Excessive crying in infancy; value of the history and physical examination

Abdul-Razak Obed, Ali

	Excessive crying in infancy; value of the history and physical examination
Al-Kindy College Medical Journal
Article 1, Volume 7, Issue 2, 2011, Pages 69-73
Author
Ali Abdul-Razak Obed
Abstract
Background: Excessive crying in early infancy is a common condition that causes a great deal of concern to the parents and physician. Objective: The aim of this study is to find the underlying etiology of excessive crying in infancy and to determine how the history, physical examination, and laboratory investigations contribute to the final diagnosis. Method: A prospective study done on 150 afebrile infants less than 4 months of age visited Al-Elwia hospital for children complaining of excessive crying of more than two hours. The study done over a one year period from the first of January 2009 to the end of December 2009. All febrile infants and those with acute illness preceding the onset of crying were excluded from the study. Results: Of 150 afebrile infants with excessive crying 95 cases (63.3%) diagnosed as having idiopathic colic, 55 cases (36.7%) have a secondary underlying disorder. The most common associated disorders include constipation, 12 cases (8%), gastro-esophageal reflux in 9 cases (6%), and feeding problems in 9 cases (6%). Urinary tract infection was the most common underlying serious etiology found in 4 cases (2.7%). History and physical examination contribute to the final diagnosis in 85% of cases. Conclusion: Accurate diagnosis of infants with colic or excessive crying requires a thorough history and physical examination to exclude underlying etiology. Screening laboratory tests apart from urine analysis and culture is of little help.
Keywords
infant; Colic; excessive crying

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