Intestinal cramps are a symptom rather than a disease, and are paroxysmal abdominal pain caused by strong contractions of the smooth muscles of the intestines.
The main symptom is abdominal pain, which may be accompanied by nausea and vomiting.
In children, it may be related to immature intestinal function; in adults, it may be related to abdominal cold and intestinal inflammation.
If the symptoms are not serious, they can be relieved by rest or localized hot compresses; if they are serious, they can be treated with medication.
What is intestinal spasm?
Definition
Bowel cramps, also known as spastic colic, is a symptom rather than a disease.
Intestinal spasm is a paroxysmal abdominal pain caused by strong contraction of intestinal smooth muscle, which may be accompanied by nausea and vomiting.
It is a more common condition in acute abdominal pain.
Types
Functional intestinal cramps
Most intestinal spasms are primary, and their etiology is unclear and may be related to somatic sensitivities.
Triggering factors include cold abdomen, overeating cold and raw food, and indigestion.
Functional intestinal spasms can be relieved by themselves, but are prone to recurrence, and attention should be paid to adjusting dietary habits.
Organic intestinal cramps
Mostly secondary to organic lesions in the abdominal cavity, such as Meckel’s diverticulum, intestinal malformation, intestinal malrotation, gastrointestinal inflammation, intestinal parasites and so on.
Organic intestinal spasms need to eliminate the predisposing factors and be treated specifically for the cause.
Morbidity
There is no morbidity statistics related to intestinal spasm in adults in China, and the morbidity rate of infants and young children is 16% to 30%.
There is no obvious gender difference in intestinal spasm, and the probability of men and women suffering from the disease is close to the same.
Bowel spasms can occur at all ages.
Questions you may be concerned about
What are the typical symptoms of intestinal cramps?
Typical symptoms of intestinal cramps in adults are abdominal pain mainly around the umbilicus, and the pain varies in severity and recurrence. The pain is colicky, sometimes painful, sometimes stopping, and each attack may last 3 to 5 minutes, with intervals of several minutes to tens of minutes.
Typical symptoms of intestinal cramps in infants and young children are persistent, inconsolable crying and restlessness, which may be accompanied by vomiting, flushed cheeks, rolling over, distended and tense abdomen, and legs curled upward. The crying will stop as the abdominal pain subsides.
What is the best treatment for intestinal cramps?
There is no absolute fastest or best treatment for intestinal cramps due to individual differences.
If the symptoms are not severe, you can rest first, and at the same time, you can use a hot water bag to apply hot compresses to the abdomen, or apply topical medication such as cooling oil locally.
When the pain is severe, you can take pivoxyl bromide and other antispasmodic treatment, dimethicone, activated charcoal and other drugs to promote the exhaust, Keserol, lactulose and other drugs to relieve constipation, and if secondary intestinal spasms can be selected after surgical resection of the cause of the treatment.
You can also use traditional Chinese medicine, acupuncture and pain relief treatment.
What are the best ways to relieve intestinal cramps in children?
Most intestinal spasms in children can be relieved by resting in a warm environment.
When the attack is not serious, you can also massage the abdomen with warm hands or use hot water bags to apply hot compresses on the abdomen, which can effectively relieve the symptoms of abdominal pain.
Avoid cold foods and foods high in sugar. Milk allergy can be changed to soy milk or hydrolyzed protein.
Acupuncture can also be used for severe abdominal pain in children, but it needs to be done under the guidance of a medical professional.
Causes
Causes
Functional intestinal cramps
Most intestinal spasms are functional and the cause is still not fully understood.
Pediatric intestinal spasms
Developmental disorders: may be related to the underdevelopment of the central nervous system and immature intestinal function.
Food allergy: consumption of cow’s milk can induce intestinal cramps in infants and young children.
Cold exposure: Catching cold while sleeping may induce intestinal cramps in infants and young children.
Other factors: indigestion caused by poor diet and calcium deficiency may trigger intestinal cramps.
Intestinal cramps in adults
Indigestion: Overeating and eating a large amount of food in a short period of time may trigger intestinal cramps in adults.
Exposure to cold: Eating too much food that is too cold and having a cold abdomen may also trigger intestinal cramps in adults.
Intestinal diseases: Inflammatory reactions in the intestines may also be associated with adult intestinal cramps.
