Colicky Pain Abdomen
Stomach aches are common. Often, they are not a cause for concern. However, there are many different causes of abdominal pain, and some could be a sign of a serious illness. Because of this, it is important to not ignore persisting abdominal pain, even if the pain is not constant or daily.
There are many different organs in the abdomen, including the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas. Any one of these organs can cause pain. If you are feeling pain in the abdomen—be it upper, lower, mild, sharp or cramp-like, it can be challenging to figure out the cause by yourself.
Gastroenterologists are specialists who can help determine the exact cause of your abdominal pain. There are four main types of abdominal pain: generalized, localized, cramp-like and colicky. Generalized pain appears most often with a stomach virus, indigestion or gas.
- The pain can be felt in over half of the abdomen.
- If the pain becomes severe, it could indicate a blockage of the intestines.
- Localized abdominal pain means that it is limited to one area of the abdomen.
- Most often, localized pain is caused by problems in a particular organ, such as an ulcer of the stomach or diverticulitis of the colon,
Crampy pain could be associated with a few different things, such as diarrhea, constipation, bloating or gas. This is common if someone suffers from celiac disease, pancreas problems (exocrine pancreatic insufficiency or EPI) or irritable bowel syndrome (IBS),
IBS is an intestinal disorder that affects both the large and small intestine. In women, cramping can be associated with menstruation, ovulation, miscarriage or other complications with reproductive organs. Crampy pain usually comes and goes and can subside on its own without treatment. Colicky pain is usually a symptom of more serious conditions like gallstones or kidney stones,
Colicky pain occurs suddenly and without warning, and is usually quite severe. Acid reflux, or GERD, is also a condition which can affect the abdomen. It can cause heartburn, indigestion or pain when swallowing. Some people with GERD will have upper stomach pain and not classic heartburn (so-called dyspepsia pattern GERD).
- If you are experiencing weight loss, fevers or rectal bleeding in addition to abdominal pain, you could be suffering from Crohn’s disease, which is a chronic inflammatory condition of the gastrointestinal tract, or even from colon cancer,
- We call these types of symptoms “alarm features.” Other alarm symptoms are a loss of appetite, feeling full before a meal is complete (early satiety), vomiting and trouble swallowing.
These symptoms should never be ignored as they often indicate a more serious cause of pain. It is very important not to ignore or minimize your symptoms and remember to discuss any persisting abdominal complaints with your primary care physician. The board-certified physicians at Greater Boston Gastroenterology can diagnose and treat your abdominal pain.
Where is colicky pain located?
Colic is often associated with babies who cry persistently, but it can also affect adults. Adults often experience colic as sudden gastrointestinal or urinary pain that becomes less intense over time. This article outlines the different types of colic in adults, the treatment options available, and some possible prevention tips.
The main symptom of colic is localized pain in the abdomen or urinary tract that comes and goes. Colic occurs when there is an obstruction within a hollow internal body part, such as the intestines, gallbladder, rectum, kidneys, or ureters. To try to rid the body of the obstruction, the muscles contract vigorously around it, and these spasms cause pain.
Some of the most common obstructions that lead to colic are gallstones and kidney stones, A colic episode can last for up to 5 hours, with intense pain that gradually subsides. There can be a residual ache for up to 24 hours. Once a person has had one episode of colic, they are likely to have more.
People with biliary colic may experience sudden, severe abdominal pain that can last for a few minutes up to 5 hours. The pain occurs in the center of the upper abdomen or just under the ribs on the right-hand side. The pain can also spread to the side or shoulder blade. Biliary colic happens when a gallstone temporarily blocks one of the bile ducts.
These ducts carry bile (digestive fluid) from the gallbladder and liver through the pancreas to the small intestine. An episode is more likely after a person eats a big meal, especially a fatty one, as more bile is necessary to break down the fat. However, biliary colic can occur at any time.
Gallstones are dried and compacted lumps of bile. They form in the gallbladder when bile builds up over time. Gallstones can be as tiny as a grain of sand up to the size of a golf ball. Gallstones are common and do not cause symptoms for most people. To diagnose biliary colic, a doctor may ask about the timing, duration, and frequency of the abdominal pain.
If episodes of biliary colic are frequent and difficult to live with, a doctor might refer a person to a gastroenterologist, who is a doctor specializing in digestive health. The gastroenterologist may want to conduct an ultrasound scan to confirm the presence of gallstones.
- If there are a lot of gallstones or if they are very large, the doctor might advise surgery to remove the gallbladder to reduce the risk of a more severe obstruction in the future.
- With renal colic, a person may experience pain in the lower abdomen or on the side of the body, between the ribs and hips.
This pain can spread to the groin and may accompany nausea, vomiting, and traces of blood in the urine. The pain of renal colic ranges from mild to intense and can last for 20–60 minutes. Renal colic occurs when kidney stones move through the urinary tract, which includes the kidneys, ureters, bladder, and urethra.
