Intestinal colic refers to spasms in the intestinal area caused by contractions of the intestinal muscles and usually lasting 20 to 30 minutes. Various causes trigger intestinal colic, the most common being irritation and blockage in the intestines. Treatment depends on the duration, severity and cause of the condition.
What is intestinal colic?
Intestinal colic is a common form of organ-related colic. Other organs often affected may include the kidneys or gall bladder, and in women, the uterus. Less commonly, colic occurs in the stomach, pancreas, urinary bladder, and salivary glands. The term “colic” originally referred only to pain in the large intestine, whose Latin name is colon or colicus. Colic refers to pain of the highest imaginable level, occurring in a motion-dependent and interval-like manner. It occurs when the smooth muscles of the organ contract in a spasmodic manner because they are subjected to excessive resistance. Intermittent means that the pain has a wave pattern: Phases of relative freedom from symptoms alternate with strong peaks of pain. Common accompanying symptoms of colic are high blood pressure, sweating, nausea and vomiting, and tachycardia, the pulse that is sharply elevated over a long period of time. Symptoms can increase to circulatory collapse.
Causes
Intestinal colic is a typical symptom of the chronic inflammatory bowel diseases Crohn’s disease and ulcerative colitis. In ulcerative colitis, the mucous membranes of the rectum and colon are inflamed; in Crohn’s disease, which can extend throughout the digestive tract, the small intestine in particular is inflamed. However, people who do not have chronic inflammation of the intestines can also suffer from intestinal colic. The causes are painful accumulations of gases in the intestine, called meteorism by the specialist, flatulence, adhesions and associated strangulation of intestinal areas, an acutely or chronically distended intestine or blockages in the intestine. Intestinal blockages occur when, for example, tumors, foreign bodies or disorders of the intestinal wall constrict or completely block the intestinal tract. Rarely, an incorrect or intolerant diet, for example in the case of lactose intolerance, leads to intestinal colic. These then occur spontaneously and once and last only a few minutes. Psychosomatic causes, for example a too high stress level, can also show up as intestinal colics.
Symptoms, complaints and signs
Intestinal colic is manifested by severe, usually cramping stomach pain and cramps in the abdominal area. The cramps occur at intervals and usually last between 20 and 30 minutes. They are usually accompanied by nausea and vomiting and diarrhea. The severe pain irritates the peritoneum, which can result in intestinal paralysis. Such paralysis is again manifested by severe pain, and in the absence of treatment, intestinal obstruction may occur, which can be recognized by a hard abdominal wall and severe pressure pain in the lower abdomen. Intestinal colic itself may also cause fever. The elevated body temperature is often accompanied by sweating, rapid heartbeat and chills. Blood pressure is extremely elevated and continues to rise as the condition progresses. In a severe course, further complaints occur in the gastrointestinal tract. Those affected usually feel listless and tired, and a general feeling of exhaustion occurs. In severe cases, intestinal colic can lead to cardiac arrest. In addition, bone fractures can occur as a result of the intense muscle contraction; the rib region in particular is at risk. Externally, intestinal colic is manifested by bulges in the abdominal area and often pale skin.
Diagnosis
Medical diagnosis is based on an extensive history to clearly exclude functional or psychosomatic bowel complaints and differential diagnoses, such as gastric disease and gallstones. The diagnosis of functional and psychosomatic complaints is difficult and usually requires the exclusion of organic causes first, but is important in defining the need for therapy and proper medication. Organic causes of intestinal colic are determined with the help of ultrasound and X-ray examinations, endoscopic measures, computer or magnetic resonance imaging, and, if the diagnosis is unclear, surgical laparoscopy. The imaging measures may be performed with the administration of contrast media, if necessary.It is also helpful to hear the patient’s descriptions of whether and how he or she feels bowel movements and to listen to the bowel area, where loud splashing sounds can often be detected.
Complications
Intestinal colic can lead to severe complications as it progresses. Initially, there may be accompanying diarrhea, flatulence, and other discomfort in the gastrointestinal tract. This is often accompanied by fatigue and a general feeling of exhaustion. The lack of appetite during the illness can lead to dehydration and various deficiency symptoms. Complications can also arise during the treatment of intestinal colic. For example, the prescribed drugs may cause allergies or there may be an injury to the intestinal wall during surgery. If the colic is based on an intestinal obstruction, life-threatening fever symptoms and severe pain may occur in the course of the disease. In addition, there is a risk of intestinal perforation. In case of severe symptoms, cardiac arrest may also occur in the course of intestinal colic. Intense muscle contractions can also cause bone fractures. It is not uncommon for sufferers to bite their tongue or otherwise cramp, increasing the risk of accidents. Cardiovascular patients are particularly at risk, as are children, the elderly and patients with a corresponding previous illness. Because of the severity of possible complications, a physician should be consulted immediately if intestinal colic is suspected.
When should you see a doctor?
