colic

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Colic

 

Definition

Colic is persistent, unexplained crying in a healthy baby between two weeks and five months of age.

Description

Colic, which is not a disease, affects 10-20% of all infants. It is more common in boys than in girls and most common in a family's first child. Symptoms of colic usually appear when a baby is 14-21 days old, reach a crescendo at the age of three months, and disappear within the next eight weeks. Episodes occur frequently but intermittently and usually begin with prolonged periods of crying in the late afternoon or evening. They can last for just a few minutes or continue for several hours. Some babies who have colic are simply fussy. Others cry so hard that their faces turn red, then pale.

Causes and symptoms

No one knows what causes colic. The condition may be the result of swallowing large amounts of air, which becomes trapped in the digestive tract and causes bloating and severe abdominal pain.
Other possible causes of colic include:
  • digestive tract immaturity
  • food intolerances
  • hunger or overfeeding
  • lack of sleep
  • loneliness
  • overheated milk or formula
  • overstimulation resulting from noise, light, or activity
  • tension
During a colicky episode, babies' bellies often look swollen, feel hard, and make a rumbling sound. Crying intensifies, tapers off, then gets louder. Many babies grow rigid, clench their fists, curl their toes, and draw their legs toward their body. A burp or a bowel movement can end an attack. Most babies who have colic do not seem to be in pain between attacks.

Diagnosis

Pediatricians and family physicians suspect colic in an infant who:
  • has cried loudly for at least three hours a day at least three times a week for three weeks or longer
  • is not hungry but cries for several hours between dinnertime and midnight
  • demonstrates the clenched fists, rigidity, and other physical traits associated with colic
The baby's medical history and a parent's description of eating, sleeping, and crying patterns are used to confirm a diagnosis of colic. Physical examination and laboratory tests are used to rule out infection, intestinal blockage, and other conditions that can cause abdominal pain and other colic-like symptoms.

Treatment

Medications do not cure colic. Doctors sometimes recommend simethicone (Mylicon Drops) to relieve gas pain, but generally advise parents to take a practical approach to the problem.
Gently massaging the baby's back can release a trapped gas bubble, and holding the baby in a sitting position can help prevent air from being swallowed during feedings. Bottle-fed babies can swallow air if nipple holes are either too large or too small.
Nipple-hole size can be checked by filling a bottle with cold formula, turning it upside down, and counting the number of drops released when it is shaken or squeezed. A nipple hole that is the right size will release about one drop of formula every second.
Babies should not be fed every time they cry, but feeding and burping a baby more often may alleviate symptoms of colic. A bottle-fed baby should be burped after every ounce, and a baby who is breastfeeding should be burped every five minutes.
When cow's milk is the source of the symptoms, bottle-fed babies should be switched to a soy milk hydrolyzed protein formula. A woman whose baby is breastfeeding should eliminate dairy products from her diet for seven days, then gradually reintroduce them unless the baby's symptoms reappear.
Since intolerance to foods other than cow's milk may also lead to symptoms of colic, breastfeeding women may also relieve their babies' colic by eliminating from their diet:
  • coffee
  • tea
  • cocoa
  • citrus
  • peanuts
  • wheat
  • broccoli and other vegetables belonging to the cabbage family
Rocking a baby in a quiet, darkened room can prevent overstimulation, and a baby usually calms down when cuddled in a warm, soft blanket.
Colicky babies cry less when they are soothed by the motion of a wind-up swing, a car ride, or being carried in a parent's arms. Pacifiers can soothe babies who are upset, but a pacifier should never be attached to a string.
A doctor should be notified if a baby who has been diagnosed with colic:
  • develops a rectal fever higher than 101°F (38.3°C)
  • cries for more than four hours
  • vomits
  • has diarrhea or stools that are black or bloody
  • loses weight
  • eats less than normal

Alternative treatment

Applying gentle pressure to the webbed area between the thumb and index finger of either hand can calm a crying child. So can gently massaging the area directly above the child's navel and the corresponding spot on the spine. Applying warm compresses or holding your hand firmly over the child's abdomen can relieve cramping.
Teas made with chamomile (Matricaria recutita), lemon balm (Melissa officinalis), peppermint (Mentha piperita), or dill (Anethum graveolens) can lessen bowel inflammation and reduce gas. A homeopathic combination called "colic" may be effective, and constitutional homeopathic treatment can help strengthen the child's entire constitution.

Prognosis

Colic is distressing, but it is not dangerous. Symptoms almost always disappear before a child is six months old.

Prevention

Many doctors believe that colic cannot be prevented. Some alternative practitioners, however, feel that colic can be prevented by an awareness of food intolerances and their impact.

