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PubMed1989

Breath hydrogen excretion in infants with colic.

Breath hydrogen excretion as an index of incomplete lactose absorption was measured in 118 healthy infants who were either breast fed or given a formula feed containing lactose, some of whom had colic. Infants with colic (n = 65) were selected on the basis of the mother's report of a history of inconsolable crying lasting several hours each day. Infants in the control group (n = 53) were not reported to cry excessively by their mothers. Breath samples were collected using a face mask sampling device preprandially, and 90 and 150 minutes after the start of a feed. Normalised breath hydrogen concentrations were higher in the group with colic than in the control group at each time point. The median maximum breath hydrogen concentration in the colic group was 29 ppm, and in the control group 11 ppm. The percentage of infants with incomplete lactose absorption (breath hydrogen concentration more than 20 ppm) in the colic group was 62% compared with 32% in the control group. The clinical importance of the observed association between increased breath hydrogen excretion and infantile colic remains to be determined. Increased breath hydrogen excretion indicative of incomplete lactose absorption may be either a cause or an effect of colic in infants.

Breast Feeding↗
PubMed2005

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy.

REASONS FOR PERFORMING STUDY: Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. OBJECTIVES: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery. METHODS: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases. CONCLUSIONS: Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute colic that necessitated further surgery. POTENTIAL RELEVANCE: Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.

Animals↗
PubMed2001

Use of the Accusport semi-automated analyser to determine blood lactate as an aid in the clinical assessment of horses with colic.

The most useful diagnostic methods in the initial evaluation of horses with colic assess the morphological and functional status of the gastrointestinal tract and cardiovascular status. This evaluation is best achieved using a combination of clinical and laboratory data. Blood lactate concentration (BL) is one of these variables. BL rises mainly due to poor tissue perfusion and anaerobic glycolysis associated with shock, providing an indicator of both the severity of disease and its prognosis. A hand-held lactate meter, Accusport, provides a rapid (60 seconds), inexpensive dry-chemical-based determination of BL. This trial evaluated the Accusport's ability to provide BL data as an adjunct to the initial clinical evaluation of horses with colic. The accuracy of the Accusport was tested by evaluation of its interchangeability with the benchmark enzymatic kit evaluation of BL in a trial using data collected firstly from 10 clinically normal control horses and subsequently from 48 horses presented with signs of colic. The BL values were recorded together with the clinical variables of heart rate (HR), capillary refill time (CRT), haematocrit (Hct), and pain character and severity on the initial assessment of the colic horses. Information regarding choice of therapeutic management (medical or surgical) and eventual case outcome (full recovery or died/euthanased) was recorded. The Accusport was found to be interchangeable with the enzymatic kit for recording BL values in colic horses with BL < 10 mmol/l, which is within the BL range associated with survival. The interchangeability of an additional, laboratory-based wet chemical assay for BL, the Stat 7 was simultaneously evaluated for the colic and control horses. The Stat 7 was found to be interchangeable with the enzymatic kit for BL determination of colic horses. No linear associations between BL values with HR, CRT, Hct or pain assessment were observed. No relationship with either selection of therapeutic method or eventual case outcome was observed. All horses with BL >8 mmol/l died or were euthanased.

Animals↗
PubMed2000

Colic in breast-milk-fed infants: treatment by temporary substitution of neocate infant formula.

Infant colic is a common problem characterized by excessive crying and fussing. We examined whether colic symptoms of exclusively breast-milk-fed infants would be improved by temporary substitution of Neocate, an amino acid-based infant formula, for breast milk. Six infants with colic were studied using Barr-type infant behavior diaries for a 3-5 d baseline period while they continued exclusive breast-milk-feeding, followed by a 4-8 d intervention period of exclusive Neocate feeding. All infants showed improvement in distressed behavior during intervention; five of the six improved within 1-2 d. For the period after 1 d of Neocate feeding, the total recorded crying and fussing time was reduced by an average of 42%, representing a decrease of 1.0 to 3.1 h daily. A significant difference was found between cry and fuss time at baseline versus during exclusive Neocate use. Concurrent with Neocate intervention, mothers strictly avoided all milk and dairy products. After colic symptoms improved, infants were reintroduced to breast milk, which was reasonably well tolerated in four of the six infants. Two infants had rapid recurrences of crying and fussing upon return to breastfeeding and required an additional period of Neocate feedings before subsequent reintroduction to breastfeeding. All infants exhibited colic symptoms when directly or indirectly challenged with bovine IgG (BGG), suggesting that BGG may play an etiologic role in colic. We propose that a brief intervention with Neocate, coupled with strict maternal avoidance of milk and dairy products under direct supervision of a lactation consultant, may be an effective treatment for colic in some breast-milk-fed infants.

