Heating pad for renal colic temperature. Treatment of renal colic at home

Main menu » Treatment of KSD » Renal colic: how to relieve pain at home and when you can’t do without an “ambulance”?

Urolithiasis disease occurs in every fourth patient who turns to the urologist with complaints.

Many believe that if the ultrasound did not reveal stones, then they are safe. This is a common misconception.

Ultrasound shows only formed stones, but it may be that they are still being formed. Only cytology can accurately determine the presence of KSD, which causes severe renal colic.

Renal colic brings severe pain, sometimes almost unbearable. You need to take certain actions before the ambulance team arrives.

In most cases, doctors cannot be dispensed with, since the patient needs not only injections, but also droppers. But sometimes the right actions help reduce pain and even stop the process at home.
For this, two things are important:

confidence in the diagnosis; the absence of signs indicating a difficult situation: high fever, icteric skin or sclera.

Many other diseases can mimic colic, up to psychosomatic pain disorders. Therefore, it is important to be sure that this attack is renal colic.

The appearance of pain suggests that a stone has begun to move towards the ureter.

When passing through the ureter, the middle pebble will cause pain, for this he just needs to take an "uncomfortable" position. Medium stones block the outflow of the urinary stream.

Most stones leave the body imperceptibly and painlessly, especially if it is sand.
If a patient is diagnosed with KSD, it is imperative to establish the type of stones: phosphates, oxalates, struvites, urates, cystine and xanthine. Because the possibility of help without going to the doctor with colic depends on it. For struvite stones, for example, any non-drug treatment gives no result. Moreover, a long attack with such stones leads to kidney shrinkage. Therefore, there is no way to help at home.

There is a prerequisite: an accurate diagnosis Do not forget that relief at home is not always possible.

Acute care for colic at home - the first phase

How to remove renal colic at home? First of all, we are aware that if we don’t know the exact cause, there is no history of nephritis and urolithiasis, we call doctors.

This is not a variation of behavior, but the only way out. If the reason is precisely known, we put the patient on a warm bed and wrap him up.

The first task: to return, at least partially, the outflow of urine and stop the spasm. The kidneys are very sensitive to heat, so a warm bed and a heating pad are a must. A heating pad can be placed between the legs, pressed against the perineum. It should not be boiling water, the patient himself will tell you when he became comfortable.

After that, you need to make an injection of an antispasmodic: Spazmalgin, Baralgin. Injections of these drugs are allowed without establishing an accurate diagnosis. Now you need to lay the person so that the kidneys are higher than the bladder.

The urge to urinate cannot be tolerated, we immediately empty ourselves into a special vessel. It is necessary to collect all the separated urine in it until the stone passes its way and exits. As soon as the medicine works, the urge will appear. Now you need to plant the patient and attach the second heating pad to the diseased kidney.

Do not give any extra medication "just in case". At this point, the kidneys are working at the limit, the outflow of urine is minimal.

Any pill will raise intoxication and worsen the condition. Until the outflow of urine is restored, nothing more can be done.

Second phase of assistance

Ask the patient how he feels: does he feel relief. It may take several hours to restore outflow.

If during this time there is significant relief, it is useful to take a comfortable bath. Water is not higher than 40 degrees. Remember that the intensity of warming provokes abscesses.

The patient can take a bath for 20 minutes, put ammonia and Corvalol next to him.

It is important not to give the patient painkillers unless there is an accurate diagnosis. Drugs such as Ketorol are allowed to be taken only if there has already been an ambulance and diagnosed with renal colic. Otherwise, Ketorol will smear all the symptoms and seriously complicate the diagnosis.

After 6 hours from the onset of the attack, we give the patient Asparkam or Panangin. This will strengthen the heart muscle, which suffers greatly. Asparkam has magnesium, it perfectly fights crystallization and dissolution. But magnesium in such conditions may not be absorbed, so we stimulate the process by taking or injecting vitamin B6.

While the spasm is going on, the gaps where the stone could get stuck will not expand and it will not move further. If the attack has not passed and the intensity of colic has not decreased, we repeat Baralgin, Nosh-pu or do Ketorol, Ibuprofen. Nosh-pa is much weaker, but you can take it. Sometimes it helps when combined with previous drugs.

Ketorol - 20 tablets of 10 mg

For cupping severe pain you can prick a mixture of Analgin and Pipolfen. The last sedative drug, after the injection, the patient will fall asleep soundly for several hours, which will cause complete relaxation of the body.

Please note that Pipolfen will cause thirst after waking up, but you can’t drink a lot in the first hours. Therefore, give the patient weak tea with lemon. Can be replaced with cranberry juice or rose hips. It is important to continue to monitor urination until colic is completely relieved.

When an emergency call is needed

Even if you are sure of the diagnosis, there are situations when stopping colic at home puts his life at risk. Here you can not hesitate and you need to immediately call a doctor. The maximum that can be allowed is taking an antispasmodic. To make it easier to understand, let's list the following situations:

the patient has one kidney; colic seized both kidneys; one of the kidneys wandering; after two days of treatment there is no improvement; the temperature rose to critical levels; the patient vomits strongly, vomits; no urine; right kidney hurts.

In the presence of such signs, the patient can be saved only with the help of narrow-profile methods.

You can not postpone and wait for improvement, otherwise the person will simply die from kidney failure or blockage of the urinary tract.

Nutrition in the treatment of colic

In general, renal colic is not even a disease. It is simply a sign or symptom of a ureteral disorder. Colic can be powerful when the patient is not up to food. But it can be restrained or already decreasing. Dietary nutrition is one of the basics that can minimize seizures. Be sure to take into account the type of your stones, as there are products that affect their formation.

The diet is based on reducing the amount of carbohydrates and fats. All heavy and irritating gastrointestinal tract is removed from the diet:

spices; fried meat and fish; legumes; canned food; muffins; eggs in any form; most of the greenery; almost completely remove salt and salty; chocolate, coffee, cocoa.

A light broth based on white chicken meat is allowed. Can be given in small amounts boiled fish, only sea and without salt. Drink plenty of water, rose hips and cranberries are ideal here. Morse the patient needs to drink more often and in large quantities, not only at the time of exacerbation. Cranberry kills infections in the urinary system and promotes the excretion process.

It is useful to eat: fresh fruits, sour milk, cucumbers, apricots, quince, pears. The food is fractional, but definitely satisfying. Cereals, vegetable soups natural. After recovery and achieving remission, the doctor should analyze your nutrition and condition. Some products will be returned in minimum quantities.

Pay attention to the type of stones. If oxalates are present, exclude from your diet:

salads; legumes; sorrel; milk; carrot; tomatoes.

With urate calculi, you can not eat:

cheese; spinach; tea; radish and radish.

Phosphates require the exclusion of dairy products, including cottage cheese.

You must understand that alcohol, hypothermia and exercise are prohibited. It is necessary to be attentive to every little thing that can potentially provoke colic.

ICD refers to those formidable diseases that need to be treated carefully, following all the recommendations.

Even if several stones came out, this does not mean recovery at all. Stones are a process caused by serious disturbances in metabolic processes. This means that the release of stones does not change anything.

Long-term treatment of the disease is necessary to restore the previous state. Even after the ICD passes, the patient is always at risk of relapse.

It is necessary to observe elementary precautions in everyday life. For example, do not overheat and do not overcool. Observe the norm of the drinking regime, otherwise the kidneys will not be able to work normally. It is also important not to carry heavy things, not to abuse physical activity. Even if you gain weight, you are not allowed to lose weight on your own. At home, you can help yourself relieve renal colic, but it will certainly return if you violate the recommendations.

If a person has had an ICD once, he must understand: the disease has a tendency to frequent relapses. Until the end of days, periodic examinations will be required, especially if the diet is violated. The minimum examination includes:

Analysis of urine; visit to the doctor; Ultrasound of the kidneys (if necessary, a cytogram).

Block from the author

Stones are mostly harmless, rarely large enough to completely block the excretory system. More often, pebbles and sand leave the body painlessly. Renal colic puts a heavy burden on the entire body, especially the heart. Do not forget to facilitate his work at the time of the attack, especially in the presence of vascular diseases. Follow the diet, the necessary diet, protect yourself from the cold, then the risk of renal colic will be significantly reduced.

Kidneys can hurt not only with ICD, but also with other diseases. Not all people can recognize that it is the kidney that hurts. In the following article: What are the signs and symptoms of kidney pain, you will find detailed information about the signs of kidney disease and how to deal with the symptom.

By the type of pain in the kidneys, you can roughly determine the disease. What diseases are evidenced by a sharp, sharp, pulling and It's a dull pain, read in this material.

Related video

Renal colic is a typical manifestation of urolithiasis, the most common kidney disease. Approximately 70-75% of patients in urological hospitals are hospitalized with this diagnosis.

In fact, we are talking about several diseases that have different origins and unequal development paths, but are united by one manifestation - renal colic. We received the first descriptions of this disease from Hippocrates, but so far scientists have not been able to solve the riddle: why are certain particles formed that do not obey the general movement of urine, but immediately grow from a crystal to a clinically significant size?

The answer to this question, perhaps, would solve this problem, but today we can only state the steady growth of this disease. Moreover, if earlier it affected mainly mature people, now it is often diagnosed even in twenty-year-olds.

Acute pain, so characteristic of this disease, is by no means caused by the “scratching” of a calculus that has come into motion, as many people think. The mechanism of its occurrence is associated with a violation of the outflow of urine as a result of tissue edema and venous stasis. The swollen tissue of the kidney puts pressure on the fibrous capsule, which has a lot of pain receptors, which causes such a sharp syndrome.

