There’s different worms that will cause different issues, eg small red worms can damage the gut as the eat the lining and encyst (bury into gut wall as part of their development), that can result in discomfort and if they all die off at once cause some big problems and the damage is long lasting, things like ongoing fecal water syndrome or very sensitive tummy. Ascarids can cause impaction but that’s generally only in young horses.
Generally we don’t see the bad worm infestations of years ago (and resulting colic) as wormers are better, there’s more types available and they are more strategically used now in conjunction with FECs.
Jess has coliced more than I like, it’s probably 10 times over 17 years tho, she was worse when younger, 2 occasions were gas from stuffing down far too much hay and resolved without vet intervention, she had 1 bad sand colic which resulted in a week in hospital, a couple of other spasmodic colics, some needing the vet others not, the last was when she had a bad asthma attack and it looks like the stress and coughing set her off. Hank has coliced twice in 8 years, 1 sand, the other I think mildly impacted. Both have routinely zero eggs found in their FECs. Dan who always has a high FEC has never coliced with me, and didn’t with his previous owners of more than 10 years.