Working Up a Colic, from Beginning to the End

Colic = abdominal pain
The principle aim of a colic ‘work-up’ is to determine the cause of this pain. In addition, it is important to determine if the cause requires surgical intervention for correction and institute prompt treatment accordingly and appropriately stabilise the patient.

There are multiple different causes and mechanisms by which abdominal pain can manifest. These include:

• Gastrointestinal (GI) or ‘visceral’ pain due to distension of the part of the gastrointestinal tract, spasm/hypermotility of the intestine, tension on the intestinal mesentery or ischaemia of a portion of the gut.
• Nongastrointestinal or ‘parietal’ pain e.g. due to a primary septic peritonitis or peritonitis secondary to gastrointestinal rupture.

In addition, there are a number of other conditions that can manifest with clinical signs that can look like colic but are due to body systems other than the gastrointestinal tract e.g. urogenital (e.g. uroliths), musculoskeletal (e.g. exertional rhabdomyolysis/ tying-up) or hepatic (e.g. cholelithiasis). [...]