Background: Infantile colic is defined as episodes of fussiness and crying lasting at least three hours per day, three days per week, for more than three weeks. Although its exact cause remains unclear, various biological, gastrointestinal, and psychosocial factors have been proposed. Hormonal alterations, including elevated ghrelin and motilin levels and decreased β-endorphin levels, have been observed in newborns with colic. Objectives: This study aimed to compare serum levels of ghrelin, motilin, and β-endorphin between colicky and non-colicky infants to better understand the pathophysiology of infantile colic. Methodology: A total of 68 term infants were included and categorized according to Wessel’s criteria. Blood samples were collected to measure serum levels of ghrelin, β-endorphin, and motilin. The parents completed a questionnaire specifically developed for this study, which collected sociodemographic and anthropometric data, medical history, feeding type, mode of delivery, lifestyle factors, and characteristics of crying episodes. Data analysis was performed using IBM SPSS Statistics for Windows, Version 31.0 (Released 2025; IBM Corp., Armonk, NY, USA). Results: Infants with colic had higher ghrelin (540.6 ± 436.0 pg/mL versus 478.9 ± 286.2 pg/mL, p = 0.490) and motilin (74.2 ± 33.4 pg/mL versus 61.8 ± 28.3 pg/mL, p = 0.103) levels, and lower β-endorphin levels (1.7 ± 1.7 ng/mL versus 2.1 ± 2.1 ng/ml, p = 0.361) compared to controls, although the differences were not statistically significant. Ghrelin levels were significantly higher in infants meeting all three colic criteria (863.8 ± 473.2 pg/mL) compared to those meeting none (528.7 ± 296.0 pg/mL, p = 0.043) or only one criterion (310.8 ± 117.3 pg/mL, p = 0.028). Beta-endorphin and motilin levels did not differ according to colic severity or feeding type, whereas ghrelin levels were lower in infants receiving mixed feeding compared to those who were formula-fed. Conclusion: Elevated ghrelin levels in colicky infants, particularly in those meeting all diagnostic criteria, may suggest a possible role of gastric hypermotility in the pathophysiology of colic. The lack of significant changes in β-endorphin levels supports the notion that colic may be a physiological rather than pain-related condition.
Elkhawly et al. (Wed,) studied this question.