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Colic

Category: Illness or disabilities

Type

Involuntary

Introduction and description

burping a baby to relieve colic

Colic (from Greek κολικός kolikos, "relative to the colon") or cholic is a form of intense pain that starts and stops abruptly.

It is a symptom not an illness or disease and may have one of any number of causes.

Symptoms

A stabbing pain which is very localised, that occurs in waves.  It may last for some time depending on the cause and whether the body manages to sort out the problem itself.  It may be accompanied by sweating and shakiness.

A bit of history

Devon colic was a condition that affected people in the English county of Devon during parts of the 17th and 18th centuries.  The first written account of the colic comes from 1655. Symptoms began with severe abdominal pains and the condition was occasionally fatal. Cider is the traditional drink of Devonians, and the connection between the colic and cider drinking had been observed for many years.  William Musgrave's publication De arthritide symptomatica (2nd edn, 1715) included the first scientific description of "Devonshire colic" – it was later referred to by John Huxham and Sir George Baker.

Cruickshank - The Cholick

The condition was initially attributed to the acidity of the beverage, but the actual cause was discovered in the  1760s when Dr George Baker put forward the hypothesis that poisoning from lead in cider was to blame. He observed that the symptoms of the colic were similar to those of lead poisoning. He pointed out that lead was present in the cider making process, as the cider presses were often lined with lead, as were the vats for fermentation and the very acid juice could leach the lead into the juice.  He conducted chemical tests and found that indeed lead could be found in Devon apple juice.

The publication of his results met with some hostile reaction from cider manufacturers, but once Baker's conclusions became accepted and the elimination of lead from the cider making process was undertaken, the colic declined. By 1818, Baker's son reported that it was "hardly known to exist" in Devon.

In other words it was a symptom of lead poisoning, and can be a symptom of poisoning of all sorts.

Causes

To be called colic, the pain must be the result of muscular contractions of an organ in the body, designed to remove an unwanted substance present, or relieve an obstruction, by forcing the content out.   Poisoning has already been mentioned as a cause – the body in this cases is trying to expel the poison or toxin.  The reasons the spasms are so intense is that with poisoning, the body is doing this in a most forceful urgent way, in line with the degree of danger the toxic substance represents.  But we may also find:

  • Renal colic -  a pain in the flank, and usually caused by an attempt by the body to expel kidney stones.  See Kidney disease
  • Biliary colic - blockage by a gallstone of the common bile duct or cystic duct and thus a disease of the gall bladder.  See Gall bladder disease
  • Intestinal colic – also called Ileus colic and resulting from a blockage of the intestines, which might itself be caused simply by a swallowed but undigestable object; or by bowel twist or similarly, bowel strangulation.  It may also be caused by Intussusception - part of the intestine has collapsed into another section of intestine - see Intestine disease
  • Baby colic - a condition, usually in infants, accompanied by incessant crying, great distress, an occasionally distended stomach and an inability to sleep from the pain.  This may itself be caused by
    • Trapped wind.  The baby gulps its food/milk and as a consequence also swallows air.  The air is of course unwanted in the stomach, so the stomach muscles contract trying to force the air/wind out.  If the baby is ‘winded’, this usually solves the problem, although the baby may well be sick in the process.  The baby may not be at fault – in other words the cause is not a greedy baby, often it is a stressed baby reacting to its mother and her lack of care or composure, or it can be simply a very hungry baby who is not being fed often enough and regularly enough. 
    • Inappropriate foods – giving a baby who should be on mother’s milk foods or liquids that are inappropriate for its age or delicate digestive system. Poisoning
    • Withdrawal symptoms - Babies suffering from withdrawal symptoms from drugs the mother has taken can be distressed and colicky.  It is a form of poisoningBenzodiazepines like Valium have and had a very bad record for producing colicky babies.
    • Pharmaceuticals – which can act as poisons in a baby.  Poisoning
    • Caesarian delivery - babies delivered by caesarian section may not have obtained the necessary intestinal flora needed to digest and process their food
    • Being born premature -the earlier the birth the more problems there may be

    Preterm and growth restricted infants may have developmental delays and deviations from normal organ function related to the gastrointestinal tract and the central nervous system. …. We observed an increased risk of infantile colic in preterm and small for gestational age infants in a large cohort. PMID:  24261325

Treatment

Find the cause

 

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