A 6-month-old boy presents to the emergency department with increased irritability and episodes of inconsolable crying for the past 4 days. His mother reports that these episodes have been increasing in frequency and are now occurring every 30 minutes. She reports that the patient will start crying abruptly without an identifiable stimulus and is inconsolable. These episodes tend to last approximately 10 minutes and seem to resolve spontaneously. Between episodes, the patient seems to be free of pain. His mother also reports poor oral intake for the past week and decreased wet diapers in the past 24 hours. She denies that he has experienced fever, vomiting, diarrhea, bloody stools, lethargy, or trauma.

The patient was born at term without complications. He has been exclusively breastfed since birth without introduction of solid foods and receives vitamin D. He has a history of gastroesophageal reflux disease diagnosed at 1 month of age...

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