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Diagnosis

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evaluation

Diagnosis of infantile colic is usually made by excluding more sinister causes (1).

A careful generic paediatric history should be taken.

  • should focus on identifying the relationship between an infant’s behaviour and time of day and duration of crying episodes
  • identify red flag features which may indicate a more uncommon but serious causes e.g. - intussusception and pyloric stenosis (1,2)

The following should be carried out in an infant suspected of having infantile colic:

  • pulse, respiratory rate and temperature
  • weight should be plotted and compared against previous measurements
    • if serial measurements of weight is not available, follow up measurements may be necessary to recognise any abnormality in growth
  • physical examination
    • expose child from head to bottom and look for bruises or trauma and identify any visible evidence of non-accidental injuries (1)

Red flag signs and symptoms which may indicate an uncommon cause include:

  • signs
    • irritability, tachycardia, pallor mottling, poor perfusion
    • petechiae, bruising, tachypnoea, cyanosis, nasal flaring
    • hypotonia, meningism, full fontanelle
    • weight<4th centile for age (or decreasing on the centile chart)
    • head circumference >95th centile (or increasing in the centile charts)
  • symptoms
    • bilious or projectile vomiting, bloody stools
    • fever, lethargy, poor feeding
    • perinatal risk factors for sepsis (premature rupture of membranes, maternal fever or infection, group B streptococcus) (1).

Biochemical and radiological examinations are usually not required if history and examination reveal no abnormalities (except for inconsolable crying) (1)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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