Animals↗
PubMed2000

[Hospitalization for renal colic in the emergency room of a large central hospital in Israel: epidemiological features and clinical manifestations].

The medical records of all patients referred to the emergency department (ED) of Sheba Medical Center for renal colic during 1996 were analyzed. Patients discharged from the ED and those hospitalized were compared. There was no significant difference between the 2 groups with regard to average age or sex distribution. Statistically significant differences were found with regard to frequency of chills and fever, history of renal colic, referral for renal colic during that year or hospitalization for renal colic or nephrolithiasis, previous positive imaging, stone removal by surgery or extracorporeal shock wave lithotripsy, fever exceeding 37.5 degrees and administration of fluids, pethidine or pramin in the ED, prolonged stay in the ED and previous appendectomy. A conditional regression model tested the predictive value of each of those factors. Inclusion of independent variables into the model led to an overall correct classification rate of 84.43%, with 44.83% sensitivity and 93.16% specificity. There were correlations between referrals for renal colic, overall renal colic rate and average monthly temperature, so there was no pure correlation between average monthly temperature and referrals to the ED for renal colic. The major indications for hospitalization were actually the clinical ones, indicating either an active metabolic disease or suspected obstruction of the urinary tract. Treatment in the ED and duration of the visit indicated disease severity.

Adult↗
PubMed2005

Prolonged and unsoothable crying bouts in infants with and without colic.

ABSTRACT.: The authors sought to determine which features of early distress were "excessive" and specific to the first months of life as described by diary recordings. In a short-term, longitudinal, controlled study, total daily amount, frequency, and bout duration of fussing, crying, and unsoothable crying were derived from validated diaries kept by parents of infants with and without diary-defined colic at 6 weeks and 5 months recruited from primary pediatrics practices. By definition, infants with colic demonstrated more distress at 6 weeks, but they also had a much greater reduction in distress by 5 months and more distress during the fifth month. However, bout frequencies and bout durations showed different patterns. Bout duration was longer for the colic group only at 6 weeks; the difference completely disappeared by 5 months. Bout frequency was higher for the colic group at 6 weeks and 5 months, but the reduction across ages was similar in infants with and without colic. These patterns were true for all distress modalities (fussing, crying, and unsoothable crying). Unsoothable crying was present in significant amounts only at 6 weeks but virtually disappeared by 5 months. The authors conclude that prolonged distress bouts and unsoothable crying are specific to the first few months and more common, though not unique, in infants with colic. This implies that our understanding of colic may depend more on why these infants cry longer once started than what makes infants cry. These features of parental experience may be important in preventive efforts to reduce negative impacts of early increased crying such as shaken baby syndrome.

Adult↗
PubMed2005

Causes of gastrointestinal colic in horses in western Canada: 604 cases (1992 to 2002).

The medical records of equine gastrointestinal colic cases presented to the Western College of Veterinary Medicine between 1992 and 2002 are reviewed. There was no breed predisposition to colic. Geldings were more prone to colic than females and stallions. Overall, the 3 most common causes of colic were large colon impaction (20.8%), large colon displacement (16.5%), and spasmodic colic (11.7%), after excluding the 13% of cases in which the diagnosis was undetermined. Of the medical cases, large colon impaction (38.4%) and spasmodic colic (22.5%) were the most common. Of the surgical cases, large colon displacement (24.5%), large colon torsion (14.3%), and strangulating lipoma (13.5%) were the most common. Recovery rate for the medical cases was 93.6%. Recovery rate for surgical cases was 73.5%. In conclusion, most of the equine colic cases were medical, and the recovery rates for both surgical and medical cases were comparable with those of other studies.

Animals↗
PubMedDate not supplied

[Acute ureteral obstruction (renal colic)].

Acute ureteral obstruction is always associated with high intrapelvic hydrostatic pressure. Objective diagnosis of renal colic can be made by direct measurement of intrapelvic pressure (IPP). We propose a very simple device for estimation of IPP consisting of ureteral catheter and polyethylene tube 150 cm long. The device gives intrapelvic pressure in centimeters of urinary column. The figures obtained corresponded to those in measurement of IPP in cm of water column. In normal 187 examinees IPP ranged from 0.5 to 14.2 cm urinary column. Mean normal IPP in females was higher than in males. In 187 patients with renal colic IPP varied from 55 to 150 cm of urinary column. Mean IPP at the height of renal colic was in females and males 97.4 +/- 3.0 and 89.8 +/- 2.5 cm of urinary column, respectively. Thus, IPP in health and renal colic is higher in females than in males. In bilateral renal colic and colic in solitary kidney catheterization of the ureter is mandatory because of anuria. Ureteral catheterization is also indicated in cases of renal colic combination with attack of acute pyelonephritis. If ureteral catheterization is indicated, IPP pressure should be measured. This is important for diagnosis of both acute ureteral obstruction and pathogenesis of anuria.

