History and Physical Examination

History

Colic remains a diagnosis of exclusion. Crying by infants with or without colic is mostly observed during evening hours and peaks at the age of 6 weeks. The cause of this diurnal rhythm is not known. The amount of crying is not related to an infant's sex; the mother's parity; or the parents' socioeconomic status, education, or ages.

On acoustic analysis, colicky crying differs from regular crying. Compared with regular crying, colicky crying is more variable in pitch, more turbulent or dysphonic, and has a higher pitch. Mothers of infants with colic, unlike mothers of infants without colic, rate the cries as more urgent, discomforting, arousing, aversive, and irritating than usual.

Obtain a detailed history about the timing, the amount of crying, and the family's daily routine. The benign nature of colic should be emphasized. Rule out causes of excessive crying in an infant, such as having hair in the eye, strangulated hernia, otitis, and sepsis.

Physical examination

Perform physical examination to confirm normalcy. Infants with colic often have accelerated growth. Weight gain is typical, whereas failure to thrive should make one suspicious about the diagnosis of colic.

Differential Diagnoses

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Author

Prashant G Deshpande, MD Attending Pediatrician, Department of Pediatrics, Christ Hospital Medical Center and Hope Children's Hospital; Assistant Clinical Professor of Pediatrics, Midwestern University

Prashant G Deshpande, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Telemedicine Association

Disclosure: Nothing to disclose.

Coauthor(s)

Sameer Wagle, MBBS, MD Consulting Staff, Division of Neonatology, Northwest Medical Center of Springdale and Willow Creek Women’s Hospital

Sameer Wagle, MBBS, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Stefano Guandalini, MD, AGAF Founder and Director Emeritus, Celiac Disease Center, University of Chicago; Former Chief, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Chicago Medicine; Professor Emeritus, The University of Chicago Pritzker School of Medicine

Stefano Guandalini, MD, AGAF is a member of the following medical societies: American Gastroenterological Association, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, North American Society for the Study of Celiac Disease

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Imaware.health.

Chief Editor

Carmen Cuffari, MD Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Prometheus Laboratories for speaking and teaching; Received honoraria from Abbott Nutritionals for speaking and teaching. for: Abbott Nutritional, Abbvie, speakers' bureau.

Colic Clinical Presentation

History and Physical Examination

History

Physical examination

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