Other factors: mental stimulation, etc. may also be associated with adult intestinal cramps.
Organic intestinal cramps
Mostly secondary to organic lesions in the abdominal cavity, such as the following diseases.
Meckel’s diverticulum.
Intestinal malformations.
Poor intestinal gyration.
Gastrointestinal inflammation.
Parasitic toxin irritation, etc.
Pathogenesis
Intestinal spasm is caused by excessive contraction of intestinal smooth muscle.
Various pathogenic factors may cause dysfunction of the nervous system controlling intestinal motility, as well as impaired intestinal blood flow, etc., which in turn induces temporary intestinal muscle spasms.
Symptoms
Main Symptoms
The main feature of intestinal spasm is the sudden onset of paroxysmal, intermittent abdominal pain, and the intervals of intestinal spasm can be asymptomatic.
The abdominal pain can last anywhere from a few minutes or tens of minutes, with onset and cessation.
Usually after repeated episodes of tens of minutes or hours, the abdominal pain may cease.
Bowel spasms in adults and infants do not present in exactly the same way.
Adult intestinal cramps
The pain is mostly in the abdomen around the navel.
Manifestation of colic, sometimes painful, sometimes stop, each attack can last 3 to 5 minutes, each interval of several minutes to tens of minutes.
It can be relieved in tens of minutes to several hours.
The pain can stop with a change in position, defecation or bowel movement.
Infants and Toddlers
Infants and young children cry suddenly and are difficult to soothe during an attack of abdominal pain because they cannot express their feelings.
The crying stops as the abdominal pain subsides, and the child may fall asleep easily during the period when the pain stops, but the pain may return soon afterward, waking the child up. This may last from a few hours to a few days.
Other symptoms
Adults
The attack may be emotionally abnormal due to the pain.
Symptoms such as pallor, sweating on the forehead and cold extremities may even occur.
Infants
It will also be accompanied by flushing of the face and perioral (lips and the part around the mouth) pallor.
Abdominal distension, as evidenced by tension and tightness of the abdominal muscles.
Legs curled upwards, cold hands and feet, clenched hands, etc.
Seek medical attention
Department of Medicine
Gastroenterology
If abdominal pain occurs suddenly, prompt medical attention is recommended.
Pediatrics
Infants and young children are advised to seek immediate medical attention if they experience tension or tightness in the abdominal muscles, or if they cry after eating.
Preparation for medical treatment
Preparation for medical consultation: registration, preparation of documents, frequently asked questions
Tips
Before visiting the doctor, you can record the symptoms you have experienced and their duration for the doctor’s reference.
Preparation List
Symptom list
Pay particular attention to the time of onset of symptoms, special manifestations, etc.
Where is the discomfort?
How long has it lasted and under what circumstances did it worsen or ease?
What were the triggers?
Are there any other symptoms?
Have there been any recent changes in appetite, bowel movements, mental status and weight?
Have you had any tests or treatments?
Have you taken any medications recently, such as salicylates, glucocorticoids, antibiotics, etc.?
What foods were eaten before the abdominal pain?
List of medical history
Any previous gastrointestinal diseases, such as cholelithiasis?
Any recent surgical treatment?
Do you have a regular diet and do you smoke or drink alcohol?
Checklist
Test results for the last 6 months, which can be brought to the doctor’s office
A doctor who suspects intestinal spasms will first ask for a medical history; a pertinent medical history may assist the doctor in making a diagnosis if any of the following are present.
Recent medical history
Recent overeating.
Recent exposure to cold in the abdomen.
Recent mental stimulation.
Recent indigestion.
Recent presence of excessively cold food.
Past Medical History.
Meckel’s diverticulum.
Gastrointestinal inflammation.
Parasitic infections.
Gastrointestinal malformations.
Clinical manifestations
Symptoms
Adult
Typical abdominal pain, mainly around the umbilicus, of varying severity and recurrent nature.
Cold sweating, pallor, and cold hands and feet are associated with the pain.
Infants
Persistent, inconsolable crying.
Vomiting, flushing of the cheeks, rolling over, and curling of the lower limbs may occur.
The face is flushed when crying, the abdomen is distended and tense, and the legs are curled upward.