Acute Disease↗
PubMedDate not supplied

[Influence of low intensive laser irradiation on ultrastructural changes in kidney tissue in experimental colic].

This investigation aimed at estimation of the influence of low-intensive laser irradiation on ultrastructural changes in renal tissue according to electronic microscopy data in case of experimental renal colic. The experiment was made on twenty rabbits with a single or recurrent colic. Ten animals after a single colic were exposed to low intensive laser therapy. Electronic microscopy showed that single renal colic is associated with marked ultrastructural changes in the proximal tubules. In recurrent colic the edema and destruction were more expressed in all nephron parts. Low intensive laser irradiation suppresses pathological processes in nephrocytes both after a single renal colic and after a recurrent renal colic; has a systemic effect on the body; stimulates compensatory processes in the contralateral kidney.

Animals↗
PubMed1989

Cow's milk whey protein elicits symptoms of infantile colic in colicky formula-fed infants: a double-blind crossover study.

There are several causes of infantile colic. The aim of this study was to evaluate, under controlled conditions, whether bovine whey proteins can elicit symptoms of infantile colic in colicky formula-fed infants. The mean age for entering the study was 6.4 weeks and the mean age for colic debut was 3.7 weeks. In 24 of 27 infants with severe colic, the symptoms disappeared when they were given a cow's milk-free diet (Nutramigen). These 24 infants were entered into a double-blind crossover study. The infants (receiving cow's milk-free diet) were given the contents of identical capsules with each meal during day 6. The same procedure was repeated on day 10. The capsules contained either whey protein powder (with Nutramigen added) or human albumin powder (with Nutramigen added). Eighteen infants receiving the whey protein-containing capsules reacted with colic, two infants receiving placebo reacted with colic (P less than .001), and four infants did not react at all. Crying hours per day for the 24 infants were 5.6 hours for formula-fed infants and 0.7 hour for cow's milk-free diet-fed infants (P less than .001). Crying hours per day were 3.2 hours for the infants receiving whey protein capsules and 1.0 hour for those receiving placebo (P less than .001). In conclusion, bovine whey protein can elicit symptoms of infantile colic in colicky formula-fed infants.

Animals↗
PubMed1995

Treatment of renal colic by desmopressin intranasal spray and diclofenac sodium.

The vasopressin analogue, 1-desamino-8-arginine vasopressin (desmopressin), is a potent antidiuretic without the pressor effects of vasopressin. A total of 18 patients with acute renal colic due to stone disease received 40 microgramsf1p4mopressin intranasal spray with encouraging results. There was a significant decrease in the colic pain intensity from an initial mean visual analogue score of 67 +/- 17 mm. to 39 +/- 36 mm. within 30 minutes (p < 0.001). Eight patients (44.4%) had complete pain relief within 30 minutes of administering intranasal desmopressin spray. Nine of 10 patients who required intramuscular diclofenac sodium achieved complete pain relief within another 30 minutes. In other words, when intranasal desmopressin spray was administered before diclofenac sodium, 94.4% of the patients achieved complete pain relief and were discharged home. The mechanism of analgesic action of desmopressin in renal colic is uncertain. At the peripheral level, desmopressin may alleviate the acute renal colic through its potent antidiuretic effect or by relaxing the renal pelvic and ureteral smooth muscles. The central analgesic effect of desmopressin by stimulating the release of the hypothalamic beta-endorphin is proposed. We conclude that intranasal desmopressin spray can be used successfully in the treatment of renal colic. It may also replace prostaglandin synthetase inhibitors in treating renal colic with the advantage of avoiding the potential side effects. Further studies are needed to investigate whether the combination of desmopressin with analgesics or spasmolytic drugs offers competitive results compared with those achieved by prostaglandin synthetase inhibitors in the treatment of renal colic.

Acute Disease↗
PubMed1994

Blood cell deformability in horses with intestinal colic.

