Bakteriell bedingte Darmentzündung – Symptome, Vorkommen in der Schwangerschaft. Wie lange dauert sie?

Intestinal colic manifests as a sudden, acute, and paroxysmal abdominal pain caused by spasmodic contractions of the smooth intestinal musculature. A defining feature is the migratory nature of the pain, which shifts in tandem with intestinal peristalsis, alongside a fluctuating intensity pattern. Affected adults often adopt a hunched posture to mitigate discomfort. Etiological factors are multifaceted, encompassing poor dietary habits (heavy, gas-producing meals), gastrointestinal disorders (irritable bowel syndrome, gastroesophageal reflux), bowel obstruction, constipation, food allergies/intolerances, diverticulosis, ulcerations, fecal impaction, and microbial dysbiosis. Colic affects both adults and infants—among the latter, it ranks as the second most common functional disorder after regurgitation. In infants, it stems from gastrointestinal immaturity, mucosal abnormalities, or impaired digestive enzyme secretion. Symptoms typically emerge between weeks 3–12 of life, resolving by month 3. Diagnosis adheres to Wessel’s criteria (the "rule of threes": crying episodes >3 hours/day, >3 days/week, persisting >3 weeks). In adults, recurrent episodes degrade quality of life; management involves dietary adjustments (excluding gas-inducing, heavy foods) and herbal support (fennel, chamomile).

The clinical manifestations of intestinal colic exhibit variability based on the patient’s age group, the severity of the painful episode, and individual physiological responses. In adults, a colic attack is typically characterized by the sudden onset of cramping abdominal pain, the location of which may shift over time. As the pain intensifies, the affected individual instinctively adopts a fetal position—drawing the legs upward and bending the torso forward—as this posture provides temporary alleviation of discomfort. Beyond the primary abdominal symptoms, the episode is frequently accompanied by nausea that may progress to vomiting, excessive flatulence due to intestinal gas accumulation, and appetite disturbances that can temporarily lead to food aversion. In infants, however, intestinal colic presents as prolonged, inconsolable crying with a high-pitched quality, which may escalate into piercing screams or shrieks. The child arches their back, clenches their fists tightly, and squeezes their eyes shut—behaviors that reflect the severity of the pain. Due to gas buildup, the abdomen becomes distended, firm, and visibly swollen. Facial and neck skin often flushes red, while the lips may develop a bluish tint, outcomes of the combined effects of pain, distress, and the physical exertion of crying. Additionally, during a colic episode, infants may pass gas more frequently and produce loose, mucous-like stools, sometimes tinged green. It is crucial to emphasize, however, that despite the distressing nature of these symptoms, intestinal colic does not adversely affect the child’s psychomotor or physical development, representing instead a transient and self-limiting condition.

Intestinal colic, a condition characterized by spasmodic abdominal pain, may also affect pregnant women, manifesting with symptoms comparable to those observed in non-pregnant individuals. Its onset is frequently associated with an inadequate or poorly balanced diet during pregnancy, as well as digestive disturbances that result in constipation and the excessive accumulation of intestinal gases. A hallmark of this condition is the sudden onset of severe, wave-like abdominal pain that emerges without warning but typically subsides spontaneously after a short duration. The precise location of the discomfort varies depending on which segment of the intestine’s smooth muscle is undergoing spasms—pain may be perceived on the left side, the right side, or diffusely across the entire abdominal region. To mitigate the risk of colic episodes, pregnant women are advised to adopt a high-fiber diet, as dietary fiber plays a crucial role in preventing constipation, bloating, and gas retention. Excellent sources of fiber include coarse-grained cereals, whole-grain bread, fresh fruits, and vegetables. Conversely, foods known to cause flatulence—such as fried, heavily processed, or sugary items—should be excluded from the diet, as they may exacerbate symptoms. Additionally, herbal infusions made from fennel can be consumed to aid digestion and alleviate excess gas. It is also important for expectant mothers to avoid excessive physical exertion; thus, strenuous or high-impact exercises are not recommended during pregnancy.

For the majority of newborns, the initial symptoms of infantile colic become apparent as early as the second week of life, with earlier onset typically correlating with increased severity, higher frequency, and prolonged duration of individual episodes. Painful colic attacks most commonly manifest during the late afternoon or evening hours; however, irritability and distress in the infant may persist throughout the entire day. A single colic episode generally lasts between several to upwards of ten minutes, recurring in a cyclical pattern every two to three hours. During the intervals between attacks, infants often fall asleep due to exhaustion resulting from continuous pain and muscular tension. It is noteworthy that some children remain entirely asymptomatic between colic episodes, exhibiting behavior indistinguishable from that of their peers. Symptoms typically resolve spontaneously by the third month of life, though colic may occur irrespective of the child’s age or health status. Given its paroxysmal, recurrent, and intensely painful nature, colic represents a significant burden for both the infant and caregivers. The most critical measures for alleviating symptoms and preventing exacerbation include the implementation of a easily digestible diet for breastfeeding mothers and the maintenance of age-appropriate physical activity for the child.