving the mother and child is advised.

The absence of increased psychological or psychosocial disability in children with recurrent abdominal pain or in their families compared to controls, noted in the above study, is also alluded to in a letter to the editor. [2]

A study of esophogeal, gastric and duodenal biopsies in 31 children with migraine found twenty nine with an underlying inflammatory lesion of the gastrointestinal tract that could explain the associated symptoms of nausea (93% of patients), vomiting (42%), and abdominal pain (55%). The authors suggest that the findings support a causal link between recurrent abdominal pain and migraine. [3]