pediatrics
Colic
Evaluation of Colic
The goal is to distinguish colic from other causes of excessive Crying , particularly serious and/or treatable medical disorders such as Otitis Media (Acute) None Urinary Tract Infection (UTI) in Children None Bacterial Meningitis in Infants Over 3 Months of Age None Appendicitis None Food Allergy None Gastroesophageal Reflux in Infants None Constipation in Children None Intestinal Obstruction None Increased intracranial pressure Hair tourniquet Corneal Abrasions and Foreign Bodies None Primary Infantile Glaucoma None Overview of Child Maltreatment None History of present illnessshould establish the onset and duration of crying and response to attempts to console and thus determine whether the infant’s crying is outside the normal range (up to 3 hours/day in a 6-week-old infant). Review of systemsshould seek symptoms of causative disorders, including constipation, diarrhea, and vomiting (gastrointestinal disorders) and cough, wheezing, and nasal congestion (respiratory infection). Past medical historyinvolves thorough questioning, which may reveal that crying is not the chief concern but a symptom that the parents have used to justify their visiting the physician to present another problem—eg, concern over the death of a previous child or over their feelings of inability to cope with a new infant. Physical examination begins with review of vital signs and then a thorough examination for signs of trauma or medical illness. Typically, no abnormalities are detected during an examination of a child who is otherwise healthy but has colic symptoms, and the examination is reassuring to parents. The following findings are of particular concern: Nausea and Vomiting in Infants and Children (especially if vomit is green or bloody or occurs > 5 times a day Constipation in Children or Fever in Infants and Children None Respiratory distress Lethargy Poor weight gain Often, infants with colic present after days or weeks of repetitive, daily crying; an otherwise normal history and examination at this point is more reassuring than in infants with acute (1 to 2 days) crying. No testing is necessary unless specific abnormalities are detected by history and examination. 