Physical signs
Abdominal tenderness is evident during the attack, but there is no tenderness and the abdomen is soft during the intervals.
Bowel sounds are hyperactive during episodes and normal during intervals.
Laboratory Tests
Routine blood tests
Routine blood tests check the total number and classification of white blood cells in the blood to help the doctor rule out inflammatory diseases with similar symptoms, such as acute appendicitis.
Inflammatory conditions can be recognized if the blood tests show an increased white blood cell count and neutrophil ratio.
There is no need to abstain from food or water before the routine blood test, but care should be taken not to drink alcohol.
Stool test
A routine stool test can help the doctor to rule out bacillary dysentery and parasitic infections with similar symptoms by the presence of an elevated white blood cell count and parasitic eggs, worms or protozoa.
Parasitic infections can be ruled out if routine fecal tests for parasites show negative results; if the white blood cell count is normal, bacillary dysentery can largely be ruled out.
Care should be taken to collect fresh samples to avoid mixing with urine and other miscellaneous preparations; specimens should be sent for examination within 1 hour after collection.
Endoscopy
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Purpose: Doctors can clearly see the extent of lesions in the intestinal lining through endoscopy.
Characteristics: Endoscopy has the characteristics of safety and reliability, etc. It can also take mucosal tissue specimens under microscopy.
Significance: Endoscopy can help doctors rule out organic diseases such as peptic ulcers.
Precautions
Start eating semi-liquid or low-slag diet, such as milk, porridge, noodles, thin rice, etc., 1 to 3 days before endoscopy, avoid eating vegetables, fruits and other foods containing more fiber.
Fasting is required on the day of examination; before the examination, take oral laxatives as prescribed by the doctor for bowel cleansing until the discharge is light yellow, non-slaggy, clear water stool.
Before the examination, please bring the electrocardiogram, previous colonoscopy results and relevant information such as pathological diagnosis and imaging examination.
For normal colonoscopy without colonoscopic treatment, you can eat after the bloating disappears in about 2 hours after the examination.
Painless colonoscopy needs to be accompanied by a family member, and after the examination, the patient should lie down and rest, and should not get up and move around until he/she wakes up completely, and should not drive on the day of the examination.
Imaging
Abdominal X-ray or CT
Purpose: It can help the doctor to rule out intestinal obstructive diseases.
Significance: Abdominal X-ray or CT examination can carry out differential diagnosis of related diseases.
Precautions
Eat a light, low-fat diet 1 day before the test, fast overnight, and take rest.
On the morning of the examination, you should fast and abstain from food and water.
Abdominal Ultrasound
Purpose: It can help the doctor to rule out diseases such as gallstones and inflammation of the bile ducts.
Meaning: Abdominal ultrasound can be used for differential diagnosis of related diseases.
Precautions
Eat a light, low-fat diet 1 day before the test, fast overnight, and take rest.
On the morning of the examination, you should fast and abstain from food and water.
Gastrointestinal Barium Angiography
Purpose: To determine whether there are ulcers, cancer and other diseases in the gastrointestinal tract.
Significance: X-ray barium meal contrast examination can be performed for differential diagnosis of related diseases.
Precautions
Oral laxatives and plenty of water should be taken the night before the test to clear the bowels.
Fasting is required on the day of the test, and the stool can be evacuated with corkscrew in the morning.
Differential Diagnosis
Acute appendicitis
Similarities: both can present with acute abdominal pain.
Differences: Acute appendicitis is often associated with fever, weakness, and depression, and the blood white blood cell count is significantly elevated.
Abdominal epilepsy
Similarities: Both may present with abdominal cramps around the umbilicus, and both may last for a period of time and have recurrent seizures.
Differences: Abdominal epilepsy is characterized by an abnormal EEG and abnormal discharges.
Cholelithiasis (gallstones)
Similarities: Both can present with severe abdominal pain.
Differences: Gallstones usually present as persistent abdominal pain in the right upper abdomen, whereas intestinal cramps tend to be periumbilical. Ultrasonography can also distinguish between the two diseases.
Treatment
Aims of treatment: The aim of treatment is, firstly, to remove the cause of the disease (including treatment of the disease causing the intestinal cramps), and secondly, symptomatic treatment is only aimed at relieving the patient’s discomfort and alleviating the pain.
