Colicky pain occurs as sudden spasmodic abdominal pain that occurs in cycles and then resolves. While it is a problem often linked with newborns, it can also occur in older children and adults.
Colicky pain can occur in children and adults as a symptom of health problems affecting the gallbladder, kidneys, or intestines. In infants, it is more often a problem involving uncontrollable crying without a known cause.
This article describes colicky pain in infants, children, and adults. It also explains causes, symptoms, treatment, and ways to prevent it at all ages.
Describing Colicky Pain Symptoms
Colicky pain symptoms involve abdominal pain that starts, intensifies, and ends suddenly in severe waves. Symptoms can vary due to their cause.
Pain Location and Sensations
The pain location and sensations of colic in adults can include:
- Generalized pain: pain that occurs in more than half your belly
- Localized pain: Pain found in only area of your belly or on one side, as in the case of kidney stone pain that occurs where the kidney stones are located
- Cramping pain: Intestinal cramps attributable to gas and bloating, often followed by diarrhea
Signs in Babies
Colic in babies occurs as a special pattern of crying in babies who are otherwise healthy. Despite eating and growing well, they cry in spells, usually at the end of the day.
Other signs of colic in babies include:
- Crying for no obvious reason such as hunger or diaper change
- Crying in a pattern that occurs at the same time every day, usually in the late afternoon or early evening
- Clenching of fists when crying
- Curling up of the legs when crying
- Arching the back when crying
- Crying as though they are in pain
- Turning bright red with pale skin around the mouth when crying
- Passing gas
Onset and Duration
In babies, colic usually occurs in the following pattern:
- Onset of colic at around 3 weeks old
- Worsening symptoms lasting about three hours a day between 4 weeks and 6 weeks of age
- Improvement after 6 weeks of age, declining to about one to two hours a day
- Resolution of colic by 12 weeks old, though it can last until 6 months of age
In adults, colicky pain often occurs as severe pain that comes in waves. It suddenly starts and abruptly ends in periods that can last minutes to hours.
Emotional Effects
Colic in babies is usually harmless in a baby’s physical growth. However, there is some evidence that it may have long-term emotional effects on the impacted infant, though more research is needed.
The emotional effects of a baby with colic can be overwhelming for parents. Being unable to soothe a distressed baby can threaten a parent’s feeling of personal adequacy concerning their parenting skills.
Parents of babies with colic often experience a broad range of emotional effects that can include:
Adolescents and adults living with chronic pain such as colic are vulnerable to the emotional effects of anxiety and depression, leading to a low health-related quality of life.
Why Colic Results in Pain
Colic results in pain that occurs due to distension, obstruction, or inflammation. Pain can result as your abdominal muscles vigorously contract to try to resolve the obstruction.
Affected Organs
Adult colic involves intestinal or urinary system pain in different types of colic:
Gallbladder
Biliary colic occurs as a result of distension (an increase in size) of your gallbladder. It occurs when the flow of bile is disrupted. Bile is a digestive aid that is produced in your liver and stored in your gallbladder.
The blockage typically results from a gallstone (a hardened deposit of bile), which blocks the flow of bile from your gallbladder. Biliary colic usually occurs as a steady or intermittent pain in your upper abdomen, often under the right side of your rib cage. The pain may be more common after eating a large fatty meal since more bile is needed to break down the fat.
Kidneys
Renal (kidney) colic occurs with the formation of kidney stones (hard clumps of minerals and salt that form in your kidneys). Severe pain, or kidney colic, can occur when the stones move around in your kidney or block the flow of urine in a ureter (one of two tubes that lead from your kidney to your bladder).
Kidney colic typically occurs as severe pain in your lower back, side, or groin. The pain may move to the groin area, affecting the testicles in men and the labia in women.
Intestines
Intestinal colic can occur as cramping in your intestines, usually due to a blockage in your large or small intestine.