Resources

Organizations

American Academy of Family Physicians. 8880 Ward Parkway, Kansas City, MO 64114. (816) 333-9700. http://www.aafp.org.
American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000. http://www.aap.org.

colic

 [kol´ik]
acute paroxysmal abdominal pain. It is particularly common during the first three months of life; the infant has paroxysmal, unexplained crying and may pull up arms and legs, turn red-faced, and expel gas from the anus or belch it up from the stomach. The exact cause of infantile colic is not known but several factors may contribute to it, including excessive swallowing of air, too rapid feeding or overfeeding, parental anxiety, allergy to milk, or other feeding problems. It generally occurs at the same time of day, usually at the busiest period. The parents need sympathetic support and assurance that the condition is not serious and most infants gain weight and are healthy in spite of the colic.
biliary colic colic due to passage of gallstones along the bile duct.
gastric colic gastrodynia.
lead colic colic due to lead poisoning.
menstrual colic dysmenorrhea.
renal colic intermittent, acute pain beginning in the kidney region and radiating forward and down to the abdomen, genitalia, and legs; the usual cause is calculi in a kidney or ureter. Symptoms include nausea, vomiting, diaphoresis, and a desire to urinate frequently.

col·ic

(kol'ik),
1. Relating to the colon.
2. Spasmodic pains in the abdomen.
3. In young infants, paroxysms of gastrointestinal pain with crying and irritability, typically occurring in late afternoon or early evening; of unknown etiology; affects infants from 3 weeks to 3 months of age.
[G. kōlikos, relating to the colon]

colic

/col·ic/ (kol´ik)
1. acute paroxysmal abdominal pain.
2. pertaining to the colon.

appendicular colic  pain in the vermiform appendix caused by inflammation.
biliary colic  colic due to passage of gallstones along the bile duct.
gallstone colic , hepatic colic biliary c.
infantile colic  a paroxysmal type seen during the first 3 months of life.
lead colic  colic due to lead poisoning.
renal colic  pain due to thrombosis of the renal vein or artery, dissection of the renal artery, renal infarction, intrarenal mass lesions, or passage of a stone within the collecting system.
vermicular colic  appendicular c.

colic

(kŏl′ĭk)
n.
1. Severe abdominal pain caused by spasm, obstruction, or distension of any of the hollow viscera, such as the intestines.
2. A condition of unknown cause seen in infants less than three months old, marked by periods of inconsolable crying lasting for hours at a time for at least three weeks.
adj. (also kō′lĭk)
Of, relating to, or affecting the colon.

col′ick·y (kŏl′ĭ-kē) adj.

colic

[kol′ik]
Etymology: Gk, kolikos, colon pain
1 n, sharp visceral pain resulting from torsion, obstruction, or smooth muscle spasm of a hollow or tubular organ, such as a ureter or the intestines. Kinds of colic include biliary colic, infantile colic, and renal colic.
2 adj, pertaining to the colon. colicky, adj.

colic

Medspeak
Pain that crescendos to a peak of severity and then slowly subsides.
 
Pediatrics
Infantile colic—A common symptom of infants, in which paroxysmal abdominal pain of presumed GI origin is accompanied by irritability, tensing of muscles and severe crying, lasting until the infant is completely exhausted.
 
Aetiology
Uncertain, possibly air swallowing, overfeeding, cow’s milk allergy, undiluted juices and emotional stress; in the absence of organic causes (e.g., strangulated hernia, intussusception, pyelonephritis or others) no therapy gives consistent relief; infants often outgrow colic by 6 months of age.

colic

Clinical medicine Pain that crescendos to a peak of severity and then slowly subsides. See Abdominal colic, Renal colic Pediatrics Infantile colic A common Sx of infants, in which paroxysmal abdominal pain of presumed GI origin is accompanied by irritability, tensing of muscles, severe crying, lasting until the infant is completely exhausted Etiology Uncertain, possibly air swallowing, overfeeding, cow's milk allergy, undiluted juices, and emotional stress; in absence of organic causes—strangulated hernia, intussusception, pyelonephritis, others—no therapy gives consistent relief; infants often outgrow colic by 6 months of age.

col·ic

(kol'ik)
1. Relating to the colon.
2. Spasmodic pains in the abdomen.
3. In young infants, paroxysms of gastrointestinal pain, with crying and irritability, due to a variety of causes, such as swallowing of air, emotional upset, or overfeeding.
[G. kōlikos, relating to the colon]

colic

Periodic spasms of pain caused by stretching of the walls of a hollow organ undergoing powerful contraction, often in the attempt to overcome a partial obstruction or to move a hard object, such as a stone.

col·ic

(kol'ik)
Spasmodic pains in the abdomen.
[G. kōlikos, relating to the colon]

colic (kôl´ik),

n a sharp visceral pain resulting from torsion, obstruction, or smooth muscle spasm of a hollow or tubular organ, such as a ureter or an intestine.

colic

1. pertaining to the colon.
2. a syndrome caused by severe paroxysmal pain due to disease of an abdominal organ. Usually due to alimentary tract disease, and rarely to infection or calculus in the urinary tract involving the renal pelvis, ureter, bladder or urethra.

