SYMPTOMS

What is intestinal spasm?

Intestinal spasm (enterospasm), also known as colic or spasmodic abdominal pain, is paroxysmal abdominal pain caused by regular or irregular strong contractions of the intestinal smooth muscle. It most commonly occurs in the diagnosis of acute functional abdominal pain in children, especially infants.

The pathogenesis may involve intestinal wall ischemia or excited parasympathetic nerves triggering spasms in the intestinal muscles, temporarily blocking the movement of intestinal contents. The strong contraction of proximal muscles leads to spasms, which subside naturally after some time, relieving the patient's pain.

Unexplained excessive crying in infants aged 0–3 months is often called infantile colic. However, the cause is not limited to intestinal spasms, and the pain may not be confined to the intestines. Therefore, "infantile abdominal colic" is a more precise term.

What are the symptoms of intestinal spasm?

The onset is sudden, mainly manifesting as paroxysmal colicky pain around the navel (belly button), though it may also occur in the lower left or right abdomen. Each episode lasts several minutes, with spasms gradually easing as intestinal peristalsis resumes, followed by recurrence. This cycle may persist for minutes to hours.

The severity of pain varies. Mild cases are tolerable, while severe cases may involve restlessness, cold sweats, and pallor. Infants often cry incessantly, especially at night, with a distended and tense abdomen, legs drawn up, and clenched fists. Feeding or soothing does not help, and crying stops only after the colic subsides, gas is passed, or exhaustion sets in. Vomiting may occur, providing slight relief.

Does intestinal spasm cause sequelae?

Intestinal spasm generally leaves no lasting effects and resolves with age. However, its impact on infants and families is not fleeting, potentially increasing negative emotions.

Studies suggest children with infantile colic are more prone to emotional/behavioral issues, attention deficits, hyperactivity, sensory processing inefficiency, cognitive dysfunction, and delayed motor development in preschool and school years. Some research also links infantile colic to migraines in adolescence.

Does intestinal spasm affect pregnancy?

If the underlying cause or triggers of intestinal spasm are resolved, it does not affect pregnancy.

Does intestinal spasm affect menstruation?

Intestinal spasm itself does not disrupt menstrual cycles. However, frequent episodes may lead to poor appetite, sleep disturbances, and excessive stress, altering hormone levels and causing irregular periods.

TREATMENT

Can intestinal spasms heal on their own?

Infantile colic is a self-limiting condition, and most infants can recover naturally as they grow older. For children or adults, intestinal spasms can only be relieved or disappear after the underlying cause is addressed.

How to relieve or alleviate intestinal spasms?

1. Diet:

• Maintain a clean diet, eat smaller, more frequent meals, and focus on soft, easily digestible foods. Avoid overeating, cold foods, or excessive hunger.
• Avoid greasy, spicy foods, alcohol, and other irritating foods.
• Breastfeeding mothers should avoid foods known to trigger allergies in babies, such as milk, dairy products, soy products, seafood, and eggs.
• Avoid giving babies cold drinks, high-sugar juices, or carbonated beverages.
• Avoid vigorous activity after meals and overeating before bedtime.
• For formula-fed babies with cow’s milk protein allergy, amino acid-based or extensively hydrolyzed formula can be used to improve gut health and relieve spasms.
• Feed babies patiently, avoiding haste. Use appropriate nipples to prevent swallowing excessive air during feeding.

2. Lifestyle:

• Maintain personal hygiene, wash hands frequently, get adequate rest, manage emotions, and avoid excessive stress.
• Keep warm and prevent abdominal cold exposure.

3. Regular exercise, quit smoking, and limit alcohol

4. Others:

• Apply local heat or gently massage the abdomen.
• For children with intestinal parasite pain, deworming treatment should be given promptly.
• Strengthen parental care for infants.

Note: If symptoms persist or worsen despite these measures, seek medical attention immediately to identify the underlying cause.

Does intestinal spasm require surgery?