Hematologic and rheologic variables were examined in a group of 13 horses with intestinal colic and a control group of 6 horses. All horses had been recently transported to the veterinary teaching hospital, and blood samples were obtained during initial examination. There were no significant differences in blood neutrophil count or plasma fibrinogen concentration between the groups, and PCV was significantly increased in horses with intestinal colic. Cell filterability was measured by passing uniform concentrations of blood, erythrocytes, and neutrophils through micropore filters. There were no significant differences between the control and intestinal colic groups in filterability of erythrocytes. Significant (P < 0.05) prolongation in filterability of blood and neutrophils was observed in the group of horses with intestinal colic, compared with the control group. This neutrophil change, indicative of decreased neutrophil deformability, corresponded with severity of the illness. Horses that failed to survive the intestinal colic episode had significantly (P < 0.05) prolonged blood and neutrophil filterability, compared with horses that survived intestinal colic. These findings indicate that deformability of neutrophils decreases in horses with intestinal colic, possibly a result of endotoxin-induced activation. This change can further impede microvascular blood flow that is altered in association with intestinal ischemia.

Analysis of Variance↗
PubMed1998

Analysis of coagulation proteins as acute-phase reactants in horses with colic.

OBJECTIVES: To measure coagulation factor VIII:coagulant (F.VIII:C) and C1-esterase inhibitor (C1-INH), hemostasis-associated acute-phase reactant proteins and coagulation factors VII (F.VII), IX (F.IX), and X (F.X), hemostasis proteins not associated with an acute-phase response, in a select population of horses with colic and hemostasis abnormalities, and presumed to have acute-phase changes. To compare these values and other routine hemostasis test results in the horses with colic with values for a population of healthy horses. To correlate the values of known equine acute-phase reactants, F.VIII:C and fibrinogen, to those of other tests of hemostasis. To identify hemostasis-associated acute-phase reactant proteins and gain insights into the effects the acute-phase response has on hemostatic abnormalities in horses with colic syndrome. SAMPLE POPULATION: 54 plasma samples from horses with colic attributable to inflammatory (n = 39) or strangulating (n = 15) intestinal disorders. PROCEDURE: Plasma samples were evaluated for activities of F.VII, F.VIII:C, F.IX, F.X, C1-INH, antithrombin III, protein C, plasminogen, and alpha 2-antiplasmin (alpha 2AP); fibrinogen concentration; and prothrombin (PT) and activated partial thromboplastin (APTT) times. RESULTS: Horses with colic had significantly higher fibrinogen concentration, greater alpha 2AP and protein C activities, and longer PT and APTT than did healthy horses. Horses with colic also had significantly lower mean F.VII activity than did healthy horses. Significant positive correlations between fibrinogen concentration and F.VIII:C, C1-INH, and alpha 2AP values, and between F.VIII:C activity and fibrinogen, C1-INH, alpha 2AP, and plasminogen values were identified. CONCLUSIONS: An acute-phase response contributes to changes observed in coagulation proteins in horses with colic attributable to inflammatory and strangulating intestinal disorders. The data suggest that plasminogen, alpha 2AP, and C1-INH, should be considered equine acute-phase proteins.

Acute-Phase Proteins↗
PubMed1995

Anomalous origins of colic arteries.

The topography of the celiac trunk and superior and inferior mesenteric arteries was studied by dissection in 27 embalmed cadavers. Variant vascular patterns were noted in four subjects. These consisted of: (1) an accessory right hepatic artery from the superior mesenteric artery, (2) an anomalous middle colic artery from the proximal segment of the splenic artery, and (3) two instances of an accessory left colic artery originating from the superior mesenteric artery. The precarious course of the middle colic artery (coming from the splenic artery) and its dominance in the formation of the marginal artery were thought to predispose the ascending and transverse colon to an increased risk of vascular damage. These cases also illustrate two variant patterns of formation of the marginal artery. In the case of the anomalous middle colic artery, the only contribution of the superior mesenteric artery to the marginal artery was through the anastomosis of its ileocolic branch with the right branch of the aberrant middle colic artery. In subjects with accessory left colic arteries, the superior mesenteric artery played a dominant role in the formation of the marginal artery by contributing the accessory left colic artery, which supplied the splenic flexure and the proximal part of the descending colon. These arterial variations underscore the importance of doing vascular studies prior to major abdominal surgery.

Arteries↗
PubMed2004

Effect of season, age, and gender on renal colic incidence.

Our objective was to examine the effect of ambient temperature, age, and gender on the incidence of emergency department (ED) renal colic visits. We retrospectively analyzed a database of 15 New Jersey EDs from January 1, 1996 to December 31, 2002. We analyzed the number of renal colic visits as a fraction of total visits in monthly intervals. We used the Chi-squared test and Pearson's correlation coefficient, with P<.05 taken as statistically significant. Of the 3.5 million patient visits in the database, 30,358 (0.9%) had renal colic. Renal colic visits were 16% more likely in warmer than colder months (P<.001) and this effect was greatest in older patients and males. We conclude that higher ambient temperature, older age and male gender are associated with increased incidence of ED renal colic visits. Advice to patients, especially older males, to avoid dehydration particularly during hot weather may help prevent bouts of renal colic.