Occasional gastrointestinal upset is not a cause for concern, especially if the causes, such as fatty foods or high-proof alcohol, are known. Usually, the discomfort goes away on its own after a few hours. Simple home remedies such as chamomile tea or bullrich salt can help to quickly calm the gastrointestinal tract again. However, caution is advised if such disturbances occur more frequently or assume the proportions of colic. In case of cramping pain in the abdomen, a doctor should always be consulted. This is especially true if other symptoms are added. Colic in combination with nausea, diarrhea and vomiting may indicate (food) poisoning. Although these are usually harmless, a doctor should always be consulted as a precaution. Medical help should also be sought if intestinal colic is accompanied by blood in the stool. Special care should be taken if the affected person still has an appendix and the right side of the abdomen is sensitive to pressure or bending the right knee causes pain in the lower abdomen. In these cases, it is probably appendicitis and should be presented to the doctor immediately. If the pain subsides unexpectedly, the emergency physician must be informed immediately, as a life-threatening rupture of the appendix could be present. Intestinal colic, which occurs in women depending on the cycle, can also be treated with over-the-counter medications or home remedies after consultation with the gynecologist.
Treatment and therapy
Therapy of intestinal colic depends on its cause and may be conventional medicine, homeopathy, or methods of traditional Chinese medicine or herbal applications. Orthodox medicine usually prescribes painkillers, measures to decongest the intestine and antispasmodic drugs as an immediate measure, as well as cause-related therapies. For example, a change in diet to a lactose-free diet can help allergy sufferers to treat their symptoms, the administration of antibiotics may be necessary, or surgical procedures may have to be performed to loosen and remove blockages. Inflammatory bowel diseases require specific therapies, for example Crohn’s disease patients receive additional adrenal hormones. More gentle, but not helpful in all cases, are treatments with gentian, anise, St. John’s wort, fennel, caraway oil, chamomile and ribwort in various combinations. They can be administered as herbal teas, scented applications, abdominal compresses and in the form of warm baths. Traditional Chinese medicine treats sufferers with acupuncture and relaxation exercises and is especially helpful for stress-related and psychosomatic intestinal colic.
Outlook and prognosis
Intestinal colic can be treated and cured in most patients receiving medical care. In principle, the prognosis is good, but it depends on the underlying disease present. Within a few hours, an improvement in health has already occurred.The cramps subside and the pain recedes. If the course is favorable, the patient is completely free of symptoms after a few weeks. In the case of organic causes, there are numerous therapeutic approaches that are very promising and lead to a favorable prognosis. If there is a chronic underlying disease, the prospects of a cure diminish. Chronic inflammation causes recurrence of intestinal colic at regular intervals and rarely leads to recovery of the patient. Nevertheless, preventive measures can also be taken in this case in a medical treatment, which brings about an alleviation of the symptoms. Psychosomatic concomitant diseases are also difficult to treat. Here, there is often a lack of insight into the illness on the part of the patient. The complaints often occur repeatedly over many years or decades. There is no improvement until the psychological problem has been treated and clarified. If the affected person faces up to therapy and the basic issue of psychological stress, he or she has a good chance of being cured. Without treatment, the risk of a chronic course of the disease and further intestinal diseases, some of which are life-threatening, increases.
Prevention
Because of the variety of causes of intestinal colic, it is difficult to prevent it. A healthy lifestyle and diet and adherence to therapeutic measures for chronic intestinal inflammation prove helpful.
Follow-up
The extent to which follow-up care becomes necessary depends on the course of the disease. Many symptoms can be successfully treated within a few weeks. There is then no need for scheduled follow-up examinations. However, patients can only prevent re-infection to a limited extent. A healthy diet and sufficient sleep are considered beneficial to health after a first intestinal colic. The situation is different in the case of a chronic course. In this case, recovery is unlikely. Intestinal colic recurs from time to time. Occasionally, imaging techniques are used to document the progress of the disease. Ultrasound and x-ray examinations are appropriate. The intestinal tract can be listened to. An extensive medical history characterizes each checkup. Follow-up care in this case aims to support the patient in his or her everyday life. Life should be free of symptoms. For this reason, medications are also administered. They have an antispasmodic effect or contribute to the decongestion of the intestine. If the causes of intestinal colic result from psychological conditions, relaxation exercises and other therapies can supplement the aftercare. The patient learns courses of action that alleviate the episodic pain peaks. Thus, aftercare only comes into play in a chronic course of intestinal colic. It provides for ongoing documentation of the disease history. The patient should experience a symptom-free daily routine.
What you can do yourself
Medical advice is always sought when intestinal colic is suspected. Various self-help measures and home remedies support the conventional medical treatment and contribute to a quick recovery. The characteristic gastrointestinal complaints can be alleviated primarily by bed rest and a diet that is gentle on the stomach. In the first ten days after intestinal colic, no excessively fatty, spicy, sweet, salty or flatulent foods should be consumed. Instead, it is recommended to eat mainly rusks and light soups and also drink plenty of fluids. Home remedies from nature can also help against the symptoms. St. John’s wort and fennel, for example, are said to have an analgesic effect, while teas with caraway and chamomile alleviate stomach cramps. Suitable applications are also scents, herbal teas, stomach compresses as well as warm baths. In general, the kidney and abdominal area should always be kept sufficiently warm during intestinal colic. This not only helps to relieve the acute discomfort, it also prevents further diseases of the gastrointestinal tract. Sometimes a change in lifestyle is also useful. Intestinal colic is usually triggered by an unhealthy diet or stress. Together with the doctor in charge, the exact triggers can be determined and remedied.