The obstruction of the outflow can be caused by the passage of a stone, small stones (in the form of sand), a blood clot, mucus or pus. The cause can also be a tumor process, and even inflammation that has arisen in neighboring organs: all this can be a prerequisite for squeezing the ureter. And yet, the most common cause is precisely the blockage of the urinary tract with a stone.

Manifestations of renal colic

Most often, everything starts completely unexpectedly, without any warning symptoms. The pain appears from the side of the back, at first unsharp, pulling. However, very soon it begins to grow and gradually moves to the side, and then to the stomach, “sliding” down along the ureter.

Pain can be localized not only in the lower abdomen, it can radiate to the groin or to the genital area, often radiates to the thigh, lower back and hypochondrium. If we talk about the intensity of suffering, then they are simply "legendary": people roll on the floor, almost losing consciousness, being on the verge of shock.

No change in body position can reduce heat, reduce these painful sensations, often only narcotic drugs can do this. Acute pain in renal colic causes bloating, muscles spasm, and bowel movements are difficult. A person is ready to take even poison to end this nightmare!

It's really extreme unpleasant symptom- renal colic. How to relieve pain? Solution this issue becomes mandatory and paramount. However, this is not the only manifestation of the disease. Patients may experience nausea, vomiting often appears, and the temperature can sometimes even be very high.

The face turns pale, sweat appears, the consciousness becomes clouded, the heart rate changes, the pressure rises. Urination is frequent and painful, but may be disturbed up to complete anuria. Usually the duration of an attack of colic does not exceed a day, but there are cases when it lasts a long time, with periods of remission and subsequent deterioration.

Renal colic: how to relieve pain during an attack?

If we briefly outline the strategy of action, then it will be expressed in three directions:

Application of heat. Analgesics. Antispasmodics.

Let's start with heat. It would seem that a hot bath to the waist with water of the maximum temperature that the patient can withstand, a heating pad on the lumbar region or mustard plasters - and the issue is resolved. However, not all so simple. There are a number of factors that must be taken into account.

For example, you can not use a hot bath for heart disease or high temperature. This method is also excluded in conditions accompanied by impaired consciousness. In addition, there must be a firm conviction that this is precisely renal colic, and not peritonitis caused by inflammation of the appendix, or something else that does not allow the use of heat.

If renal colic is accurately established, then a hot sitz bath is a very good remedy for pain relief. If there are contraindications to the bath, you can use mustard plasters or a heating pad.

Of the painkillers, the most commonly used drugs are "Analgin" or "Baralgin". Any drug given as an injection has a stronger and fast action than tablets.

However, do not take painkillers for renal colic before seeing a doctor. This can "blur" the picture and make it difficult to make a correct diagnosis.

Antispasmodics in renal colic are subject to the same requirement. If the diagnosis is not in doubt, then taking them will help to expand, relax the walls of the ureter, facilitating the flow of urine and thereby improving the patient's condition. Usually, the No-shpa drug is well suited for this purpose, and you need to take a large dose of the medicine - up to four tablets.

There are times when all these remedies are not able to relieve pain. In this situation, a doctor who has narcotic drugs in his arsenal, for example, the drug Promedol, can help. For a person experiencing renal colic, how to relieve pain is the main issue, but you still need to start with an accurate diagnosis.

Examinations to clarify the diagnosis

Symptoms of colic may resemble an "acute abdomen". This concept includes a whole group of diseases. In addition to appendicitis, hepatic colic looks similar, it is also necessary to exclude acute cholecystitis and pancreatitis.

An error can also occur in the presence of peptic ulcers of the duodenum or stomach. Some vascular diseases, intestinal obstruction, not to mention women's ailments, have almost similar symptoms. The symptoms of renal colic in women have their own specifics, so a special section is devoted to this topic.

In addition to the "acute abdomen", a hernia of the intervertebral disc, sciatica, herpes zoster, or even ordinary intercostal neuralgia give a similar picture. An almost complete coincidence of signs occurs with intestinal obstruction.

Many of these diseases require emergency action. So the task facing the doctor, seeing the patient for the first time, is not at all an easy one. That is why one should never resist the offer to go to the hospital and have a comprehensive examination there. With renal colic, this is an absolute, one hundred percent indication.

In this case, an incorrect diagnosis may well cost a life. For example, the ureter could be completely blocked by a stone. This cannot be determined by external examination, but it may well lead to necrosis of the kidney, its acute failure. You may need to insert a catheter or surgery and drain the organ. It is unlikely that all this can be done without leaving home.

In a hospital environment, a doctor can prescribe a variety of examinations as needed, as well as provide proper assistance for renal colic. However, first of all, they usually do general tests, while clarifying the biochemistry of the blood and, of course, an ultrasound of the excretory system, and possibly an x-ray.

"Female" specificity of renal colic

The symptoms of colic described above are not sexual, except that sometimes pain in men radiates to the scrotum. For women, pain in the area of ​​the labia is more characteristic. Otherwise, all this is universal.

At the same time, the same symptoms of renal colic in women may indicate completely different diseases that men, by virtue of their nature, cannot have. For successful treatment, it is extremely important to make a clear differentiation when diagnosing a patient in order to exclude the following causes:

fallopian tube rupture; ovarian apoplexy; tubal abortion; ectopic pregnancy; ovarian pedicle torsion.

All of these conditions can cause blockage of the ureter and create the typical picture of colic. In this case, warning signs may include:

cold sweat; pallor; low blood pressure; tachycardia; dizziness.

Of particular difficulty for the treatment is renal colic in women, which occurs against the background of pregnancy. By itself, this condition does not create conditions for the development of urolithiasis, but it is during this period that exacerbations of all chronic diseases very often occur.

This is especially true for the kidneys, which are especially actively involved in the process of creating a new life and are forced to work with a vengeance. Manifestations of the disease are common, but the arsenal of means for relieving pain is seriously limited.

Firstly, hot baths are excluded, as well as other thermal procedures on the kidney area - this can lead to premature birth. For obvious reasons, narcotic painkillers for renal colic in this case are also not applicable.

At the same time, prolonged intense pain in itself can provoke a premature onset of labor activity, so the only correct way out is to immediately consult a doctor. In the most extreme case, it is possible to take antispasmodics: the drugs "No-shpa", "Papaverin" or "Baralgin", it is possible in the form of injections.

What is the first thing to do with renal colic?

Of course, to relieve pain, to save a person from nightmarish torment. This is the first thought that may come to mind, but it is not the best. First aid for renal colic should be provided by a doctor.

Moreover, before his arrival, it is advisable to refrain from any attempt at home treatment in order to avoid complications and keep all symptoms in a pronounced form, without interfering with the correct diagnosis.

This is especially important in complicated cases: colic of one remaining kidney, elderly age, bilateral attack, bad general state, heart disease, etc. What to do if the doctor is unavailable for some reason? How to alleviate renal colic in this case? In principle, the main methods have already been described.

It is only important to add that in cases where there is doubt about the true causes of pain, the use of antispasmodics would be the least dangerous, but if there is no doubt, you can use a heating pad, bath, analgesics. Some experts recommend adding half a tablet of Nitroglycerin under the tongue.

To stop an attack in a hospital, novocaine blockade, acupuncture, electropuncture, and physiotherapy are also used. If all measures do not bring the desired result, urine output will be restored using a catheter. It is also possible to pre-destruct the stone with the help of special equipment.

It is in a hospital that it is easier and more logical to undergo a thorough examination in urology after the attack has been eliminated. In any case, it is necessary to remember the serious danger of self-treatment in the presence of such a formidable symptom as renal colic. How to relieve pain, how much and what examinations to do, how to treat - all this should be decided only by a doctor.

Renal colic. ICD-10

To date, in Russia, at the level of the Ministry of Health, a standard for the treatment of this disease has been approved. This is a step-by-step developed system, in accordance with which assistance is provided to patients with similar symptoms. A system was created based on the data of the International Classification of Diseases of the Tenth Revision. It provides all methods of diagnosis and treatment of diseases. In accordance with the ICD, renal colic has the code N23.

How to eat with renal colic

After removing the pain syndrome, nausea gradually disappears, and the patient returns to the ability to eat. It is important to understand that a diet for renal colic is very important for a quick recovery. Specific product recommendations can only be given by a doctor, as he knows the chemical composition of the stones. As for general recommendations, then they are:

meals are frequent, fractional, portions are small; do not overeat, especially at night; exclude spicy, fried, smoked, canned foods; do not subject food to prolonged heat treatment; it is better to steam or boil, you can bake.

The diet for renal colic is relevant during the illness. As the kidneys recover, the range of products should be expanded, while being guided by recommendations for a healthy and balanced diet.

And this means that, firstly, there should be enough products to provide all the needs of the body, but not too much.

Secondly, the food should be varied, with the obligatory inclusion of "live" products: vitamins, minerals, fiber.

Thirdly, moderation in the consumption of tasty, but not healthy foods.

And finally, the most important thing: to provide the body large quantity truly pure water without any impurities. Many believe that compliance with this condition alone can completely heal the body.

Folk methods of treatment

Help with renal colic is offered to us by numerous traditional healers. Although they, first of all, are advised to consult a doctor. But in the process of waiting, you can attach a cabbage leaf to your lower back or drink an infusion of birch buds.

Horsetail has proven itself well, and knotweed helps with such an ailment. For colic, a decoction is prepared from a mixture of centaury and sage, it is even better to add chamomile there. You can drink such a drug for a long time, up to two months. But horsetail can not only be drunk, but also added to the bath.

Hot potato compresses or oatmeal broth are also suitable. In general, there are many recipes. If you add diet to all this, success is guaranteed. But on one condition: please call a doctor!