General treatment
Rest: If the symptoms of intestinal cramps are not serious, rest can be the first step.
Local general treatment: At the same time, hot water bags can be used to apply hot compresses to the abdomen, or local application of topical medications such as Qingliang oil, which can effectively relieve the symptoms of abdominal pain.
Regulate diet
Breastfeeding women do not consume milk, dairy products, fish and eggs.
Artificial feeding given soy milk or milk powder with hydrolyzed casein can significantly improve intestinal cramps in infants.
Medications
Antispasmodics
Drug effects: antispasmodics can block muscarinic receptors in smooth muscle and can act directly on smooth muscle to relieve intestinal smooth muscle spasm.
Commonly used drugs: pivacurium bromide and so on.
Precautions: Allergic to pivacurium bromide, children and pregnant women need to be prohibited; esophageal, gastric and duodenal ulcers, as well as breastfeeding women need to be used with caution.
Promote intestinal gas discharge drugs
Drug effects: by changing the surface tension of gas bubbles, so that the gas bubbles fusion or diffusion, to promote gas discharge, reduce pain symptoms.
Commonly used drugs: dimethyl silicone oil, activated charcoal, α-galactosidase and so on.
Precautions: Promote intestinal gas discharge drugs generally have no adverse reactions.
Drugs for constipation
Drug effects: lubricate and stimulate the intestinal wall, soften the stool, so that the stool is easy to discharge, relieve the symptoms of constipation.
Commonly used medications: topical medications such as corkscrew, and lactulose.
Precautions: Before using lactulose, you need to determine whether there is intestinal obstruction, if so, it should not be used.
Deworming drugs
Effects: Deworming drugs can effectively kill parasites.
Commonly used drugs: Deworming net (Tetramisole), Deworming liquid (Levamisole), Acetylsulphonamide (Mebendazole) and Enteric-coated liquid (Albendazole).
Cautions: Infants and children under 2 years of age should not take deworming drugs because liver function is not fully developed at this time and taking deworming drugs will affect liver function and cause damage to the liver.
Surgery
When surgery is needed
Secondary intestinal spasms usually require surgery to remove the cause.
If the diagnosis cannot be confirmed and the attacks are frequent and the condition is critical, surgery may be necessary to open the abdomen.
Surgery
Surgery is performed according to the nature and location of the lesion, and is recommended by your doctor.
Precautions
The anatomy and function of the colorectum should be thoroughly examined and evaluated before surgery.
Traditional Chinese Medicine (TCM)
Traditional Chinese medicine (TCM) therapy: TCM prescriptions can be tailored to the different pathologies of intestinal spasms, focusing on warming the middle and dispersing the cold, moving qi and relieving pain.
Acupuncture therapy: Acupuncture is characterized by rapid pain relief. Therefore, severe abdominal pain can be treated with acupuncture for pain relief first.
Prognosis
Cure
Untreated people can be affected in their normal life and study due to the appearance of pain.
It can be cured with active and scientific treatment.
Daily routine
Daily Management
Daily management
Keep warm: the temperature of water should be moderate when using warm water bag, and when using it for infants and young children, family members should take care of it and change it in time.
Drug management
When using medication, you should strictly follow the doctor’s instructions and should not change, increase or decrease the dosage or stop the medication at will.
Pay attention to the adverse effects of drugs, if dizziness, nausea, vomiting, or other discomfort occurs, should be reported to the doctor.
Management of infants and young children
Infants and toddlers are unable to express their feelings, so pay special attention to sudden cries and cries, especially those that can’t be coaxed, and report them to the doctor promptly.
Work and rest management
Ensure adequate sleep time.
Others
Stop smoking and drinking.
Positively adjust the bad mood and keep a good mindset.
Follow-up
Importance of follow-up examination: Regular follow-up examination helps to find out whether there is any complication in time, which is crucial to the treatment effect of the disease.
Follow-up time: Follow the doctor’s instructions for regular follow-up; if abdominal pain with nausea and vomiting occurs in daily life, it is recommended to consult the doctor in time.
Examinations required at follow-up: People with intestinal spasms may need to undergo endoscopy at follow-up.
Prevention
Avoid eating foods that are too cold.
Pay attention to dietary hygiene and do not eat cold food.