- Pain is most likely to occur when a kidney stone blocks the passage of urine from the kidney to the bladder.
- Idney stones are crystal-like lumps of minerals and salts that form inside the kidneys.
- They can be similar in size to gallstones — from the size of a grain of sand to the size of a golf ball.
To diagnose renal colic, a doctor will want to identify possible risk factors, such as a family history of kidney stones, dehydration, the use of certain medications, and any gastrointestinal conditions a person has. The doctor will also perform an abdominal examination to help rule out other conditions, such as appendicitis and diverticulitis,
an inability to pass stool or gasvomitingnauseadiarrhealoss of appetitebloating
Intestinal colic is the result of a partial or complete blockage in the small or large intestine that prevents food, fluids, air, or stool from passing through. Blockages can be due to:
scar tissue from a previous abdominal surgerycertain inflammatory conditions, such as Crohn’s disease, diverticulitis, endometriosis, peritonitis, or pelvic inflammatory diseaseimpacted fecescancerous tumors
Before diagnosing intestinal colic, a doctor will want to discuss the person’s medical history and perform a physical exam. They may also want to conduct blood tests and imaging tests, such as a CT scan or an X-ray. To treat episodes of colic at home, a person can try:
drinking plenty of water to stay hydratedtaking pain relievers such as paracetamol or ibuprofenputting a hot water bottle on the painful area to ease discomfortgently rubbing or massaging the affected area
Once a doctor diagnoses colic, they may recommend the following treatment options:
pain relievers, anti-inflammatory drugs, and anti-sickness medications to help ease the symptomssurgery to remove kidney stones or the gallbladder or to investigate intestinal blockagesdrugs that dissolve stones shock-wave treatment, which can break stones into small fragments
There is evidence to suggest that gallstones and kidney stones run in families. However, following a healthy lifestyle can help minimize the risk of developing them. To maintain good gastrointestinal and urinary health, people should try to:
Maintain a moderate weight.Eat a balanced diet, including lots of fiber,Stay hydrated.Cut back on salt and fat.
Most episodes of colic pass after a few hours, but it is best to get a diagnosis from a doctor if they happen regularly. A person with the following symptoms should seek urgent medical attention:
jaundice (yellowing of the skin and whites of the eyes)abdominal pain that lasts for a long time or is so intense that a person cannot relieve it in any positiona high temperature and chillsa rapid heart ratean inability to drink without vomitingpersistent vomiting
Colic in adults is common and occurs due to an obstruction inside the body. A doctor can help identify what is causing the obstruction and recommend lifestyle changes or medical interventions, if necessary.
What type of pain is colicky?
Introduction – Biliary colic is a common presentation of a stone in the cystic duct or common bile duct of the biliary tree. Colic refers to the type of pain that “comes and goes,” typically after eating a large, fatty meal which causes contraction of the gallbladder.
- However, the pain is usually constant and not colicky.
- Treatment of this disease is primarily surgical, involving removal of the gallbladder, typically using a laparoscopic technique.
- This medical condition does not typically require hospital admission.
- Biliary colic generally refers to the pain that occurs from a temporary obstruction of the biliary tree which resolves on its own.
Prolonged obstruction of the biliary tree or complete impaction of a stone within the biliary tree will eventually lead to cholecystitis or cholangitis, at which pain the pain will constant and increasing.
How long does colicky pain last?
Colic goes away on its own, sometimes by age 3 months. In most cases it is gone by age 6 months.
When does colicky pain occur?
Living with colic – Colic doesn’t cause any short-term or long-term problems for your baby. But colic can be difficult for parents. It can be hard to care for babies who don’t stop crying. You may feel overwhelmed or frustrated. If you’re feeling this way, it’s important to ask for help.
You didn’t cause the colic, so try not to feel guilty. Colic will go away. Most babies outgrow it by the time they are 3 to 4 months old. Just because your baby has colic doesn’t mean they’re unhealthy. There are many ways to soothe your baby. Giving your baby extra attention, such as holding them for extended periods, won’t spoil them.
Contact your baby’s doctor if:
Your baby’s crying is mixed with a fever, vomiting, loose or bloody stools, or decreased movement. Your baby’s crying or behavior changes suddenly.
What is colicky and non colicky pain?
Last reviewed 01/2018 Colicky pain is described as pain which comes and goes; it is important to note that in true colic there is a baseline of no pain. This distinguishes colic occuring as a result of gastrointestinal obstruction – a true colic – from other misnamed colics such as renal and biliary colic.
What is the most painful type of cramp?
A charley horse refers to a sudden and painful muscle cramp. It often occurs during exercise and at night. It commonly affects the calf muscle at the back of the lower leg but can also occur in the foot and, occasionally, the thigh. These muscle contractions may also affect pregnant people and individuals with certain health conditions.