Well, if you are serious, it is unlikely that folk methods will compete with modern medicine in the treatment of the acute phase of the disease. But now you have been relieved of a pain attack, had an examination, given recommendations on nutrition, and prescribed medication. Now we need to work hard to cleanse our kidneys of unnecessary "trash", dissolve and expel everything that should not be there. At this stage, the experience of traditional medicine is simply irreplaceable.

It is the polished collections of herbs and medicinal plants that have been polished for centuries will help to completely say goodbye to the disease, and at the same time restore the disturbed metabolism. The best thing is to find an experienced herbalist and, with patience, carry out the course of treatment to the end, as expected.

And after that, be sure to re-examine and compare the results. What can you do? In this world, nothing is given to us without difficulty, but health is worth it!

How to prevent renal colic

The formation of stones is often provoked by diseases of the endocrine glands. Also, an excess of vitamin D in the body or a lack of A contributes to the deposition of salts. Disease plays an important role in this process. digestive system. Nutrition for renal colic, or rather, the principles of such nutrition, should be applied after recovery in order to prevent the recurrence of the disease.

Restriction of human mobility is also a risk factor. A hot climate creates conditions for dehydration and, accordingly, an increase in the concentration of urine. Even the frequent use of mineral water becomes a source of introduction of salts into the excretory system. Daily drinking of clean water, and in large quantities, but in small portions, can play a decisive role in defeating the disease.

Sanatoriums and resorts for urolithiasis

Many have heard about how well spas help to recover from kidney disease. mineral water. However, each water acts only on a certain type of stones. In the presence of phosphates, you can go where there are acidic mineral waters:

Truskavets.Kislovodsk.Zheleznovodsk.

If you have urates in your urine, then you need alkaline water:

Borjomi. Zheleznovodsk. Truskavets. Essentuki.

Pyatigorsk. Essentuki. Zheleznovodsk.

Many people experience the appearance of stones and sand in the kidneys. These formations periodically come out, which provokes severe pain.

This condition is called urolithiasis.. It occurs quite often in men and women, because the treatment of renal colic at home is a very topical issue.

The essence of pathology

Renal colic is commonly referred to as acute pain attacks in the lumbar region. ICD-10 code - N23. Renal colic, unspecified.

This condition may be the result of a sharp violation of the outflow of urine from the kidney or a violation of blood circulation in the organ.

Sometimes the pain syndrome occurs due to excessive stretching of the renal pelvis. This condition is associated with a violation of the outflow of urine, which creates increased pressure. People with renal colic need urgent care.

Symptoms

Pain in renal colic usually appears suddenly and is localized in the lumbar region or hypochondrium. It is preserved both when moving and at rest.

To provoke an exacerbation of the disease can blows to the lower back, prolonged walking, lifting heavy objects.

Pain in this disorder has certain features:

discomfort is localized in the lumbar region - most often from a certain side; the pain has an intense cramping character; discomfort felt constantly and increase during urination; the pain radiates to the genitals, groin area, thigh and rectum.

In addition to discomfort, the following symptoms may appear:

bloating; increase in temperature; nausea; vomit; a feeling of bursting of the bladder - this is due to the accumulation of urine and a violation of its excretion; false urge to empty the bowels; bloody impurities in the urine.

Severe pain syndrome can provoke a state of shock and even fainting.. At the same time, the person's skin turns pale, cold sweat is released, pressure drops. After the attack ends, stones and bloody clots appear in the urine.

Renal colic

Provoking factors

Renal colic appears due to blockage of the urinary tract and impaired outflow of urine. In most cases, this problem occurs against the background of urolithiasis and is accompanied by the movement of stones.

According to statistics, in 90% of cases, pathology is a consequence of urolithiasis. However, sometimes seizures appear due to other kidney damage:

acute inflammation of the pelvis- in this case, the paths are blocked by mucous or purulent clots; kidney tuberculosis- there is a blockage by a fragment of a caseous focus; kidney cancer- the paths are blocked by parts of the tumor or blood clots; kidney damage- the paths are clogged with blood clots; external pressure on the urinary tract- may be associated with traumatic injuries or neoplasms in the pelvic organs.

When the kidney is lowered, pain attacks are associated with an inflection of the ureter. This anomaly is quite rare and is accompanied by an increase in discomfort in an upright position.

First aid

If a person has no history of nephritis or urolithiasis, when an attack occurs, you should immediately consult a doctor.

If the cause of the pain is known, first aid for renal colic should include the following:

First of all, you need to put the patient to bed and wrap him up well. Then it is necessary to restore the outflow of urine and eliminate the spasm. To do this, place a heating pad and press it against the perineum. It should not be too hot - you need to maintain a comfortable temperature. Inject an antispasmodic- Spazmalgon, Baralgin. Injections of these funds are allowed to be performed without an accurate diagnosis. After this, the patient should be positioned so that the kidneys are higher than the bladder. The urge to urinate is forbidden. It is necessary to immediately empty the bladder using a special vessel. Urine is collected in it until the stone comes out. When the medicine takes effect, the urge will appear. At this point, the patient should be seated and another heating pad should be applied to the affected kidney.

Any drugs can provoke intoxication of the body and lead to a deterioration in the condition.

Second phase of assistance

First aid for renal colic should be provided in several stages. After the first measures, you need to ask the person about his well-being. It may take several hours for the outflow to normalize.

If the condition has improved markedly, you can take a bath. In this case, the water temperature should not exceed 40 degrees. It is important to consider that too much warming up can provoke an abscess.

The duration of the procedure should be about 20 minutes. Near the patient it is worth marking ammonia and Corvalol. In this case, it is not recommended to give an anesthetic if the exact diagnosis is unknown.

Substances such as Ketorol can only be given after a visit by a doctor who has diagnosed renal colic. Otherwise, the drug will distort the clinical picture, and therefore it will be very difficult to make a diagnosis.

6 hours after the onset of an attack, you can give a person Panangin or Asparkam. Thanks to this, it will be possible to strengthen the heart, which is under severe stress.

In addition, Asparkam contains magnesium, which does an excellent job of crystallization. However, there is a risk of problems with the absorption of this substance. To stimulate the process, vitamin B6 is used.

If the attack has not passed and the severity of colic persists, you need to use antispasmodics again - Baralgin, No-shpu. It is important to consider that No-shpa has a weaker effect, but it is permissible to use it.

If there is pain of high intensity, it is worth pricking a mixture of Analgin and Pipolfen. The second drug has a sedative effect. After this measure, the patient will be able to fall asleep for several hours, which will ensure complete relaxation.

It is important to consider that after waking up, Pipolfen will provoke severe thirst. However, you can not drink a lot of liquid.

The patient can be given weak tea with the addition of lemon.. It is also permissible to replace it with wild rose or cranberry juice. In this case, it is necessary to control the process of urination until the colic passes.

When should you call a doctor?

Sometimes there are situations when attempts to cope with the situation on their own pose a real threat to the patient's life. In such a situation, you can not hesitate.

The only thing that can be done before the ambulance arrives is to give an antispasmodic drug.

you need to call a doctor in such cases:

colic struck two kidneys at once; the patient has only one kidney; one of the kidneys is wandering; for 2 days of therapy, there is no improvement; pain is localized in the right kidney; the temperature rises to critical levels; a person has severe nausea and vomiting; no excretion of urine.

When such symptoms appear, only qualified medical assistance can save a person’s life. If it is not provided in time, death will occur due to kidney failure or blockage of the urinary tract.

Medical treatment

Many people are interested in what to do at home with renal colic. Drug therapy most often involves the use of such antispasmodics:

Papaverine; No-shpa; Drotaverine; Spasmol; Bespa.

How to relieve pain in renal colic? For this, painkillers are used - Ketorol, Toradol, Veralgan.

If necessary antibiotic therapy urolithiasis significantly increases the risk of dysbacteriosis. In addition, strong antibiotics provoke an increase in the load on the kidneys.

That is why it is so important to use antifungal agents, Bifidumbacterin and include fermented milk products in the diet. Antibacterial agents must be taken under the supervision of a specialist, otherwise you can get unpredictable consequences.

Folk methods of treatment

To cope with the pathology, you can resort to the help of effective folk remedies:

Drink a decoction of pumpkin seeds. It is also useful for several days to do a compress on the kidney area before going to bed. To do this, you need to brew crushed flaxseeds in a small amount of water. Once a week it is worth eating only boiled wheat. At the same time, it should be washed down with water in which the grain was cooked. Take a large blackberry root and cook in 5 liters of water until the water has evaporated by half. Drink a decoction three times a day for 100 g. Take 1 small spoon of flax seeds, add a glass of water and bring to a boil. Take half a glass every 2 hours. This should be done for 2 days. Before use, mix with water. You can add lemon juice to improve the taste. Take 1 small spoonful of cumin fruit and add 1 tablespoon of buckthorn bark, mint leaves and marshmallow root. Add 250 ml of boiling water and prepare a decoction. Take 1 glass in the evening. Take 1 tablespoon of lemon balm leaves, mint and chamomile flowers. Pour in a glass of boiling water. Consume 1 glass per day. Take a couple of tablespoons of celandine grass and 250 ml of water. Take a decoction in the morning and evening up to 1 cup. This must be done before meals. Take a couple of tablespoons of crushed rosehip roots, add 1 glass of water and cook for a quarter of an hour. Leave to insist. When the product has cooled, it must be filtered. Use 4 times a day for half a glass. It is recommended to do this for at least 1 week. Take 10 g of rhubarb root, 25 g of yarrow herb, 15 g of sand immortelle flowers. Take 1 tablespoon of the mixture, add 250 ml of boiling water and leave for 1 hour. Strained means to take 30 minutes before meals. Use in the formation of stones in the kidneys. Take 20 g dried lingonberry leaves , add a glass of boiling water, boil for 15 minutes. After cooling, the composition should be filtered. Dissolve 1 large spoonful of honey in the product. Drink a glass three times a day. This should be done half an hour before meals. Take 1 tablespoon of carrot seeds, mix with a glass of boiling water. Leave to infuse for 12 hours. The strained product should be consumed warm in half a glass. This should be done 5-6 times a day.

