What’s the best cure for colic?
The first few months can be a trying time for parents with babies that are afflicted by infant colic and cry inconsolably for hours at a time despite every attempt to settle them. Over the years many fanciful theories have been proposed as to its cause: the babies are overfed, underfed or fed the wrong things. Or it is the parents’ fault for picking their babies up too often or bouncing them too much after their feeds.
This is all nonsense. It takes time for the autonomic nerves that control the rhythmical movements of the gut to become fully functional – resulting in intestinal spasms, hence the accompanying loud bowel sounds and temporary cessation of crying after passing wind. The commonly prescribed Infacol is, regrettably, not very effective, so the “best medicine” is the strong reassurance that the crying will eventually resolve, as it does usually by three months.
This commonsense interpretation of infant colic is relevant to other gut-related symptoms in babies, including the gastroesophageal reflux that causes them to regurgitate after feeding, which may be associated with their reluctance to carry on eating, as well as coughing and crying. This reflux of the stomach contents is also physiological due to immaturity of the nerves controlling the movement of the oesophagus.
In recent years, there has been a trend for labelling it as gastroesophageal reflux disease, warranting treatment with drugs such as the acid suppressant lansoprazole or domperidone – currently (if astonishingly) prescribed to a quarter of all babies in France, according to a recent survey. Certainly, some babies can be distressed by painful acid reflux, which, if confirmed by appropriate investigations, warrants treatment with such drugs. But most do not; rather, as with infant colic, it will resolve with time, as by the age of one children cease to regurgitate.
Again, the “best medicine” is strong reassurance. For those who wish to know more, there is a useful review by Dr John Puntis, of Leeds General Infirmary, called Gastro-oesophageal reflux in young babies: who should be treated? ( Archives of Disease in Childhood, 2015, vol 100, pp989-93).
Iron in the soul
Since the suggestion in this column that the heightened sense of well-being described by some blood donors following a session could be due to their having (without their knowing) haemochromatosis, several readers have urged a fuller account of this common, but preventable, illness caused by excess absorption of iron from the gut. “The damage it has done to my body is incalculable,” writes a South African reader belatedly diagnosed with the condition at the age of 61, by when it had seriously damaged his hips and ankle joints, requiring them to be replaced.
The adverse effects become apparent only after the age of 40, by when the accumulation of iron in the tissues can also result in, variously, cirrhosis of the liver, diabetes, heart failure, low libido and bronzing of the skin. The diagnostic tests measuring the iron levels in the blood could not be more straightforward, as indeed is treatment with regular bloodletting. So it is clearly important to identify those afflicted before the serious consequences become apparent.
Routine screening is not currently recommended, but those of Celtic origin are particularly vulnerable, with one in five people of Irish descent being carriers of the abnormal gene, attributed to a genetic mutation in AD 900. Relatives of those with the condition should also be tested, along with those with one or more of the conditions mentioned above, for which there is no obvious apparent cause.
Listen up...
Finally, a fortuitous cure for deafness. Further to the recent comments from the woman troubled by fluctuations in her hearing, Mrs SC, from Leeds, wrote to say she was similarly puzzled by the performance of her recently acquired hearing aids. “After a miserable ‘deaf ’ day unable to understand anything anybody says, I go to bed determined to have my hearing aids fixed – only to discover the next day they are not that bad after all.”
A month later she wrote with an update. She had started the “Gut Makeover Diet” – as featured in this newspaper – in anticipation of its claimed benefits (more energy, modest weight loss) from boosting the numbers of friendly bacteria in the colon. The diet includes cutting out dairy foods, since when she has noted a vast improvement in her hearing – much like one of the respondents to the conundrum who had commended going “dairy free”: “Today I realised I was doing the ironing while listening to the radio – and did not even have my hearing aids in.”
Many fanciful theories have been proposed: babies are overfed, underfed or fed the wrong things