- Nocturnal leg cramps may have their origins in strenuous daytime activity, perhaps along with electrolyte imbalances and the use of some medications.
- Weight gain, blood flow disruption, and peripheral nerve compression may cause muscle cramps during pregnancy.
- Neurological changes, dehydration, and electrolyte imbalances may cause cramps during or after exercise, especially in the arms or legs.
Charley horse is another term for cramps, especially those that affect the leg. Although some people may use charley horse to describe muscle spasms or twitches, these phenomena are very different. Generally speaking, doctors recognize the importance of distinguishing between cramps and similar-seeming conditions, such as:
- dystonia, a movement disorder involving involuntary movements
- myotonia, the process of muscles tensing, including both voluntarily flexing and involuntary contracting
- tetany, an electrolyte imbalance due to low levels of calcium
- myalgia, or muscle aches
Scientists understand that a charley horse occurs when muscles suddenly cramp or tighten, resulting in pain. The condition most typically happens in the calf muscle at the back of the lower leg. The sudden and uncontrollable spasm is often brief, but it can last up to 10 minutes,
For most people, the muscle contracts painfully without lasting problems. For others, however, the cramps can be extremely painful and cause discomfort for days. A cramp can have different effects depending on its location. Painful leg cramps can make it more difficult to walk, for instance. Stomach cramps, by contrast, can lead to feelings of discomfort, which may dissuade some people from eating.
Additionally, a cramp’s timing can affect its significance. For example, if leg cramps frequently happen at night, sleep disruption can result. As a 2021 review explains, there are several risk factors for leg cramps:
- Being over 60: Nocturnal leg cramps affect around 37% of Americans over 60 years of age.
- Being pregnant: Muscle cramps affect around 50% of pregnant individuals, especially at night.
- Having chronic renal failure: Around 50% of people with chronic renal failure experience muscle cramps, especially in the legs.
- Having amyotrophic lateral sclerosis ( ALS): People with ALS have a 95% chance of experiencing muscle cramps.
- Having diabetes : Around 60% of people with type 1 diabetes have muscle cramps. In people with type 2 diabetes, the number is around 80%.
Acute calf pain can also happen for reasons not related to cramps. These include:
- deep vein thrombosis
- a ruptured Baker’s cyst
A review of studies published in 2017 found that the following types of illness often occur alongside leg cramps:
- cardiovascular diseases, including coronary artery disease and high blood pressure
- kidney diseases and treatments, including uremia and dialysis
- neurological conditions, such as motor neuron disease and polio
- musculoskeletal problems, including arthritis
- metabolic conditions, including type 2 diabetes, liver disease, and thyroid problems
What is colicky pain and dull pain?
If you experience chronic biliary colic and gallstones, surgery may be able to provide relief. Biliary colic is a dull pain in the middle to upper right area of the abdomen. It occurs when a gallstone blocks the bile duct, the tube that normally drains bile from the gallbladder to the small intestine.
- The pain goes away if the stone passes into the small intestine and unblocks the duct.
- The usual treatment for chronic gallstones with pain is removal of the gallbladder.
- This organ is not essential to digestive health.
- Biliary colic happens when the gallbladder contracts and causes a gallstone to temporarily block the duct that drains the gallbladder.
Gallstones are hard masses made up of cholesterol and bilirubin that form in the gallbladder. They can be small and numerous, or large and few. Gallstones form due to chemical imbalances in bile or infrequent or incomplete emptying of the gallbladder. Increased pressure in the gallbladder causes the pain and discomfort associated with biliary colic.
How do you diagnose colic?
Infantile Colic: Recognition and Treatment Infantile colic is a benign, self-limited process in which a healthy infant has paroxysms of inconsolable crying. The standard diagnostic criteria—known as the “rule of three”—is crying more than three hours per day, more than three days per week, for longer than three weeks.
- Symptoms typically resolve by three to six months of age.
- Colic affects approximately 10% to 40% of infants worldwide, typically peaks at about six weeks of age, and can be associated with significant parental guilt and frustration, as well as multiple physician visits.
- Colic has been associated with postpartum depression and shaken baby syndrome.
, Parents typically report that paroxysms occur in the evening and are unprovoked. The incidence is equal between sexes, and there is no correlation with type of feeding (breast vs. bottle), gestational age (full term vs. preterm), socioeconomic status, or season of the year.
- Despite decades of research, the cause of infantile colic is not known.
- Proposed causes include alterations in fecal microflora, intolerance to cow’s milk protein or lactose, gastrointestinal immaturity or inflammation, increased serotonin secretion, poor feeding technique, and maternal smoking or nicotine replacement therapy.
