Colic Pain or Colicky Pain or Gut Rot

What is Colicky Pain?

Colicky pain is also known as Colic pain or gut rot. Colicky pain is observed in chest and abdomen.

 Colic Pain or Colicky Pain or Gut Rot

Bowel, ureter, urethra and fallopian tube are tubular organs. Middle segment of tubular viscera is enveloped by smooth muscles. Contraction or narrowing of tubular viscera is caused by contraction of smooth muscles. Colic pain is caused by contraction of tubular viscera. Bowel constriction or narrowing as well as contraction of any tubular viscera in chest, abdomen and pelvis results in severe colic pain. Colicky pain or gut rot is sharp and stabbing cramps. Cramping pain lasts for few minutes and cycle of pain is repeated every few minutes. Colicky pain may or may not be associated with other symptoms. Other symptoms could be diarrhea, constipation, nausea or vomiting.

Colicky Pain is a Common Abdominal Symptom and is Often Described as Follows-

  • Tummy pain
  • Tummy ache
  • Stomach ache
  • Stomach pain
  • Gut ache
  • Belly ache or
  • Gut rot.

What Are The Classifications of Colicky Pain?

Colicky Pain or Colic Pain or Gut Rot can be classified into Chest Colic, Abdominal Colic, Renal Colic, Biliary Colic and Pelvic Colic

1. Chest Colic-

Chest pain when caused by spasm or irritation of esophagus is known as chest colicky pain. Chest colicky pain is often mistaken for heart attack or angina. Chest colic originates in esophagus. Cause of chest colic is as follows-

Classification of Colic Pain or Colicky Pain or Gut Rot

  • Foreign Body- Foreign body when stuck at lower end of esophagus causes severe burning and squeezing colic pain in esophagus
  • Heartburn- Heartburn is also known as regurgitation or esophageal reflux. Regurgitation is reverse flow of stomach content in to lower esophagus.
  • Stricture of Esophagus- Stricture is narrowing of the lower end of esophagus. Tightening and scarring following repeated inflammation of lower end of esophagus cause stricture.
  • Ulcer of Esophageal Mucosa- Esophageal mucosal irritation and inflammation causes multiple ulcers. Multiple ulcer causes colicky pain.
  • Hiatal Hernia- Hiatus is a larger stomach opening in diaphragm. Stomach slides into chest around esophagus known as hiatal hernia.

2. Abdominal Colic

a. Stomach

  • Gastritis- Gastritis is an inflammation of stomach. Cause of gastritis is viral or bacterial infection. Gastritis causes nausea, vomiting and colic pain. Colic pain is caused by inflammation of gastric mucosa and contraction of stomach smooth muscles.
  • Gastric Ulcer- Gastric ulcer causes burning continuous pain. In few cases gastric ulcer causes frequent stomach contractions and colic pain.

Abdominal Colic

b. Small Intestine

  • Enteritis- Viral or bacterial infection of small intestine causes severe colic pain. Colic pain is often associated with diarrhea and vomiting.
  • Ulcerative Colitis- Ulcerative colitis (UC) is inflammatory bowel disease that results in colic pain and diarrhea. Symptoms are frequent and lasts for few days. Patient has good and bad days. Ulcerative colitis is an autoimmune disease.1
  • Crohn's Disease- Crohn's disease is a regional inflammatory bowel disease of gastrointestinal tract. Symptoms of crohn's disease are colic pain, nausea, vomiting, diarrhea and weight loss. Crohn's disease is initiated after bacterial infection of the bowel in autoimmune compromised patient.1
  • Diverticulitis- Diverticula are a pouch of bowel wall that floats in bowel cavity. Inflammation of diverticula is known as diverticulitis. Symptoms of diverticulitis are colic pain, fever, nausea, constipation and diarrhea.
  • Intussusception- Small bowel is a long tubular viscera, which floats within abdominal cavity. The distal part of the small intestine slips or invaginates inside the proximal bowel. Intussusception causes colic pain, nausea, vomiting and rectal bleeding.
  • Volvulus- Malrotation of small bowel around mesentery is known as volvulus. Rotation of intestine results in twist and obstruction of small bowel.
  • Adhesions- Abdominal scars following abdominal surgery or trauma causes sticking of bowels and result in adhesions of bowel. Bowel adhesion may result in obstruction of the bowel lumen. Intestinal obstruction caused by adhesions result in colic pain, nausea and constipation.
  • Tumors- Bowel tumor causes bowel obstruction. Symptoms of bowel tumor are colic pain or colicky pain, constipation, weight loss, loss of appetite and weakness.

c. Appendix

Appendicitis- Appendicitis is inflammation of appendix. Symptoms of appendicitis are colic, fever, vomiting, nausea and diarrhea.

d. Large Intestine

  • Colitis- Colitis is inflammation of large colon. Inflammation is caused by viral, bacterial or parasite infection. Colitis is presented as colic, diarrhea, fever, bloating stomach and bleeding.
  • Ulcerative Colitis- Ulcerative colitis (UC) is inflammatory bowel disease that results in colic pain and diarrhea. Symptoms are frequent and lasts for few days. Patient has good and bad days. Ulcerative colitis is an autoimmune disease.
  • Crohn's Disease- Crohn's disease is a regional inflammatory bowel disease of gastrointestinal tract. Symptoms of crohn's disease are colic pain, nausea, vomiting, diarrhea and weight loss. Chron's disease is triggered following bacterial infection of the bowel in autoimmune compromised patient.
  • Diverticulitis- Diverticula are a pouch of bowel wall that floats in bowel cavity. Inflammation of diverticula is known as diverticulitis. Symptoms of diverticulitis are colic pain, fever, nausea, constipation and diarrhea.
  • Volvulus- Mal-rotation of small bowel around mesentery is known as volvulus. Rotation of intestine results in twist and obstruction of small bowel.