Nutrition Features

What can you eat with the appearance of renal colic? This symptom worries many people. If the pain attack has a high intensity, the patient is not up to eating.

If the symptoms are unexpressed, a diet for renal colic is observed. Thanks to this, it will be possible to minimize the number of seizures.

When choosing a diet, you need to consider the type of stones. Nutrition should be based on a decrease in the amount of carbohydrates and fats. Be sure to remove from the menu all heavy foods and dishes that irritate the digestive organs.

These include the following:

spices; fried fish and meat; salt, pickles; sweet pastries; eggs; chocolate, cocoa, coffee.

It is allowed to eat light broths based on chicken meat . It is also permissible to consume sea fish in boiled form. It is advisable to drink a lot, especially cranberry fruit drinks and rosehip decoctions.

It is also worth eating fresh fruits and dairy products. Cucumbers, pears, apricots are especially useful. Food should be fractional.

Features of the disease in pregnant women

In women, stones in the upper urinary tract are quite common during pregnancy. In this case, the following manifestations occur:

cramping pain in the form of seizures; hematuria; removal of stones.

Such seizures can lead to premature birth . That is why it is so important to make an accurate diagnosis in time. It is very important to immediately stop the pain syndrome and prevent the occurrence of complications.

Any medical manipulations can be carried out only in a hospital, which will help to avoid dangerous consequences.

Forecast and prevention

Many people are interested in how long an attack lasts. If renal colic is provoked by urolithiasis with small stones, it usually disappears after the removal of stone fragments during urination.

If timely assistance is not provided, there is a risk of developing an acute form of obstructive pyelonephritis. This anomaly can lead to death in a short time.

The most common consequences of the disease include:

urosepsis and bacteremic shock; deterioration of the diseased kidney; development of stricture of the ureter; acute form of obstructive pyelonephritis.

If the causes of the development of the disease are eliminated in time, the risk of relapse can be prevented. Prevention of pathology is the management right image life.

It is important to adhere to a healthy diet, to do an ultrasound examination annually abdominal cavity, which will help to detect the disease at an early stage.

To prevent recurrences, you need to adhere to a therapeutic diet:

increase the amount of fluid consumed; consume juices, fruits, vegetables, dairy products; include dietary fiber in the diet; limit the consumption of eggs, meat, fish, legumes, cereals.

Renal colic - enough dangerous state which can lead to serious consequences. To avoid this, it is very important to provide the patient with adequate assistance in a timely manner.

At home, it is allowed to use antispasmodics and folk recipes.

Chills occur in the case of a sharp increase in pressure in the renal pelvis, which leads to the development of pyelovenous reflux ( reverse flow of blood and urine from the pelvis and calyces of the kidney into the venous network). The entry of decay products into the blood leads to an increase in body temperature to 37 - 37.5 degrees, which is accompanied by a tremendous chill.

Separately, it is necessary to mention that after an attack of renal colic, when the ureter occlusion is eliminated, the pain syndrome becomes less pronounced ( the pain becomes aching) and stands out with respect to a large number of urine ( accumulation of which occurred in the pelvis of the affected kidney). Impurities or clots of blood, pus, and also sand can be seen in the urine. Occasionally, individual small stones may be passed out with the urine, a process sometimes referred to as "stone birth". In this case, the passage of a stone through the urethra can be accompanied by significant pain.

Diagnosis of renal colic

In most cases, for a competent specialist, the diagnosis of renal colic is not difficult. This ailment is assumed even during a conversation with a doctor ( which in some cases is sufficient for diagnosis and initiation of treatment), and is confirmed by inspection and a series of instrumental and laboratory tests.

It must be understood that the process of diagnosing renal colic has two main goals - establishing the cause of the pathology and differential diagnosis. To establish the cause, it is necessary to undergo a series of tests and examinations, as this will allow more rational treatment and prevent ( or delay) repeated exacerbations. Differential diagnosis is necessary in order not to confuse this pathology with others with a similar clinical picture ( acute appendicitis, hepatic or intestinal colic, perforated ulcer, thrombosis of mesenteric vessels, adnexitis, pancreatitis), and prevent wrong and untimely treatment.


In connection with a pronounced pain syndrome, which forms the basis of the clinical picture of renal colic, people with this disease are forced to apply for medical assistance. During an acute attack of renal colic, a doctor of almost any specialty can provide adequate assistance. However, as mentioned above, due to the need to differentiate this disease from other dangerous pathologies, first of all, you should contact the surgical, urological or therapeutic department.

Be that as it may, the most competent specialist in the treatment, diagnosis and prevention of renal colic and its causes is a urologist. It is this specialist who should be contacted first of all if renal colic is suspected.

When renal colic occurs, it makes sense to call ambulance, as this will allow earlier treatment to eliminate pain and spasm, as well as speed up the process of transportation to the hospital. In addition, the emergency physician preliminary diagnosis and sends the patient to the department where he will be provided with the most qualified assistance.

Diagnosis of renal colic and its causes is based on the following examinations:

• survey;
• clinical examination;
• ultrasonography;
• X-ray methods of research;
• laboratory study of urine.

Survey

Correctly collected data on the disease suggest renal colic and possible reasons its occurrence. During a conversation with a doctor, special attention is paid to the symptoms and their subjective perception, risk factors, as well as comorbidities.

During the survey, the following facts are revealed:

• Characteristics of pain. Pain is a subjective indicator that cannot be quantified, and the assessment of which is based only on the verbal description of the patient. For the diagnosis of renal colic, the time of onset of pain, its nature ( sharp, dull, aching, constant, paroxysmal), the place of its distribution, the change in its intensity when changing the position of the body and when taking painkillers.
• Nausea, vomiting. Nausea is also a subjective sensation, which the doctor can learn about only from the patient's words. The doctor needs to be informed when nausea appeared, whether it is associated with food intake, whether it is aggravated in some situations. It is also necessary to report episodes of vomiting, if any, their relationship with food intake, changes in the general condition after vomiting.
• Chills, fever. It is necessary to inform the doctor about the development of chills and elevated temperature body ( if, of course, it was measured).
• Changes in urination. During the interview, the doctor finds out if there are any changes in the act of urination, if there is an increased urge to urinate, if there was a discharge of blood or pus along with urine.
• The presence of attacks of renal colic in the past. The doctor should find out whether this attack is a new one or if there have been episodes of renal colic before.
• The presence of a diagnosed urolithiasis. It is necessary to inform the doctor about the fact of the presence of urolithiasis ( if there is one now, or was in the past).
• Diseases of the kidneys and urinary tract. The fact of having any pathologies of the kidneys or urinary tract increases the likelihood of renal colic.
• Operations or injuries of the organs of the urinary system or the lumbar region. It is necessary to inform the doctor about the surgeries and injuries of the lumbar region. In some cases, other surgical interventions, as this suggests possible factors risk, and accelerate differential diagnosis (removal of the appendix in the past rules out acute appendicitis in the present).
• Allergic reactions. Be sure to tell your doctor if you have any allergic reactions.

The following data may be required to determine risk factors:

• diet;
• infectious diseases ( both systemic and urinary tract organs);
• bowel disease;
• bone diseases;
• place of residence ( for determining climatic conditions );
• place of work ( to determine working conditions and the presence of harmful factors);
• the use of any medicinal or herbal preparations.

In addition, depending on the specific clinical situation, other data may be required, such as, for example, the date of the last menstrual period ( to rule out ectopic pregnancy), chair characteristic ( to rule out intestinal obstruction), social conditions, bad habits and much more.

Clinical examination

The clinical examination for renal colic provides little information, but when combined with a well-conducted interview, it may suggest renal colic or its cause.

During a clinical examination, it is necessary to undress in order for the doctor to be able to assess the general and local condition of the patient. To assess the condition of the kidneys, their percussion can be performed - a light tapping of the hand on the back in the region of the twelfth rib. Pain experienced during this procedure symptom of Pasternatsky) indicates damage to the kidney on the corresponding side.

To assess the position of the kidneys, they are palpated through the anterior abdominal wall (which during an attack can be tense). The kidneys are rarely palpable during this procedure ( sometimes only their lower pole), however, if it was possible to palpate them completely, then this indicates either their omission or a significant increase in their size.

To exclude pathologies that have similar symptoms, deep palpation of the abdomen, gynecological examination, digital examination of the rectum may be required.

Ultrasonography

Ultrasonography ( ultrasound) is an extremely informative method of non-invasive diagnostics, which is based on the use of ultrasonic waves. These waves are able to penetrate the tissues of the body and reflect from dense structures or the boundary between two media with different acoustic resistance. The reflected waves are recorded by a sensor that measures their speed and amplitude. Based on these data, an image is built that allows you to judge the structural state of the organ.


Since many factors affect the quality of an ultrasound image ( intestinal gases, subcutaneous fat, bladder fluid) it is recommended to pre-prepare for this procedure. To do this, a few days before the examination, exclude milk, potatoes, cabbage, raw vegetables and fruits from the diet, as well as take activated charcoal or other drugs that reduce gas formation. Drinking regimen can not be limited.

Ultrasound without prior preparation may be less sensitive, but in emergency cases where urgent diagnosis is needed, the information obtained is sufficient.

Ultrasound is indicated in all cases of renal colic, as it allows you to directly or indirectly visualize changes in the kidneys, and also allows you to see stones that are not visible on the x-ray.