Common causes of blockages leading to intestinal colic include:
- Impacted stool
- Stricture (narrowing) from Crohn’s disease or diverticulitis
- Adhesions (fibrous scar tissue) after surgery
- Volvulus (twisted bowel)
- Hernia (a tear in a muscle or other tissue that allows part of an internal organ to bulge through)
- Benign (noncancerous) or malignant (cancerous) colon tumors
Related Surgeries
Colicky pain can occur after surgeries that involve the following areas:
- Pelvis
- Abdomen
- Lower digestive tract
- Colon and rectum
- Female reproductive systems (gynecologic surgeries)
These procedures are more likely to result in abdominal adhesions. These bands of scar-like tissue form inside your abdomen between two or more organs or between organs and your abdominal wall, causing these surfaces to become adhered together.
As abdominal adhesions kink, twist, pull, or compress your intestines and other abdominal organs, you can experience an intestinal blockage or obstruction. This can restrict the. movement of food or stool through your intestines, leading to colicky symptoms.
Other Exacerbating Factors
Having any of these exacerbating factors can increase your risk of having colicky pain:
- Stoma: A stoma is a surgical opening between a hollow organ and your body surface. It is created in the gastrointestinal tract in colostomies and ileostomies to collect waste that cannot pass through your colon. It can also be created in your urogenital tract in urostomies to redirect urine content. An obstruction in the stoma can cause colicky pain and cramping.
- Inflammatory bowel disease (IBD): IBD includes Crohn’s disease and ulcerative colitis. These disorders are characterized by chronic inflammation that damages your gastrointestinal tract. As a result, the nerves that propel food through your digestive system can become overly sensitized As a result, they can overreact to mild stimuli, causing spasms and colicky, cramping pains.
Is It Colicky Pain or Something Else?
There are numerous causes of abdominal pain. This can make it hard to determine whether the problem is colicky pain or another medical condition.
If your baby is demonstrating signs of colic, do not hesitate to contact your healthcare provider for a consultation. Colic typically begins within the first few weeks of life, so it can be challenging to determine what is normal for your baby.
Your baby’s healthcare provider can identify the cause of colic and advise what you can do to relieve symptoms. In some cases, the cause of colic remains unknown. Causes of colic in babies can include:
- Pain from gas
- Hunger
- Overfeeding or poor feeding technique
- Allergy or Intolerance for certain foods or proteins in breast milk or formula
- Sensitivity to certain stimuli
- Emotions such as frustration, fear, or excitement
- Reflux
- Constipation
In older children and adults, colicky pain can have a broad differential diagnosis (difficulty narrowing down the cause since this type of pain is true of many conditions). If symptoms continue, contact your healthcare provider. Many conditions with similar symptoms can be easily remedied with the right treatment. Other conditions require immediate care for the best results. Some common conditions that mimic symptoms of colic include:
Severe Symptoms and Complications of Colicky Pain
Call 911 or go to an emergency room emergency care for the following severe symptoms of colicky pain:
- Severe stomach pain that interferes with your normal ability to function, move, eat, or drink
- Sudden onset of stomach pain
- High fever
- Blood in your stool, urine, or vomit
- Stomach pain after an accident that caused abdominal trauma
- Severe nausea
- Pain in the upper abdomen under your rib cage
- Jaundice (yellow skin or eyes)
- Vomiting blood or a black material that resembles coffee grounds
How to Manage Colicky Pain at Home
In babies, colic can often occur for unknown reasons. If you’ve established that your baby is not hungry or in distress for another reason, you may be able to manage colicky pain at home by trying these strategies to distract and soothe your baby during bouts of with the following strategies:
- Hold and cuddle your baby.
- Swaddle your baby in a soft blanket.
- Walk with your baby.
- Sing and talk softly to your baby.
- Gently rock your baby by swaying them back and forth or using a baby swing under your supervision.
- Gently rub your baby’s back.
- Position your baby near rhythmic noises such as a sound machine or a sound machine.
- Take your baby for a ride in the car.
- Provide a pacifier for your baby.
- Try Mylicon (simethicone), an over-the-counter gas remedy for babies.
