Where does colic collide?

In paediatrics, infantile colic is a behavioural syndrome of recurrent, prolonged, inconsolable crying and fussing in an otherwise healthy, well-fed infant in the first months of life, classically defined by Wessel's 'rule of threes': crying for more than three hours a day, on more than three days a week. Lehtonen's 1995 review Infantile Colic stresses that, despite the name, demonstrable gut pain is usually absent, with gastrointestinal, neurodevelopmental, and parent-infant factors all proposed. The referent is this self-limiting crying syndrome of early infancy, distinct from a horse's abdominal crisis or the pain of a ureteric stone.[1]

Unit

The duration and frequency of inconsolable crying episodes

Recovery means

Self-limiting: it typically resolves by three to four months of age, so management centres on reassurance and soothing rather than cure.

Measured by

Quantified by cry-and-fuss diaries against the rule-of-threes threshold.

In urology, renal or ureteric colic is the sudden, severe, cramping pain of an upper urinary-tract stone lodged in the ureter, felt in the loin and radiating to the groin, caused by acute obstruction that raises pressure and provokes smooth-muscle spasm and local prostaglandin release. Bultitude and Rees's 2012 Management of renal colic describes the presentation and the role of NSAID analgesia and imaging. The referent is this acute obstructive stone pain, which shares with equine and infantile colic only the ancient root 'kolon', the pain of a hollow abdominal organ, and not the underlying condition.[2]

Unit

The severity of loin-to-groin pain from an obstructing ureteric stone

Recovery means

Resolves when the stone passes or is removed; analgesia and medical expulsive therapy aid passage, with intervention for larger or obstructing stones.

Measured by

Assessed by pain severity, urinalysis for haematuria, and imaging (CT KUB) to locate and size the stone.

In equine veterinary medicine, colic is not a diagnosis but a clinical catch-all for signs of abdominal pain in the horse (pawing, rolling, flank-watching, and restlessness), arising from causes as varied as gas distension, impaction, intestinal displacement, or life-threatening strangulation. Cohen's 2017 account of the epidemiology of colic sets out its incidence and risk factors and marks it as a leading cause of death in horses. The referent is the horse's whole syndrome of abdominal pain and the urgent medical-or-surgical decision it forces, far broader than an infant's crying or a kidney stone's pain despite the shared word.[3]

Unit

The presence and severity of abdominal-pain behaviour in the horse

Recovery means

Many gas or spasmodic colics resolve with analgesia and medical care, while displacements or strangulations need surgery; outcome depends on how early the cause is corrected.

Measured by

Assessed by pain behaviour, heart rate, gut sounds, rectal examination, and abdominal fluid analysis.