Infantile intestinal spasm

　　The main causes of infantile intestinal spasm are intestinal factors and non-intestinal factors, as follows:

　　1. Excessive production of intestinal gas, which has four main sources: inhaled gas, neutralization of gastric acid, diffusion from the blood, and bacterial fermentation.

　　2. Increased intestinal motility.

　　3. Gastrointestinal hormones.

　　4. Dietary factors. Some studies show that the occurrence of intestinal spasm in breastfed infants is related to the mother's milk consumption, and food allergy may be a cause of intestinal spasm.

　　5. Other factors.

　　Infantile intestinal spasm can be accompanied by dehydration, even signs of shock and peritonitis, and children may be accompanied by tumors, polyps, Meckel diverticulum, ascariasis, and other conditions. Prolonged obstruction in children may lead to dehydration and bacteremia, causing tachycardia and fever, and occasionally hypovolemic or infectious shock. Some patients may develop pelvic abscess, intestinal abscess, subdiaphragmatic abscess, iliac fossa abscess, and adhesive intestinal obstruction, among others.

　　During the onset of infantile colic, the main manifestations are persistent and difficult-to-soothe crying. The main manifestations are restlessness, and may be accompanied by vomiting, flushed cheeks, rolling, and the lower limbs are curled up. When crying, the face is flushed, the abdomen is bloated and tense, and the legs are curled up. These symptoms can be relieved by anal gas or defecation, and in small infants, they can occur repeatedly and present as a self-limiting process. Excessive crying in infants can cause parents to be anxious, but children with colic can grow and develop healthily.

　　To prevent colic, parents should pay attention to arranging the child's diet and rest during holidays and avoid the child eating excessive cold drinks and indigestible food. Once abdominal pain occurs, contact a health care doctor immediately and seek treatment early.

　　1. Mothers who breastfeed should eat less food that causes bloating, such as milk, apples, and melons;

　　2. Commonly, you should massage the baby's belly clockwise, and you can also gently massage the baby when the baby is crying and fussing.

　　3. When the baby is crying and fussing, you can use a hot water bottle to apply heat, but pay attention to not make the temperature too high, and you can also rub your hands and press them on the baby's stomach to apply heat.

　　4. Try not to let the baby cry, as crying will inhale air and cause bloating;

　　5. Do not give the baby a pacifier unless necessary;

　　6. After feeding, be sure to pat the baby's back to let the baby burp out the air swallowed.

　　7. Feed the baby regularly, a 2-month-old baby should eat every 3 hours, and a baby over 3 months should eat every 4 hours. If the baby is fussy, feed water in between, regular feeding is good for the recovery of intestinal function.

　　The main clinical examination methods for infantile colic include blood routine, stool routine, biochemical tests for the whole body, and ultrasound, as follows:

　　1. Blood routine

　　Blood routine is the most general and basic blood test. Blood is composed of two main parts: liquid and cellular components, and the blood routine examination tests the cellular part of blood. It is one of the commonly used auxiliary examination methods for doctors to diagnose diseases. It can understand whether the child has digestive tract infection, and when infection occurs, the white blood cell count and the proportion of neutrophils will increase.

　　2. Stool routine

　　Stool routine examination to understand whether colic has caused bleeding in the digestive system, and if necessary, a stool OB test should be performed.

　　3. Biochemical tests for the whole body

　　Biochemical tests for the whole body to understand whether liver function, kidney function, myocardial enzymes, electrolytes, and other indicators are abnormal, and while actively treating the disease, it is necessary to check whether the internal environment indicators are stable.

　　4. Abdominal permeability and abdominal ultrasound

　　Abdominal permeability and abdominal ultrasound are used to understand the severity of colic and whether there is intestinal obstruction.

　　The dietary taboos for infantile colic mainly depend on different feeding methods, as follows:

　　1. For artificially fed babies, the initial feeding should be small and frequent.

　　The concentration ratio is appropriate, and the milk volume and concentration should be gradually increased in a regular manner, which is conducive to the maturation of gastrointestinal motility function and the secretion of digestive juices.

　　2. Breastfeeding mothers should try to eat less spicy foods.

　　Some easily gas-producing, spicy, alcoholic, coffee, and other刺激性 foods can produce adverse stimuli to the baby's central nervous system and gastrointestinal tract through the mother's metabolic products entering the baby's body.

　　3. When feeding, it is best to hold the baby and place them in a head-high, foot-low position.

　　It is more appropriate to keep the angle between the baby's chin and the bottle about 30-40 degrees.

　　Determine the treatment based on the scoring results of intestinal colic, with the scoring criteria referring to the intensity and duration of crying, accompanying symptoms, and the parents' views on the child's crying. If the crying is related to intestinal colic but not severe, use the first and second-level treatment plans; if it is a severe case of intestinal colic, use the third-level treatment plan.

　　1. First-level treatment

　　Comfort the child, rock the child, reduce environmental noise, and use a hot water bottle to捂婴儿腹部; provide support and care to parents; take dimeticone. Dimeticone is a non-absorbable drug that promotes gas excretion by changing the surface tension of bubbles, causing them to fuse or disperse, and has no side effects on the human body. Other drugs that reduce intestinal gas, such as activated carbon and α-galactosidase, can adsorb gas or help digest high-fiber foods, reducing the production of gas from fermentation, but the efficacy for intestinal colic is not yet certain.

　　2. Second-level treatment

　　That is, medication. Antispasmodics (such as cimetropium bromide) can block the muscarinic receptors of smooth muscle, and can also directly act on smooth muscle to relieve smooth muscle spasms.

　　3. Third-level treatment

　　Change diet and (or) medication. Lactating women should not consume milk, dairy products, fish, and eggs; artificial feeding infants should be given soy milk or hydrolyzed casein formula, which can significantly improve infantile intestinal colic. For those with colic caused by CMPI, removing milk protein and switching to soy milk or hydrolyzed protein can alleviate the symptoms of 71%-88% of children. Medication (such as dicyclomine hydrochloride) has certain side effects, and sometimes the efficacy is not ideal; dietary changes may be more suitable than medication.