– Two studies have demonstrated higher levels of fecal calprotectin, a marker of colonic inflammation, in infants with colic., When evaluating a crying infant, physicians should conduct a thorough history and physical examination to assess for underlying medical disorders and to determine the need for further testing (), Because colic is benign, the mainstay of treatment is parental reassurance and support. After confirming the diagnosis, physicians should educate parents about the benign and self-limited nature of colic, and offer resources for support ( – ), The probiotic Lactobacillus reuteri (strain DSM 17938) reduced colic symptoms in four out of five clinical trials., – No adverse effects were reported. Two recent meta-analyses and one systematic review found that administration of five drops of L. reuteri per day significantly decreased colic in infants who are breastfed (average of 61 minutes less crying time per day at 21 days).
– One trial found a significant increase in crying or fussing in bottle-fed infants who received L. reuteri, Based on these results, L. reuteri DSM 17938 may be considered as a treatment option for breastfed infants, but cannot be recommended for formula-fed infants. Simethicone, Although simethicone drops are readily available and often used to treat colic, a systematic review of three randomized controlled trials found that they are no better than placebo.
Dicyclomine, Although a systematic review of three randomized controlled trials found that dicyclomine was significantly better than placebo for the treatment of colic, it is contraindicated in infants younger than six months because of adverse effects such as drowsiness, constipation, diarrhea, and apnea.
- Proton Pump Inhibitors,
- A four-week randomized controlled trial of 30 infants with colic symptoms and gastroesophageal reflux or esophagitis found that omeprazole (Prilosec) was no better than placebo at reducing crying or fussing time.
- The prevalence of colic is similar between breastfed and bottle-fed infants; therefore, breastfeeding mothers should be encouraged to continue.
A randomized controlled trial showed significant reductions in colic symptoms among breastfed infants whose mothers followed a low-allergen diet. Infants whose mothers excluded cow’s milk, eggs, peanuts, tree nuts, wheat, soy, and fish from their diet cried for 137 minutes less per day, compared with 51 minutes less per day in the control group.
- A systematic review of six studies supported the effectiveness of low-allergen diets in reducing colic.
- These diets may be an option for some breastfeeding mothers, but should be accompanied by dietary counseling to ensure adequate nutrition.
- Return to a normal diet can be considered after the infant reaches three to six months of age.
Parents of formula-fed infants with colic often consider switching formulas. A systematic review of 13 studies found a statistically significant decrease in crying time among infants who switched to partially, extensively, or completely hydrolyzed formulas (),
- These studies suggest that a two-week trial of a different formula may be considered for infants with colic.
- To make the change more palatable, parents can transition to hydrolyzed formula by mixing the new formula with regular formula incrementally over four days, until only hydrolyzed formula is being given.
These formulas are expensive, however, and may not be covered by assistance programs (e.g., Women, Infants, and Children). If the new formula is successful in reducing colic symptoms, regular formula may be restarted after three to six months of age. Four studies that evaluated the use of soy formula for the treatment of colic provided insufficient evidence to make clinical recommendations. The American Academy of Pediatrics recommends against the routine use of soy formula in the management of infantile colic, because soy can be an allergen.
Physical therapies for colic include chiropractic and osteopathic manipulation, massage, and acupuncture. A Cochrane review found insufficient evidence to support chiropractic or osteopathic manipulation, because many studies were small, nonblinded, and had a high likelihood of bias. Trials of acupuncture and infant massage have had conflicting results, and further studies are needed to determine their benefits and harms.
, Herbal supplements, including Mentha piperita (peppermint) and various herbal teas (including fennel, chamomile, vervain, lemon balm, and licorice), have decreased crying time in some studies. – Despite these findings, a systematic review concluded that further research is required before recommending these treatments.
- Infants in one small study who received 2 mL of 12% sucrose solution at 5 p.m.
- And 8 p.m.
- Daily had reduced colic symptoms.
- Another study showed similar improvement, but details about sucrose administration were lacking.
- Gripe water,” which consists of dill seed oil, bicarbonate, and hydrogenated glucose, has also been used for the treatment of colic.
However, there are no trials demonstrating its effectiveness, and it may cause harm. Two small, poorly designed studies suggested possible benefits from the use of a vented bottle., Although swaddling has been proposed as a method for reducing crying in infants, a study of nighttime swaddling found no statistically significant benefit.
Data Sources : Searches were performed in PubMed, the Cochrane Database of Systematic Reviews, National Guideline Clearinghouse, U.S. Preventive Services Task Force, Essential Evidence Plus, and EBM Online. Key search words included colic, infantile colic, colic/treatment, colic/etiology, probiotics, acupuncture, infant massage, simethicone/colic, medication/colic, and chiropractic/colic.
Search dates: April 2014, October 2014, and February 2015. The authors thank Diane Kunichika for her assistance with the literature search. The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of the Army, the Department of Defense, or the U.S.