Adolescent↗
PubMed2005

Rapid extracorporeal shock wave lithotripsy treatment after a first colic episode correlates with accelerated ureteral stone clearance.

OBJECTIVES: To investigate the relationship between delay in extracorporeal shock wave lithotripsy (ESWL) after a first colic and subsequent time to complete stone clearance. METHODS: This prospective, non-randomized study included 94 patients treated with ESWL for unilateral solitary proximal ureteral stones after at least one episode of colic pain. Time between the first onset of colic pain and ESWL and stone clearance was recorded. The pretherapeutic degree of hydronephrosis has been assessed using ultrasound. RESULTS: Mean stone size was 7.9 +/- 2.3 mm and mean time before ESWL after a first colic was 93.4 +/- 143.5 h. At 3 months, 3 patients were lost to follow-up. In 76.9% of patients stones were completely cleared and a further 3.3% harbored residual fragments < or =3 mm. Delay in treatment after a first colic correlated with subsequent time to stone clearance (p < 0.0001). Mean time to stone clearance in patients treated within 24h was 6.4 +/- 6.3 days compared with 16.0 +/- 17.8 days for those treated later (p = 0.008). Maximum stone diameter correlated with time to stone clearance (p = 0.031), but the degree of hydronephrosis did not. CONCLUSIONS: Rapid ESWL after a first onset of colic pain resulted in accelerated stone clearance independent of the degree of hydronephrosis but had no impact on the need for auxiliary procedures.

Adult↗
PubMedDate not supplied

Current beliefs and management strategies for treating infant colic.

INTRODUCTION: The purpose of this study was to describe the current beliefs about the etiology of colic as well as current management approaches used by pediatric health care providers. METHOD: An open-ended, short- answer survey concerning beliefs about the etiology and treatment of colic was conducted at major National Association of Pediatric Nurse Associates and Practitioners and American Academy of Pediatric meetings. The two groups of providers surveyed, pediatric nurse practitioners (PNPs) (n = 216) and pediatricians (n = 215), were similar in age and years of practice. RESULTS: PNPs were more likely to define colic as "excessive crying." No differences were found in the beliefs regarding etiology of colic. Pediatricians reported seeing more colicky infants per month. A strong relationship existed between etiology and primary treatment approach. Statistically significant differences were found between PNPs and pediatricians in approaches to management of colic. DISCUSSION: Colic remains a prevalent and mysterious malady, with a critical need for more evidence-based treatment protocols. Differences in approaches used by providers were found, with PNPs more likely to use behavioral and environmental approaches to treatment.

Adult↗
PubMed1996

Maternal intake of cruciferous vegetables and other foods and colic symptoms in exclusively breast-fed infants.

OBJECTIVE: We sought to assess relationships among components of maternal diet and the presence of colic symptoms among exclusively breast-fed infants aged < or = 4 months. DESIGN: Data were collected by means of a mailed questionnaire that solicited information on the presence of symptoms of colic in infants and maternal intake of 15 foods (including four cruciferous vegetables) during the week before completion of the questionnaire. SUBJECTS: Exclusively breast-feeding women (n = 272) and their 273 infants aged < or = 4 months. STATISTICAL ANALYSES PERFORMED: Dietary variables were analyzed categorically by logistic regression. Two-by-two tables were used to calculate relative risks. RESULTS: Relative risks (RRs) and 95% confidence intervals (CIs) for colic symptoms by food items the mothers consumed ranged from 0.7 (CI = 0.3 to 1.5) for beef to 2.0 (CI = 1.1 to 3.5) for cow's milk. Maternal intake of cabbage (RR = 1.3, CI = 1.1 to 1.5), cauliflower (RR = 1.2, CI = 1.0 to 1.4), broccoli (RR = 1.3, CI = 1.0 to 2.2), cow's milk (RR = 2.0, CI = 1.1 to 3.5), onion (RR = 1.7, CI = 1.1 to 2.5), and chocolate (RR = 1.5, CI = 1.0 to 2.2) were significantly related to colic symptoms. Maternal intake of more than one cruciferous vegetable was associated with an RR of 1.6 (CI = 1.1 to 2.4) for infants experiencing one or more colic symptoms. CONCLUSION: Results of this study provide initial evidence that maternal intake of cruciferous vegetables, cow's milk, onion, or chocolate during exclusive breast-feeding is associated with colic symptoms in young infants.

Adult↗