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This causes gas and pressure to build up within the gastrointestinal tract which can be very painful. Treatment is usually a mixture of spasmolytic and analgesic medications (Wikipedia).
Sand impactions can cause many forms of colic. The sand can cause impactions in the pelvic flexure, right dorsal colon, and cecum creating a blockage in the GI tract...
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Sand and dirt can also tear away at the lumen of the intestines creating peritonitis and weight down the intestinal loops to where passage of materials becomes impossible. In most cases administering a laxative, like paraffin, can relieve the complications. If there is an overload of sand or dirt in the horse, surgery may be needed...
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