bovine colic
is characterized mainly by recurrent bouts of downwards arching of the back, restless walking, looking at the flank, lying down, rolling, and getting up again. Colic is evident for a few hours only and is followed by spontaneous recovery in most cases. These cases are probably caused by intestinal spasm.
The next most common cause is intestinal obstruction by phytobezoar, volvulus, strangulation (2), or intussusception. In these the colic disappears but no feces are passed for some days. Rectal examination reveals scant, pasty gray or blood-stained feces, and possibly the presence of distended loops of intestine. Enterotomy or enterectomy is essential for survival. Rare cases also occur due to renal infarction or to ureteric obstruction.
colon impaction colic
impaction of the colon on a diet high in tough fiber is common in horses and pigs. There is mild abdominal pain and hard fecal masses are passed. See also meconium ileus, impaction colic (below).
equine colic
most cases are due to intestinal disease. Characteristic signs are bouts of pain marked by pawing, looking at the flank, lying down and getting up restlessly, rolling; the gut sounds are either absent or excessive. Mild cases recover spontaneously or after medical treatment for gut spasm or impaction with dry feed. Life-threatened cases have shock, circulatory collapse and usually positive findings on abdominal paracentesis. Surgery is often obligatory. Acute colic is also an important part of the syndrome in acute enteritis and colitis in which diarrhea is a paramount sign. Peritonitis is usually manifested as subacute colic.
flatulent colic
of horses is due to gas accumulation in the large intestine when grazing on lush pasture. There is severe pain, obvious distention of the abdomen, and the rectum is obstructed by distended loops of bowel. Sporadic cases occur as a result of partial obstruction of the intestine by fibrous adhesions. Trocarization through the flank or rectum is often necessary. Called also tympanitic colic. Previously called intestinal meteorismus.
gastric dilatation colic
of horses due to gastric dilatation is a severe acute disease due to gorging on hay or grain, especially immediately after racing, or due to lipoma causing strangulation at the pylorus. Regurgitation through the nostrils or the discharge of large quantities of fluid gastric contents through a nasal tube is a frequent sign. Death is common as a result of gastric rupture.
impaction colic
in horses is due to dry or indigestible feed, or bad teeth, or in foals by the retention of meconium. Subacute pain bouts occur at long intervals and over several days; death in untreated cases is due to exhaustion. Effective treatment is large oral doses of mineral oil (paraffin) administered by nasal tube. See also colon impaction colic (above).
intestinal obstruction colic
in horses is caused by intestinal obstruction consisting mostly of acute life-threatening cases due to intussusception, strangulation or volvulus, usually affecting the small intestine, although sometimes it is the cecum or colon. Typical signs are shock, absence of gut sounds, very severe pain, short course, positive findings of blood-stained fluid on paracentesis, distended loops of gut on rectal examination and death due to shock and dehydration unless the blockage is relieved by surgery.
Less severe cases are caused by impaction of the ileocecal valve by undigested fine fiber or grain, by sand accumulation, obstruction by phytobezoars, enteroliths or linear foreign bodies, usually in the small colon. See also under enterolith, phytobezoar, linear foreign body, volvulus, intussusception, strangulation.
lead colic
colic due to lead poisoning.
recurrent colic
equine colic that recurs at intervals of weeks or months. Due usually to repeated dietary indiscretions or to a persisting defect, e.g. bad teeth, verminous aneurysm.
renal colic
intermittent and acute pain usually resulting from the presence of one or more calculi in the kidney or ureter.
sand colic
is caused by the ingestion of soil or sand and can be an acute syndrome due to ileocecal valve impaction or chronic mild pain with diarrhea for a period of months.
spasmodic colic
this form of colic in horses is often due to excitement. Bouts of sharp pain are accompanied by loud, frequent gut sounds, and spontaneous recovery is usual within an hour. Occasional cases develop volvulus during bouts of rolling.
thromboembolic colic
is caused by infarction of a section of gut wall or by stimulation by migrating strongyle larvae and may appear as intermittent spasmodic colic or subacute colic for a number of days followed by development of peritonitis. See also strongylosis.
tympanitic colic
see flatulent colic.
References in periodicals archive ?
We believe these results will have an impact on the treatment of infants with colic, says Doctor Savino.
Among those patients, the likelihood of remaining colic free was comparable in strong and weak contractors (minimal gallbladder volume less than or equal to 6 mL and greater than 6 mL, respectively).
As an aged mare who has always been fond of her food,I suspected that her spasmodic colic had been caused in part by her teeth, which as she has become older are less effective in grinding down her grass.
However colic can come on for no apparent reason,although the most common causes are improper feeding, worm infestation,large feeds when exhausted, cooked feeds, sharp teeth, sudden changes of food and watering after feeding.