3. Renal Colic2, 3

a. Kidney

  • Stone- Kidney stone is also known as renal calculus or nephrolithiasis. Kidney stone lies in kidney or renal pelvic pouch. Renal colic causes colic pain known as renal colic associated with nausea and hematuria.
  • Tumor- Renal tumor causes obstruction of renal passage which results in severe colic pain or colicky pain. Colic is associated with fever, hematuria and retention of urine.

Renal Colic

b. Ureter

  • Stone- Ureter stone can cause severe colic pain secondary to obstruction. Colic is known as renal colic. Ureter stone also causes hematuria and nausea. Ureter stone resulting in renal colic is often difficult to diagnose.4
  • Infection- Infection of ureter is often associated with infection of bladder and kidney known as urinary tract infection. Colic pain is secondary to spasm of ureter. Urinary tract infection causes colic pain, fever and hematuria.
  • Tumor- Ureter tumor is rare and causes obstruction of the urinary passage. Dilation of ureter following obstruction causes spasm of the ureter resulting in colic pain.

c. Urinary Bladder

  • Stone- Bladder stone causes retention of urine and spasm of bladder resulting in severe spasm of bladder. Contraction of bladder results in bladder colic. Bladder colic is often associated with hematuria and nausea.
  • Infection- Urinary bladder infection is known as cystitis. Cystitis often causes spasm and contraction of urinary bladder results in bladder colic.
  • Tumor- Bladder cancer causes obstruction of urine flow from bladder to urethra. Retention of urine causes bladder distension. Bladder distension follows bladder spasm and bladder colic.

4. Biliary Colic

  • Cholecystitis or Cholangitis- Inflammation of gall bladder is known as cholangitis or cholecystitis. Cholangitis causes spasm of gall bladder and result in colic pain. Colic pain of gall bladder is also known as biliary colic. Colic pain is associated with nausea, vomiting and fever. Biliary colic is often managed in outpatient clinic.5
  • Cholelithiasis: Gall bladder Stone- Stones in gall bladder cause inflammation of gall bladder and obstruction of bile flow. Inflammation and distension of gall bladder follows spasm of gallbladder and results in biliary colic. Biliary colic is associated with nausea and fever.
  • Tumor- Gallbladder tumor causes spasm and obstruction of bile flow. Severe biliary colic is associated with loss of appetite, loss of weight, fever and nausea.
  • Ulcer- Gallbladder ulcer is associated with bile stone and results in severe spasm of gall bladder resulting in colic pain.

5. Pelvic Colic

a. Fallopian Tube-

Fallopian tube opens in to uterus. Inflammation or ectopic pregnancy in fallopian results in spasm of the tube and pelvic colic pain. Distal end of fallopian tube is open-ended and lies in contact with ovary. Following ovulation ovary passes into fallopian tube. Fertilization of ovary with sperm rarely occurs in fallopian tube instead of uterus. The fertilized ovum then stays in fallopian tube and growth of fetus causes distension of fallopian tube and severe colic pain.

Pelvic Colic

b. Uterus-

  • Menstruation- Most female patient may feel menstruation as mild to moderate pain and few feel menstruation as severe colic pain.
  • Infection- Infection of uterus causes severe pain and periodic spasm of the uterus. Pain is often severe and colicky in character. Pain is associated with fever and bleeding from vagina.
  • Tumor- Uterus cancer causes severe pain because of expansion of uterus. Pain is often colicky and squeezing in character

c. Ovarian Torsion-

Ovarian torsion is rare with normal ovary. Torsion is observed when size of ovary is increased. Ovary is enlarged in presence of large corpus luteal cysts or ovarian tumor. Ovary rotates with fallopian tube around the broad ligament and mesentery covering ovary known as mesovarium. Ovarian torsion causes sharp burning and squeezing colic pain. Pain is associated with nausea and vomiting. Fever is often observed if structures within mesentery and fallopian tube is necrose.

Also Read:

References

1) The incidence of ulcerative colitis (1995-2011) and Crohn's disease (1995-2012) - Based on nationwide Danish registry data.

Nørgård BM1, Nielsen J2, Fonager K3, Kjeldsen J4, Jacobsen BA5, Qvist N6.

J Crohns Colitis. 2014 Mar 24. pii: S1873-9946(14)00103-2.

2) Normal renal sonogram identifies renal colic patients at low risk for urologic intervention: a prospective cohort study.

Yan JW, McLeod SL, Edmonds ML, Sedran RJ, Theakston KD.

CJEM. 2014 Feb 1;16(0):1-8.

3) Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study.

Pernet J, Abergel S, Parra J, Ayed A, Bokobza J, Renard-Penna R, Tostivint I, Bitker MO, Riou B, Freund Y., CJEM. 2014 Feb 1;16(0):1-7.

4) Management of symptomatic ureteral calculi during pregnancy: Experience of 23 cases.

Abdel-Kader MS1, Tamam AA, Elderwy AA, Gad M, El-Gamal MA, Kurkar A, Safwat AS. Urol Ann. 2013 Oct;5(4):241-4. doi: 10.4103/0974-7796.120294.

5) Outpatient management of biliary colic: A prospective observational study of prescribing habits and analgesia effectiveness.

Johnston MJ1, Fitzgerald JE2, Bhangu A3, Greaves NS4, Prew CL4, Fraser I4., Int J Surg. 2014;12(2):169-76. doi: 10.1016/j.ijsu.2013.12.003. Epub 2013 Dec 15.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: October 5, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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