Colicky pain and neurology. Aleem M A, Hakkim A M. BMJ 2016;354:i4195

BMJ

Practice

What Your Patient is Thinking“It’s just a bit of colic,” they said

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4195 (Published 17 August 2016)

Cite this as: BMJ 2016;354:i4195

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Re: “It’s just a bit of colic,” they said

Colicky pain and neurology

There are some neurological disorders that should also be considered as the causes for colicky pain in infants. They are infantile migraine, pre and post herpetic neurologia, radiculities muscle cramps and, rarely, lead poisoning.

Neurochemistry

Babies with colicky pain have higher levels of serum motilin, a hormone that stimulates contractions or spasms in the gastrointestinal tract. Colicky babies may also have increased levels of ghrelin, a hormone that stimulates the appetite. And it’s possible that one of the causes of colic pain is related to levels of serotonin and melatonin. Serotonin increases intestinal contractions, melatonin suppresses them. In children and adults, serotonin and melatonin levels peak in the evening.Young babies are different. Their serotonin levels peak in the evening, but their melatonin levels don’t. As a result, there isn’t enough melatonin to counteract the serotonin and babies have more cramps. This would explain why colic tends to disappear after 3 months of age. That’s when melatonin circadian rhythms mature.

Competing interests: No competing interests

25 August 2016

M A Aleem

Neurologist

A M Hakkim

ABC Hospital.Dhanalakshmi Srinivasan Medical College and Hospital . Apollo Hospital

Annamalainagar, Trichy 620018. Apollo Hospital Trichy 620010. Dhanakakshmi Srinivasan Medical college and Hospital , Perambalur 621113 . Tamilnadu India.

@drmaaleem