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

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%), gastroesophageal
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.