The purpose of this presentation is to discuss true allergic colic—as differentiated from the many other forms of colic. An allergic etiology probably accounts for only a small fraction of the colic seen in infancy. Nevertheless, it is worth emphasis because it is in this field that one can present objective evidence.
It used to be generally assumed that "infantile colic" implied only a spastic disturbance of the small intestine. In the light of present understanding, this spastic phenomenon may involve not only the small intestine, but also the colon, and even the pylorus of the stomach.
THE EXPERIMENTAL STUDIES
One does not have to speculate on the "modus operandi." It has been possible to demonstrate visible evidence of this otherwise subjective phenomenon by roentgenogram. In atopic children, specifically chosen because they were subject to intestinal cramps from known foods, it was possible to activate various parts of the gastrointestinal tract by feeding these allergenic foods concealed in barium. These studies were published in detail some time ago.
We could produce segmental contraction of the small intestine, demonstrating configurations on the roentgenogram comparable to those seen in sprue or celiac disease; and observe pylorospasm and colonic spasm in association with cramping abdominal pain, varying from mild to severe. Many of these children had confirmatory positive cutaneous tests to the provocative foods. Although these observations were made on children 4 to 14 years of age, there is no reason to doubt that similar mechanisms are operative in infants. Obviously infants are not suitable subjects for such studies.
- Copyright © 1956 by the American Academy of Pediatrics