Try the following strategies to treat colicky pain in older children and adolescents:
- Sip water or other clear fluids in small amounts.
- Avoid solid food during the first few hours of pain.
- If you have been vomiting, wait six hours before eating, then resume with mild foods such as rice, applesauce, or crackers. Avoid dairy products.
- For colicky pain that occurs high up in your abdomen after meals, try using antacids.
- Avoid the following foods: High-fat foods fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages
- Take Motrin or Advil (ibuprofen) or Aleve (naproxen) to ease symptoms and inflammation if your colic is due to gastroenteritis, ulcerative colitis, or Crohn’s disease.
- Apply a heating pad to the abdominal area.
- Try using a laxative if you have not had a bowel movement in several days or longer.
- Go for a walk or take a warm shower, which can help ease colicky pain caused by intestinal gas.
How to Treat Colicky Pain
Additional treatments for colicky pain depend on the cause of pain in older children and adults. Your healthcare provider may advise one of the following therapies:
Prescription antispasmodic colic medicine to ease spasms in the wall of your bowel:
Treatment of kidney stones includes:
- Noninvasive extracorporeal shock wave lithotripsy: This involves the use of sound waves to crush kidney stones.
- Percutaneous nephrolithotomy: This involves the insertion of a tube through a small hole in your back to remove or break up kidney stones.
- Ureteroscopy: This involves passing a fiber-optic camera up into your ureter and kidney to remove or break up smaller stones using delicate instruments
- Pyelolithotomy: This involves the surgical removal of a kidney stone as an open or laparoscopic procedure.
Removal of gallstones includes:
- Cholecystectomy: This involves the removal of your gallbladder through open surgery or laparoscopic surgery.
- Shock wave lithotripsy: This treatment uses shock waves to blast gallstones into small pieces.
- Endoscopic retrograde cholangiopancreatography: This uses endoscopy (inserting a long, narrow tube with a tiny camera and tools attached into the body) to remove a lodged gallstone.
- Oral dissolution therapy: This treatment uses medications that include Actigall (ursodiol) and Chenix (chenodiol) to break up gallstones.
Talk to your healthcare provider before introducing treatments for your baby’s colic. The following list includes a sample of the complementary and alternative therapies that may be advised:
Long-Term Effects of Living With Colic
There is some evidence that colic may have long-term effects on infants who experience it.
It can also cause a significant emotional burden on parents who feel inadequate or helpless in managing their child’s needs.
Living with long-term colicky pain is physically and emotionally draining. When children and adults endure long-term colicky pain, they become vulnerable to anxiety, depression, and a decreased quality of life at home and at work.
Lifestyle Habits to Offset Colicky Pain
The following lifestyle habits may help offset colicky pain:
- Manage underlying conditions such as Crohn’s disease and ulcerative colitis.
- Drink plenty of water to stay hydrated every day.
- Eat small meals more often instead of a few large meals.
- Consume a well-balanced diet high in fiber and rich in fruits and vegetables.
- Exercise often.
- Reduce intake of foods that produce gas.
- Avoid soft drinks that contain phosphoric acid.
In babies with colic, the following lifestyle habits may help relieve colic:
- Hold or sit the baby upright during feeding to reduce the amount of air the baby swallows.
- Hold the baby upright after eating, then tap them on the back to eliminate any gas.
- Avoid spices, caffeine, and alcohol if you are breastfeeding since cheese ingredients may pass into breast milk.
- Avoid overfeeding or feeding your baby too quickly. Bottle-feeding should take about 20 minutes.
Summary
Colicky pain is a common problem in infants. However, it can also impact older children and adults.
While home treatments may help improve episodes of colicky pain, long-term symptoms should not be ignored. A healthcare provider can diagnose the cause of your pain and advise appropriate treatments.
In infants, treatment may involve lifestyle changes and home remedies until the infant outgrows the problem. In children and adults, treatment can vary based on the cause. Lifestyle changes, medication, therapies, and/or surgery may be advised.