With renal colic, ultrasound allows you to visualize the following changes:

• expansion of the pelvicalyceal system;
• an increase in the size of the kidney by more than 20 mm compared to the other kidney;
• dense formations in the pelvis, ureters ( stones);
• changes in the structure of the kidney itself ( previous pathologies);
• swelling of the kidney tissue;
• purulent foci in the kidney;
• changes in hemodynamics in the renal vessels.

X-ray methods of research

Radiation diagnosis of renal colic is represented by three main research methods based on the use of x-rays.

Radiation diagnosis of renal colic includes:

• Plain x-ray of the abdomen. An overview picture of the abdomen allows you to visualize the area of ​​​​the kidneys, ureters, bladder, as well as the condition of the intestines. However, only X-ray positive stones can be detected using this research method ( oxalate and calcium).
• excretory urography. Method excretory urography It is based on the introduction into the body of a contrast X-ray positive substance, which is excreted by the kidneys. This allows you to monitor the circulation in the kidneys, evaluate the function of filtration and concentration of urine, as well as monitor the excretion of urine through the pelvicalyceal system and ureters. The presence of an obstacle leads to a delay of this substance at the level of occlusion, which can be seen in the picture. This method allows diagnosing blockage at any level of the ureter, regardless of the composition of the stone.
• CT scan. Computed tomography creates images that help assess the density of stones and the condition of the urinary tract. This is necessary for a more thorough diagnosis before surgery.

Despite the shortcomings of the overview X-ray image, during an attack of acute renal colic, it is he who is done first of all, since in the vast majority of cases the stones formed in the kidneys are X-ray positive.

Computed tomography is indicated for suspected urolithiasis caused by urate ( uric acid) and coral-like ( more often - post-infectious nature) stones. In addition, tomography allows you to diagnose stones that could not be detected by other methods. However, due to the higher price for computed tomography resorted to only when absolutely necessary.

Excretory urography is carried out only after complete relief of renal colic, since at the height of the attack, not only does the outflow of urine stop, but the blood supply to the kidney is also disturbed, which, accordingly, leads to the fact that the contrast agent is not excreted by the affected organ. This study indicated in all cases of pain arising in the urinary tract, with urolithiasis, with the detection of blood impurities in the urine, with injuries. Due to the use of a contrast agent, this method has a number of contraindications:

Excretory urography is contraindicated in the following patients:

• With allergic reaction on iodine and on a contrast agent;
• patients with myelomatosis;
• with a blood creatinine level above 200 mmol / l.

Laboratory study of urine

Laboratory testing of urine is extremely important method studies with renal colic, since with this disease there are always changes in urine ( which, however, may not be present during an attack, but which appear after its relief). A general urine test allows you to determine the amount and type of impurities in the urine, identify some salts and fragments of stones, and evaluate the excretory function of the kidneys.

In a laboratory study, analysis of morning urine is carried out ( which accumulated in the bladder during the night, and the analysis of which allows one to objectively judge the composition of impurities) and daily urine ( which is collected during the day, and the analysis of which allows you to evaluate the functional ability of the kidneys).

In a laboratory study of urine, the following indicators are evaluated:

• the amount of urine;
• the presence of salt impurities;
• urine reaction acidic or alkaline);
• the presence of whole erythrocytes or their fragments;
• the presence and quantity of bacteria;
• the level of cysteine, calcium salts, oxalates, citrates, urates ( stone-forming substances);
• creatinine concentration ( kidney function index).

With renal colic and urolithiasis, a high content of calcium salts, oxalates and other stone-forming substances, blood and pus impurities, and a change in the reaction of urine can be detected.

It is extremely important to analyze the chemical composition of the calculus ( stone), since further therapeutic tactics depend on its composition.

Treatment of renal colic

The goal of treating renal colic is to eliminate pain and spasm of the urinary tract, restore urine flow, and eliminate the root cause of the disease.

First aid for renal colic

Before the arrival of doctors, you can perform a number of procedures and take some medicines that will help reduce pain and improve your general condition. In this case, one should be guided by the principle of least harm, that is, it is necessary to use only those means that will not aggravate or cause complications for the course of the disease. Preference should be given to non-drug methods, as they have the fewest side effects.


In order to alleviate the suffering of renal colic before the arrival of an ambulance, the following measures can be used:

• Hot bath. A hot bath taken before the arrival of the ambulance can reduce spasm of the smooth muscles of the ureter, which helps to reduce pain and the degree of blockage of the urinary tract.
• local heat. If the bath is contraindicated or cannot be used, you can apply a hot heating pad or a bottle of water to the lumbar region or to the abdomen on the side of the lesion.
• Drugs that relax smooth muscles(antispasmodics). Taking drugs that help relax smooth muscles can significantly reduce pain and, in some cases, even cause the stone to pass on its own. For this purpose, the drug No-shpa is used ( drotaverine) in a total dose of 160 mg ( 4 tablets of 40 mg or 2 tablets of 80 mg).
• Painkillers. Painkillers can only be taken for left-sided renal colic, since pain on the right side can be caused not only by this disease, but also by acute appendicitis, cholecystitis, ulcers and other pathologies in which self-administration of painkillers is contraindicated, as it can lubricate the clinical picture and make diagnosis difficult. To relieve pain at home, you can use ibuprofen, paracetamol, baralgin, ketanov.

Medical treatment

The main treatment for renal colic should be done in a hospital. At the same time, in some cases, there is no need for hospitalization, since the passage of the stone and the restoration of the outflow of urine allow us to talk about positive dynamics. Nevertheless, within one to three days, monitoring and control of the patient's condition is carried out, especially if there is a possibility re-development renal colic or if there are signs of kidney damage.

The following categories of patients are subject to mandatory hospitalization:

• who do not have a positive effect from taking painkillers;
• who have a blockage of the urinary tract of the only functioning or transplanted kidney;
• blockage of the urinary tract is combined with signs of infection of the urinary system, a temperature of more than 38 degrees.

Drug treatment involves the introduction into the body of drugs that can alleviate symptoms and eliminate the pathogenic factor. In this case, preference is given to intramuscular or intravenous injections, as they provide a faster onset of action of the drug and do not depend on the functioning of the gastrointestinal tract ( vomiting can significantly reduce the absorption of the drug in the stomach). After stopping an acute attack, it is possible to switch to tablets or rectal suppositories.

For the treatment of renal colic, drugs with the following effects are used:

• painkillers - to eliminate pain;
• antispasmodics - to relieve spasm of the smooth muscles of the ureter;
• antiemetic drugs - to block reflex vomiting;
• drugs that reduce urine production - to reduce intrapelvic pressure.

Painkillers

Pharmacological group	Main Representatives
Non-steroidal anti-inflammatory drugs	Ketorolac	Intramuscular injections at a dose of 60 mg every 6 to 8 hours for no more than 5 days ( until the pain stops)
	diclofenac	Intramuscular injections at a dose of 75 - 100 mg per day with a further transition to tablets
Non-narcotic painkillers	Paracetamol	Inside at a dose of 500 - 1000 mg. Often used in combination with narcotic painkillers, as it enhances their effect.
	Baralgin	Intravenously or intramuscularly, 5 ml every 6 to 8 hours as needed.
Narcotic pain relievers	Tramadol Omnopon Morphine Codeine	The dose is set individually depending on the severity of the pain syndrome ( usually 1 ml of 1% solution). To prevent smooth muscle spasm, it is prescribed in combination with atropine at a dose of 1 ml of a 0.1% solution.
Local anesthetics	Lidocaine Novocaine	By these means, a local blockade of the nerve is carried out in order to interrupt the transmission of the pain impulse when other methods of anesthesia are ineffective.

Antispasmodics

Pharmacological group	Main Representatives	Dosage and method of application, special instructions
Myotropic antispasmodics	Drotaverine Papaverine	Intramuscularly, 1 - 2 ml until colic is removed.
m-cholinolytics	Hyoscine butyl bromide	Inside or rectally, 10-20 mg 3 times a day
	Atropine	Intramuscularly at 0.25 - 1 mg 2 times a day

Antiemetics

Drugs that reduce urine production

The most rational is the relief of renal colic with intramuscular injection of ketorolac in combination with metoclopramide and some myotropic antispasmodic. If ineffective, you can resort to narcotic painkillers, which must be combined with atropine. The purpose of other drugs depends on the specific clinical situation. The duration of treatment depends on the duration of renal colic, and can be 1 to 3 days ( in some cases more).

In addition to the listed drugs, drugs from the group of blockers can be used. calcium channels (nifedipine), nitrates ( isosorbide dinitrate), alpha-blockers and methylxanthines, which can reduce spasm of smooth muscles and eliminate pain, but whose effectiveness in renal colic has not yet been sufficiently studied.

In some cases, drug treatment also involves the use of drugs that help dissolve stones in the urinary tract. It should be borne in mind that only uric acid stones can be dissolved by medication. For this, drugs alkalizing urine are used.

Drugs used to dissolve uric acid stones

In parallel with this, the treatment of the pathology that caused the stone formation is provided. For this, various vitamins and minerals, nutritional supplements, drugs that reduce the concentration of uric acid, diuretics can be used.

Surgery

Surgical treatment allows you to quickly and completely eliminate the obstruction that caused blockage of the urinary tract. This method of treatment is used in cases where conservative drug therapy is not effective enough, or when any complications have developed.

Surgical treatment of renal colic is indicated in the following situations:

• complicated urolithiasis;
• hydronephrosis of the kidney dropsy of the kidney);
• wrinkling of the kidney;
• ineffectiveness of medical treatment;
• stones larger than 1 cm in diameter that cannot pass on their own.

