Intestinal colic caused by food.

EDITORIAL SYNOPSIS Bolus colic in children eating unripe apples is well recognized but the many possible causes in adults are less well known: its importance, particularly in patients who have had partial gastrectomy, is well brought out in this paper. Intestinal colic following meals is a common complaint, but in most cases when patients complain of such colic it is dismissed in a cloud of vague terminology such as 'food sensitivity', 'intestinal hurry', 'intestinal irritation', or even 'wind colic'. Possibly there is at times truth in each of these expressions but in the majority of cases the real cause of the colic is largely unknown. The purpose of this paper is to present evidence that some cases of post-prandial intestinal colic are due to incomplete or temporary obstructive episodes caused by a food bolus. Since Eichhorst in 1940 first reported a case of obturation of the small intestine by a bolus of 909 cherry stones, many foodstuffs have been incriminated in causing similar obstructive episodes. In reviewing the literature, Ward-McQuaid (1950) found reports of 178 patients with small intestinal obstruction caused by 45 different materials. Records of 53 different foodstuffs which had been similarly associated were reported from this Department in 1964, and to this was added a further case of obstruction being caused by a bolus of partially cooked rice (Stephens, 1964). Since that time a further review of the literature has revealed another nine foods which have been incriminated. These are Christmas and a case of grass ball obstruction of the ileum in an 18-year-old psychologically disturbed youth (Kune, 1965). In reporting our case of obstruction caused by a bolus of rice it was postulated that the bolus might have passed spontaneously had conservative measures been instituted, but only after the patient had suffered further colicky pain (Stephens, 1964). This postulate was supported by evidence presented by Powley (1961) who wrote of an edentulous gastrec-tomized patient who had suffered colicky pain and abdominal distension on several occasions after eating meals oftripe. Ultimately on one such occasion after eating tripe he developed such severe symptoms that a laparotomy was performed. He was found to have obstruction of the ileum by a large bolus of tripe. It was considered that his previous attacks of pain had been due to temporary or incomplete obstructive episodes caused by a bolus of tripe. Two recent reports lend further evidence in support of this …