# Infantile Colic - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: NICE Clinical Knowledge Summaries Infantile Colic 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph) - Infantile Colic - disease-level clinical article (infantile-colic-clinical.txt) ## Treatment metadata - Simethicone — 40 mg — oral.liquid - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text INFANTILE COLIC Sources: NICE Clinical Knowledge Summaries Infantile Colic 2022 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph) Review status: REVIEWED against Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph), Infantile Colic - disease-level clinical article (infantile-colic-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (10) - Crying is loud, sudden and high-pitched, reflecting the infant's abdominal discomfort [abdominal pain] - Blood in the stool raises concern for a dairy protein allergy, soy-related colitis, an anal fissure, or intussusception [bloody diarrhoea · diarrhoea] - Forceful, projectile vomiting suggests pyloric stenosis or bowel obstruction instead of colic [stricture · vomiting] - Crying that begins after 3 months of age or persists past 4 months falls outside the usual colic pattern and needs further work-up [abdominal pain] - A colicky infant otherwise looks well and gains weight as expected - It begins in the second or third week of life - The crying is persistent and inconsolable, in a baby who is otherwise healthy and well fed [excessive crying] - It is behind 10% to 20% of all visits to a paediatric provider in the first few weeks of life - The core of it is excessive crying, irritability and screaming that cannot be consoled, running 3 hours or more with no cause to be found [excessive crying · irritability] - The usual soothing methods do not work while an episode is running SIGNS - what you find (6) - A bulging soft spot on the head raises concern for raised intracranial pressure or meningitis rather than colic - Oral thrush or tongue-tie on exam points to a feeding problem rather than colic - Reduced bowel sounds or abdominal tenderness on exam suggests obstruction, not colic [abdominal tenderness] - Bruising or other signs of trauma on exam should raise concern for non-accidental injury [bruising] - A hair tourniquet wrapped around a finger, toe or the genitals is a specific, fixable cause of unexplained crying - Episodes tend to come in the evening, with a red face, the legs drawn up, and a tense abdomen TESTS (5) - Colic is a clinical diagnosis; labs and imaging generally aren't needed when history and exam are reassuring - Rome IV requires the crying to start and resolve before 5 months of age, be otherwise unexplained, and occur without poor weight gain, fever or illness - The older Wessel rule pins colic to crying lasting a minimum 3 hours daily, occurring at least 3 days each week, persisting beyond 3 weeks - A positive fecal occult blood test points toward cow's milk protein allergy as the cause of the crying - The diagnosis is only confirmed in retrospect, when the crying settles on its own IF NOT THIS - what else fits (5) - Dairy-protein allergy or intolerance to formula affects well under 5 percent of infants with colic-like crying - Testicular torsion or an inguinal hernia should be excluded as a cause of the crying - Supraventricular tachycardia is the cardiac cause to rule out - Pyloric stenosis, reflux or bowel obstruction are the treatable gut causes to exclude - Early signs of autism spectrum disorder are a rare cause, usually only recognised in hindsight Source StatPearls "Infantile Colic" - disease-level clinical article Status traced to the source above 1. SIMETHICONE [1st line] Adult Not applicable - not applicable Peds Children: 100 to 200 mg orally 3 to 4 times daily or as required. Source Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph) Why Pediatric condition presented in infant care. Caution Exclude red flags: poor weight gain, vomiting, fever, or blood in stool. Defined by Rule of 3s: crying >3 hours/day, >3 days/week, >3 weeks in healthy infant. Reassure parents that condition is benign and self-limiting by 3-4 months. Egypt BABY REST 40MG/0.6ML ORAL DROPS 15 ML PHARCO 16.00 EGP SIMETHICONE 2% (30ML) ORAL DROPS. AMRIYA 24.00 EGP -> ? strength differs, ? different route - not oral liquid SIMETHICONE-MUP 2% EMULSION ORAL DROPS 30 ML MUP 27.00 EGP -> ? strength differs, ? different route - not oral liquid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Infantile Colic - disease-level clinical article (infantile-colic-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution The red flags include fever requiring sepsis evaluation, abdominal distension, and onset outside the 3-4 month window. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)