Since the main cause of renal colic is urolithiasis, in most cases there is a need for surgical removal of stones from the urinary tract. To date, several effective methods, which allow you to break and extract stones with the least injury.

Stones can be removed in the following ways:

1. remote lithotripsy;
2. contact lithotripsy;
3. percutaneous nephrolithotomy;
4. endoscopic stone removal;
5. stenting of the ureter;
6. open kidney surgery.

Remote lithotripsy
Remote lithotripsy is a modern method of stone destruction using a focused high-energy ultrasound beam, which, upon impact on the stone, causes it to crush. This method is called remote due to the fact that it can be used without breaking the skin, by applying the device to the skin in the corresponding region ( For best results and muscle relaxation, this procedure is performed under general anesthesia.).

This method of destruction of stones is used when stones are less than 2 cm in size and located in the upper or middle part of the pelvis.

Remote lithotripsy is contraindicated in the following situations:

• blood clotting disorders;
• densely spaced stones;
• blockage of the ureter.

contact lithotripsy
Contact lithotripsy involves direct exposure to high-energy physical factor (ultrasound, compressed air, laser) on a stone ( this is achieved by inserting a special tube through the urinary canal into the ureter or by puncturing the skin at the level of the stone). This method allows you to more accurately and efficiently affect the stones, and also provides a parallel extraction of the destroyed fragments.

Percutaneous nephrolithotomy
Percutaneous nephrolithotomy is a method of surgical removal of kidney stones, in which a small puncture is made ( about 1 cm) of the skin and a special instrument is inserted through it, with the help of which the stone is removed. This procedure involves constant monitoring of the position of the instrument and stone using fluoroscopic examination.

Endoscopic stone removal
Endoscopic stone removal involves the introduction of a special flexible or rigid instrument equipped with optical system through the urethra into the ureter. At the same time, due to the ability to visualize and capture the stone, this method allows you to immediately remove it.

Ureteral stenting
Ureteral stenting involves the introduction of a special cylindrical frame by endoscopic means, which is installed at the site of narrowing of the ureter or its incision, to prevent stones from getting stuck in the future.

Open operation on the kidney
Open kidney surgery is the most traumatic method of stone removal, which is practically not used at the moment. This surgical intervention can be used with significant damage to the kidney, with its purulent-necrotic change, as well as with massive stones that are not amenable to lithotripsy.

Preparation for surgical removal of stones involves the following activities:

• Delivery of analyses. Before performing a surgical intervention, it is necessary to pass a general urinalysis and a general blood test, do a fluorography, conduct an ultrasound and x-ray examination of the kidneys.
• Therapist's consultation. To exclude possible contraindications and systemic pathologies, it is necessary to consult a therapist.
• Diet. Proper diet allows you to avoid excess gas and accumulation of feces in the intestines, which greatly simplifies the intervention. To do this, a few days before the operation, it is necessary to abandon sour-milk products, fresh vegetables, and legumes. No food is allowed on the day of the procedure.

The recovery time after surgery depends on the extent of the operation. For non-invasive and minimally invasive procedures ( lithotripsy, endoscopic and percutaneous stone removal) return to normal activity is possible after 2 - 3 days.

Treatment with folk remedies

Alternative methods of treating renal colic should be resorted to only when it is not possible to obtain qualified medical care.

The following remedies can be used to treat renal colic:

• Hot tub. As mentioned above, hot water helps to relax the smooth muscles of the ureter. 10 g can be added to water ( 2 tablespoons) grass cudweed, sage leaves, birch leaves, chamomile and linden flowers.
• Medicinal infusion. Six tablespoons of a mixture of birch leaves, harrow root, juniper fruits and mint leaves must be poured with 1 liter of boiling water and infused for half an hour. The resulting decoction should be consumed warm within an hour.
• Decoction of birch leaves. Eight tablespoons of birch leaves, twigs or buds must be poured with 5 glasses of water and boiled for 20 minutes in a water bath. Consume hot for 1-2 hours.

Some medicinal plants can be used to treat and prevent urolithiasis, as they help dissolve and slow down the growth of stones. It is extremely important to select medicinal plants based on the chemical composition of cameos, since the use of an incorrect remedy can cause an aggravation of the disease.

The following types of stones can be treated with traditional methods:

1. urate ( uric acid) stones;
2. oxalate and phosphate stones.

Urates ( uric acid) stones
For the treatment of urate stones, decoctions from mixtures of several plants are used, which are taken within 1.5 - 2 months.

Urate stones can be treated with the following decoctions:

• Lingonberry decoction. Two tablespoons of a mixture of lingonberry leaves, knotweed grass, parsley root and calamus rhizomes are poured with a glass of boiling water and boiled for 10 minutes in a water bath. It is used 70 - 100 ml three times a day for 20 - 40 minutes before meals.
• Decoction of barberry. Two tablespoons of barberry fruits, juniper, shepherd's purse herb, steel root are poured with a glass of boiling water and boiled for a quarter of an hour, after which they insist 4 hours. It is consumed warm, 50 ml 4 times a day before meals.
• A decoction of birch leaves. Two tablespoons of birch leaves, black elderberry flowers, flax seeds, parsley grass, rose hips are placed in 1.5 cups of boiling water and infused for an hour. Used 70 - 100 ml 3 times a day before meals.

Oxalate and phosphate stones
Treatment of oxalate and phosphate stones is carried out over several courses, each of which lasts 2 months, with a break between them of 2 to 3 weeks.

Treatment of oxalate and phosphate stones is carried out by the following methods:

• A decoction of barberry flowers. Two tablespoons of a mixture of barberry flowers, immortelle flowers, lingonberry leaves, black elderberry flowers, sweet clover grass, motherwort herb are poured with a glass of boiling water, boiled in a water bath for 10 minutes and infused for 2 hours. Consume 50 ml 3 times a day before meals.
• A decoction of budry grass. Two tablespoons of budra grass, blue cornflower flowers, wintergreen leaves, peppermint leaves are poured with one and a half cups of boiling water, boiled for 5 minutes and infused for an hour. Use 50 ml 4 times a day before meals.
• A decoction of immortelle flowers. Two tablespoons of a mixture of immortelle flowers, budra grass, black elder flowers, blue cornflower flowers, bearberry leaves, burnet rhizomes are poured with a glass of boiling water, boiled in a water bath for a quarter of an hour and infused for 4 hours. Use in a warm form, 50 ml 4 times a day before meals.

Prevention of renal colic

What do we have to do?

For the prevention of renal colic, it is necessary:

• consume enough vitamins A, D;
• sunbathing ( stimulate the synthesis of vitamin D);
• consume enough calcium;
• consume at least 2 liters of water per day;
• treat pathologies and infections of the urinary system;
• correct congenital metabolic pathologies;
• go for a walk or other physical exercise.

What should be avoided?

With renal colic and urolithiasis, it is necessary to avoid factors that contribute to the growth of stones and spasm of the ureters. To this end, it is recommended to follow a diet with a reduced content of stone-forming substances.

It is necessary to follow a diet for the following types of stones;

• oxalate stones. It is necessary to reduce the intake of oxalic acid, which is found in lettuce, spinach, sorrel, potatoes, cheese, chocolate, tea.
• cysteine ​​stones. Since cysteine ​​stones are formed as a result of a violation of cysteine ​​metabolism, it is recommended to limit the consumption of eggs, peanuts, chicken meat, corn, and beans.
• Phosphate stones. It is necessary to reduce the consumption of dairy products, cheese, vegetables.
• Uric acid stones. With the formation of uric acid stones, it is necessary to reduce the intake of uric acid, which is found in meat products, smoked meats, legumes, coffee and chocolate.

Must be avoided:

• hypothermia;
• drafts;
• systemic and urological infections;
• dehydration;
• injuries of the lumbar region;
• sedentary lifestyle.

Many pathologies of the urinary system proceed hidden for the time being, without showing any pronounced symptoms. Therefore, most people who have signs of trouble in this area do not turn to specialists immediately. However, some conditions, such as urolithiasis, for example, can, under certain conditions, manifest themselves so suddenly and painfully that they make you immediately rush to the doctor for help. It's about renal colic.

What is renal colic

Renal colic is a sudden attack of severe cramping pain in the lumbar region, which occurs due to acute violation outflow of urine from the kidney. The pressure inside the pelvis rises, the blood supply to the organ is disturbed, there is a strong irritation of the nerve endings and an attack of intense pain occurs. This syndrome can be a complication of a number of urinary tract diseases. Colic is assessed as an emergency requiring prompt relief pain and restoration of kidney function. The attack itself can last from 2 to 20 or more hours, while the severity of pain and its localization may change.

Renal colic is an attack of acute pain due to a violation of the outflow of urine from the kidney.

Colic can be unilateral or bilateral. Since the main cause of the attack is the blockage of the ureter by a stone in urolithiasis, in the vast majority of cases, colic occurs on one side. With a right-sided or left-sided lesion, the clinical course of an attack is almost the same, and differs only in the localization and one-sided irradiation of pain.

In children and the elderly, colic is observed very rarely, as a rule, middle-aged people are susceptible to an attack. Often, colic occurs repeatedly if the patient does not receive proper treatment, and only the symptoms are eliminated by taking painkillers.

What are the reasons for a seizure?

Sudden obstruction of the urinary outflow is associated with internal blockage or external compression of one or two ureters. When this happens:

• reflex spasm of the muscular layer of the ureter;
• a sharp increase in intrapelvic pressure;
• decrease in inflow arterial blood, due to which the blood supply to the kidney is disturbed (ischemia);
• venous stasis, leading to swelling of the parenchyma (kidney tissue);
• overstretching of the outer renal capsule.