Surgery is needed for organic intestinal conditions meeting surgical criteria, such as intestinal tumors or congenital malformations. In some cases, exploratory laparotomy may be necessary if the cause of frequent abdominal pain is unclear and severely impacts daily life.

What tests are needed for intestinal spasms? Is a gastrointestinal endoscopy required?

Intestinal spasms are a common symptom with multiple causes. Depending on the clinical situation, the following tests may be performed to identify the cause or rule out other acute abdominal conditions:

• Blood tests and C-reactive protein to assess infections like acute appendicitis or mesenteric lymphadenitis.
• Stool tests to check for parasites, infections (e.g., acute dysentery, enteritis), or allergies.
• Liver function and amylase tests to rule out acute cholecystitis or pancreatitis.
• Abdominal X-rays to detect intestinal obstruction.
• Abdominal ultrasound to identify intussusception, exclude hepatobiliary or pancreatic diseases, or evaluate masses.
• Gastrointestinal endoscopy to directly observe lesions like erosions, ulcers, tumors, or polyps for further diagnosis.

What should be avoided with intestinal spasms?

Avoid vigorous activity after meals and overeating before bedtime. Feed babies patiently, using appropriate nipples to prevent excessive air intake during feeding.

Are there dietary restrictions for intestinal spasms? What foods should be avoided?

Avoid overeating, cold foods, or excessive hunger. Steer clear of greasy, spicy foods, and alcohol. Breastfeeding mothers should avoid known allergenic foods like milk, dairy, soy, seafood, and eggs. Avoid giving babies cold drinks, high-sugar juices, or carbonated beverages. Formula-fed babies may use hypoallergenic or allergen-free formulas.

Can you engage in vigorous exercise with intestinal spasms?

Vigorous exercise should be avoided as it diverts blood flow away from the intestines, worsening abdominal pain and potentially causing vomiting.

DIAGNOSIS

When Should Patients with Intestinal Spasms Seek Medical Attention?

Patients with intestinal spasms should seek immediate medical attention if accompanied by the following symptoms or conditions:

• Persistent and unbearable abdominal pain;
• Or accompanied by significant bloating, frequent vomiting, with no relief from abdominal massage or heat therapy;
• Or accompanied by bloody stools or cessation of gas and bowel movements.

For children, if abdominal massage or heat therapy fails to provide relief, or if the following conditions occur, the possibility of organic lesions should be considered, and prompt medical attention is required:

• Abdominal pain lasting more than 2 hours;
• Fever following abdominal pain;
• Frequent vomiting after abdominal pain without diarrhea (especially if there is no passing of gas or stools);
• Tenderness and abdominal muscle rigidity (hard abdomen);
• Palpable abdominal mass.

POTENTIAL DISEASES

What are the possible causes of intestinal spasms?

Intestinal spasms may be related to the following conditions:

Organic intestinal lesions: intussusception, intestinal ascariasis, intestinal adhesions, intestinal volvulus, intestinal tumors, congenital intestinal malformations, ischemic bowel disease, acute gastroenteritis.

Non-organic lesions: gastrointestinal motility disorders, cold exposure, hunger, constipation, indigestion, improper feeding, cow's milk allergy, lactose intolerance, intestinal dysbiosis, autonomic nervous system dysfunction, environmental factors such as psychosocial issues, domestic violence, lack of parent-child interaction, or parental anxiety.

Symptom manifestations:

• Intestinal spasms accompanied by vomiting, abdominal masses, and bloody stools are seen in intussusception and intestinal tumors; those without bloody stools are seen in intestinal adhesions and volvulus. Patients with intestinal adhesions usually have a history of abdominal surgery.
• Intestinal spasms with nausea, vomiting, diarrhea, and bloating may occur in intestinal ascariasis, as well as non-organic diseases caused by psychological factors or improper diet, such as intestinal dysbiosis, indigestion, lactose intolerance, etc.; if accompanied by fever, it suggests acute gastroenteritis.
• Intestinal colic with bloody stools is commonly seen in ischemic bowel disease.