All these processes are accompanied by irritation of sensitive receptors and a pain attack occurs.

The direct cause of colic is usually a mechanical obstruction to the outflow of urine from the pelvis through the ureter. In about 60% of cases, such an obstacle is a stone infringed by the ureter, which has formed in the kidney and, for some reason, has changed its location. Mucous clots or purulent plugs formed during pyelonephritis, dead papillae or caseous masses in case of kidney tuberculosis, fragments of a necrotizing tumor can also block the urinary tract. In addition, a painful attack can occur when the ureter is twisted or kinked, which happens when the kidney is lowered (nephroptosis), its dystopia (congenital disorder of the normal location), with an abnormal narrowing (stricture) of the ureteral canal.

Most often, colic occurs due to a stone blocking the urinary tract.

Compression of the urinary tract from the outside can occur when:

• neoplasm of the kidney, prostate or ureter;
• retroperitoneal or subcapsular traumatic hematoma, including after remote crushing of stones by ultrasound.

Other common causes of a painful attack include congestion and inflammatory diseases of the urinary organs:

• hydronephrotic transformation of the kidney, that is, pathological expansion of the renal pelvis, urinary stagnation in it, followed by atrophy of the parenchyma;
• acute local swelling of the mucous membrane with periurethritis (inflammation of the tissues surrounding the urethra), prostatitis, urethritis;
• stagnation of blood in the venous system of the small pelvis;
• acute vascular diseases of the genitourinary system - kidney infarction, thrombosis of the renal veins or embolism (blockage) of the renal arteries.

Complete blockage of the ureter causes hydronephrosis - distension of the renal pelvis

Renal colic can also develop with a disorder of the urinary outflow due to congenital malformations - a spongy kidney, megacalyx (pathological expansion of some cups), achalasia of the ureter (a defect consisting in the underdevelopment of its neuromuscular apparatus).

Video: mechanism for the development of renal colic

Seizure symptoms

Renal colic is always manifested by a complex of symptoms that can be observed in different combinations, but in most cases show significant similarity. Main features:

• sharp pain;
• qualitative and quantitative changes in urine;
• vomiting, nausea, flatulence (bloating), diarrhea or constipation;
• increased heart rate and hypertension;
• terrific chills, slight fever.

Pain syndrome

Intense pain occurs suddenly in the lower back or vertebral-costal angle. An attack can develop at any time - day or night, during sleep. Often the onset of colic is associated with intense physical activity, long walking or bumpy driving, taking large amounts of fluids or diuretics.

Pain from the lumbar region can spread:

• in the iliac, right or left, region or mesogastric (below the epigastric and above the navel); such irradiation of pain is possible with blockage of the ureter at the level of its exit from the pelvis;
• in the groin and thigh, rectum - this is typical when the ureter is blocked at the place of intersection with the iliac vessels;
• in the genitals: in women - in the perineum and labia, in men - in the scrotum and head of the penis; such sensations are characteristic of low blockage of the ureter, close to the bladder.

Renal colic is characterized by constant pain with undulating tides. The pressure in the kidney progressively increases, so changing the position of the body does not bring any relief. The person is restless, rushing about in search of a pose that reduces suffering.

The long course of an attack - throughout the day - leads to reversible changes in the kidney. In the absence of medical care and the duration of renal colic for more than 3–5 days, severe irreversible disorders of the functions and structure of the organ are observed.

Very severe pain can lead to the development of a state of shock, which is manifested by pale skin, cold sweat, hypotension, bradycardia (slow heart rate), clouding of consciousness.

Pain in renal colic gives to the thigh, groin, genitals, lower abdomen

Urine changes

During an attack, mainly quantitative changes in urine are observed, since it enters the bladder only from a healthy kidney. Qualitative changes - various impurities in the form of blood, pus, calculi, salts - are detected after the elimination of urinary tract obstruction.

During an attack, there is a persistent urge to empty the bladder, urination becomes painful, the patient may feel severe pain in the urethra. Frequent calls usually occur with a low location of the obstruction to the urinary outflow, which causes reflex contractions of the bladder.

During an attack, there is sometimes oliguria (little urine) or anuria (complete absence of urine). Usually, the amount of urine during unilateral renal colic changes slightly, as the volume of filtered blood through a healthy organ increases compensatory. However, with structural or functional disorders of the second kidney (or its absence), acute urinary retention may occur.

After stopping the obstruction, the patient excretes urine with blood

Gastrointestinal disorders

Nausea and bouts of vomiting, stool disorder, flatulence during an attack are reflex and are associated with the proximity of the solar (celiac) and perirenal nerve plexuses. As a result of partial irritation of the solar plexus, which innervates the stomach and intestines, the patient experiences nausea and vomiting occurs, which is not associated with food intake and does not alleviate the condition. Violation of intestinal motility leads to gas retention (flatulence).

Changes in pulse and pressure

The kidneys are directly involved in maintaining an adequate level of blood pressure. This is necessary to ensure sufficient blood flow to filter it and remove harmful products. In colic, changes occur leading to a compensatory increase in pressure to increase blood supply and filtration in a healthy kidney. In addition, the neurovegetative reactions of the body to severe pain contribute to an increase in blood pressure.

On the background high blood pressure there is a slowdown in the heart rate and a decrease in the pulse, in the case of a rise in temperature, the pulse, on the contrary, quickens.

Temperature increase

A sharp increase in intrapelvic pressure can lead to a reverse flow of fluid from the pelvis and calyces into the venous network. The entry into the bloodstream of the decay products causes an increase in the patient's temperature to 37.2-37.5 ° C, the appearance of a stunning chill.

During colic, the patient's body temperature rises

Symptoms after removal of occlusion

After the obstruction that blocked the ureter is removed, the symptoms of an attack gradually subside. The intensity of the pain decreases, its character becomes aching, a large amount of urine is released, in which there are various impurities: blood, flakes, pus, mucous inclusions, sand or small stones.

Video: popular about renal colic

How is the diagnosis made?

For an experienced specialist, the diagnosis of an emergency condition is not difficult. The doctor makes a preliminary diagnosis during the examination and questioning of the patient. It is possible to confirm that the patient has renal colic and differentiate it from other conditions through tests and instrumental examination. In the course of research, the cause of the attack is determined.

An ambulance doctor can make a diagnosis, and an extended examination of the patient is carried out in the urological department of the hospital under the guidance of a doctor of the corresponding specialty.

Diagnosis begins with a survey - the doctor finds out:

• patient complaints;
• the presence of infectious diseases, pathologies of the genitourinary and gastrointestinal systems;
• diet;
• place of work (to assess industrial hazards);
• the use of medicines;
• bad habits.

Clinical examination consists in examining the patient, palpation (palpation) through the anterior abdominal wall and percussion (tapping) of the kidneys. A positive symptom of Pasternatsky (increased pain with a slight tapping on the back in the area of ​​the lower rib) indicates damage to the kidney from a certain side.

With renal colic, a sharply positive symptom of Pasternatsky is observed.

To rule out problems with the prostate, men may be shown a digital rectal examination, women undergo a gynecological examination to exclude pathologies with similar symptoms.

Hardware research:

• Sonography (ultrasound) of the kidneys and bladder is the main method that provides information to confirm the diagnosis. Ultrasound allows you to visualize changes in the kidneys and ureters, to detect stones. Ultrasound of the abdominal organs is also performed to exclude their pathology.
• X-ray - a survey picture of the abdomen allows you to identify significant changes in the urinary organs and visualize X-ray negative stones (calcium and oxalate), as well as exclude acute abdominal pathology.
• Excretory urography - the method is based on the intravenous administration of a contrast agent that passes through the kidneys, followed by x-rays. This method allows you to determine the functional disorders of the kidneys and underlying urinary organs. It is carried out after the relief of renal colic.
• Computed tomography is not always performed, most often the method is used for a more detailed diagnosis before surgery. Pictures allow you to determine the density of stones and the condition of the excretory tract.

Ultrasound of the kidneys - the first stage of instrumental examination of the patient with renal colic

Laboratory methods are used after the elimination of the attack. A general urinalysis allows you to assess the type and amount of impurities in the urine, detect salts and particles of stones. The total amount of urine, its reaction, the presence of erythrocytes, bacteria, protein, leukocytes, the level of stone-forming substances: calcium salts, citrates, oxalates, cysteine, uric acid salts are taken into account.

After an attack, the patient must pass urine for analysis.

Renal colic should be distinguished from conditions that present with severe lumbar or abdominal pain:

• acute pancreatitis, cholecystitis, appendicitis;
• hepatic colic;
• intestinal obstruction;
• thrombosis of celiac vessels;
• aortic aneurysms;
• ectopic pregnancy;
• acute adnexitis (inflammation of the appendages) or torsion of the legs of the ovarian cyst;
• perforated stomach ulcer;
• torsion of the testicle, its inflammation (orchitis) or inflammation of its epididymis (epididymitis);
• herniated disc;
• lumbar osteochondrosis;
• radiculitis;
• intercostal neuralgia.

Table: differentiation of signs of renal colic and other diseases

Pathology	Where does it hurt	How it hurts	Patient behavior	Associated symptoms	Dysuric phenomena
In the lower back, radiates to the genitals, perineum, thigh, side of the affected kidney	The pain is severe, appears suddenly, has an undulating course	Tossing about, can't find a place	Nausea, dry mouth, vomiting, flatulence	Frequent persistent urge to empty the bladder, painful urination, pain in the urethra.
Acute appendicitis	To the right of the navel, gives to the groin, upper part belly	Pain builds up gradually	Motionless, often finds comfortable posture- lying on your side with legs bent	Signs of peritoneal irritation	Usually absent
Acute adnexitis and other gynecological pathologies	Above the bosom, below the abdomen; radiates to the coccyx, lower back, groin, or perineum	Begins with nagging pains, gradually increasing	Calm, a woman seeks to find a comfortable position - sitting or lying down	Signs of irritation of the pelvic floor and peritoneum	There are sometimes
Diseases of the spinal nerves - osteochondrosis, sciatica, intercostal neuralgia	Lower back, along nerves; gives to the groin or thigh	Strong, sudden, acute, may increase gradually	The position of the body is forced, motionless	Characteristic for neurological pathologies	Not observed, in some cases there may be difficulty with urination (with infringement of the nerve roots responsible for the functioning of the urinary system)
hepatic colic	Right, under the ribs; can give back right shoulder, shoulder blade	Sudden, strong, "pecking"	Trying to find a comfortable position to ease the pain	The abdomen is tense, jaundice is often observed, stool disorder	Not visible
Acute pancreatitis	On the left, under the ribs, give to the back, can be herpes	Appears suddenly, very strong, penetrating	The position of the patient is motionless; possible shock	Manifestations of general intoxication	Not present
Bowel obstruction	The whole abdomen hurts, without a clear localization, diffuse pain throughout the abdominal cavity	Strong, grippy	The patient is restless, trying to alleviate his suffering by searching comfortable position, possible shock	Stool retention, severe bloating, symptoms of general intoxication	There may be reflex oliguria.

Attack treatment

Purpose of therapy:

• relief of acute pain;
• elimination of spasm of excretory tracts;
• restoration of normal passage of urine;
• elimination of the root cause that caused colic.

An attack may go away without treatment if the temporary obstruction of the ureter is caused by a small obstruction, such as a small stone, which then passed on its own. However, in no case can one hope that everything will go away by itself, since the cause can be much more serious and the lack of qualified assistance can subsequently lead the patient to the operating table, while the functionality and structure of the kidney can be irreversibly damaged.

How to provide first aid

To alleviate the condition with renal colic, you can apply the following methods:

• Take a hot bath (temperature 37–39 ° C) for 15–20 minutes. This will help relieve muscle spasm of the walls of the ureter and slightly reduce pain.
• Dry warmth in the lower back. An alternative to a bath is a heating pad or hot water bottle. It is advisable to attach another heating pad to the reflexogenic zone responsible for the work of the ureters, - inner surface hips on the affected side.
• Drink an antispasmodic. You can use No-shpu (Drotaverine), Papaverine, Trigan, Riabal, Duspatalin. The last three remedies are more often used in diseases of the digestive organs (hepatic colic, intestinal spasms, etc.), but since they effectively relax smooth muscles, they can be safely used for spasm of the ureter. For greater efficiency, it is better to use injectable forms of antispasmodics.
• Use painkillers. Doctors recommend taking analgesics before the arrival of the brigade emergency care only with left-sided colic, since pain on the right side can be caused by another acute pathology (cholecystitis, appendicitis, ulcers, etc.) But if a person has been suffering from urolithiasis for a long time and it is known for sure that the cause of the pain is renal colic, then it is recommended to take such drugs: Ibuprofen (Nurofen), Nimesulide (Nise), Paracetamol, Ketanov (Ketorolac), Tempalgin or combined drugs (pain reliever and antispasmodic) - Baralgin, Revalgin, Spasmolgon.

A warm heating pad should be applied to the lower back to relieve spasm and relieve pain.

It should be remembered that at high temperature and symptoms of general intoxication, indicating an infectious process, in particular, pyelonephritis, heating is strictly contraindicated, as it can aggravate inflammation and lead to purulent complications.

Video: help with colic

Medical treatment in a hospital setting

The main therapy for an attack is carried out in a hospital. If the stone quickly came out and the urinary outflow was restored, then the person can stay at home.

Compulsory hospitalization is needed in such cases:

• there is no positive dynamics from the use of painkillers;
• a person has one or a transplanted kidney;
• colic in a pregnant woman, a child or an elderly person;
• there are signs of a urinary tract infection, in particular, the temperature is above 38 ° C.

For the treatment of an attack, the following drugs are used:

• painkillers:
  • Baralgin, Novalgin, Volteren, Renalgan, Ketorolac;
  • with very severe pain - narcotic drugs:
    • Tramadol, Promedol, Omnopon, Morphine;
  • Novocain can be applied topically for intrapelvic blockade or blockade of the round uterine ligament in women and the spermatic cord in men;
• antispasmodics:
  • No-shpa, Papaverine, Platifillin, Atropine, Scopolamine, Galidor, Spazmotsistenal, Unispaz, Avisan, Omnic (men only);
• antiemetics:
  • Metoclopamid (Cerukal, Raglan);
• drugs that reduce urine production:
  • Desmopressin.

After stopping the attack, the patient is prescribed drugs to eliminate the cause of colic. If it is urolithiasis, then they are discharged special means taking into account the chemical composition of stones. Regardless of the cause of the attack, herbal preparations can be prescribed: Kanefron, Cyston, Fitolizin, Urolesan.

Photo gallery - drugs for renal colic

Ketorol - an anesthetic drug used for moderate and severe pain syndrome Atropine - a spasm reliever Platifillin - effectively relaxes smooth muscles Canephron - herbal preparation with anti-inflammatory and moderate diuretic action Papaverine can be used to relieve spasm and pain Baralgin - a combined remedy for effective pain relief
Promedol - narcotic analgesic, used to relieve very severe pain Spasmolgon - a drug for relieving pain and spasms Fitolizin - a drug in the form of a paste based on plant materials, has antispasmodic, anti-inflammatory and diuretic properties Cerucal - an antiemetic Drotaverin (No-shpa) - an antispasmodic, most often used for spasms different localization

If conservative measures do not bring the desired effect, the patient undergoes a stenting of the ureter (insertion of a hollow tube through the urethra) or a nephrostomy (insertion of a drainage tube into the renal pelvis through a small puncture in the lumbar region) to organize urine diversion from an overflowing pelvis. In some cases, for example, with a very large stone that cannot be dissolved or crushed remotely, or with severe stricture of the ureter, an operation is performed and the obstruction to the urinary outflow is removed.

If it is impossible to restore the outflow of urine conservative means a nephrostomy is placed

Folk methods

Improve the patient's condition and enhance the effect traditional treatment possible with the help folk methods. However, without the permission of a doctor, the use of herbs is prohibited. medicinal plants can only be used after diuresis has been restored, since many herbs used in urology have a diuretic effect and during obstruction will contribute to even more overflow of the renal pelvis and damage to the organ.

If it is possible to take a bath during an attack, you can add a decoction of herbs to the water:

1. Take 10 g of cudweed grass, linden and chamomile flowers, birch leaves and sage.
2. Pour a liter of water and boil for 10 minutes.
3. Leave for 20 minutes, strain and add to the bath.

Phytonast to relieve spasm and relieve pain:

1. In equal parts, you need to take birch buds, juniper fruits, harrow root, mint leaves.
2. Take 3 tablespoons of the mixture and pour half a liter of boiling water.
3. Insist 40 minutes. Strain.
4. Drink the infusion warm for an hour.

For any pathologies of the kidneys, it is useful to use lingonberry and cranberry fruit drinks, which have strong anti-inflammatory properties.

If the attack of pain is caused by urolithiasis, it is recommended to take certain herbs, taking into account the type of stones:

• with urates:
  • decoctions of cranberries, knotweed, calamus root, parsley, birch leaves, currant leaves, strawberries, oat infusion;
• with oxalates and phosphates:
  • decoctions of budra, barberry flowers, immortelle, rosehip infusion, grape leaves.

With cystine stones, phytotherapy is ineffective.

Photo gallery: herbs for renal colic

Yarrow is an effective anti-inflammatory agent Bearberry has pronounced diuretic properties Birch leaves have a moderate diuretic, anti-inflammatory and analgesic effect Thyme has pronounced antibacterial and anti-inflammatory properties Sage has anti-inflammatory, antimicrobial, analgesic properties Knotweed - a herb with a pronounced diuretic effect Grape leaves are used to treat oxalate and phosphate stones

Physiotherapy

In the acute phase, to alleviate the suffering of the patient, the following methods of physiotherapy can be used:

• acupuncture - a mechanical effect on the reflex zones by introducing special thin needles at certain points on the patient's body;
• electroacupuncture - a method of pain relief by applying electric current to needles located in the reflexogenic zones;
• diadynamic therapy - is used for small stones in the ureter and is an exposure to a current of constant strength and low frequency; procedures relieve pain, swelling, improve blood circulation;
• ultrasound therapy - acts on the principle of vibromassage, anesthetizes, relieves inflammation and stimulates recovery processes;
• amplipulse therapy - exposure to tissues with a current of a certain frequency in order to eliminate spasm of smooth muscles and relieve pain;
• pulsed magnetotherapy - used for pain relief, elimination of edema and normalization of blood circulation in the kidney;
• inductothermy - treatment with high frequency magnetic field to relieve spasm and acute pain.

Physiotherapy for renal colic is aimed at stopping spasm and pain relief

None exercise during renal colic, it cannot be carried out, firstly, because of severe pain, and secondly, the patient needs to ensure maximum rest during an attack to relieve the load on the kidneys and slow down the filtration processes. Physiotherapy exercises can be prescribed after the elimination of an acute attack, while taking into account the cause that caused the violation of the passage of urine.

Diet

During an attack, the patient is hardly able to eat anything. After cupping acute pain and restoring diuresis, table number 10 is usually recommended, which implies normal calorie content and eating in fractional doses 4-6 times a day. At the same time, the amount of liquid should not be limited, on the contrary, you need to drink at least 2–2.5 liters per day. As a drink, you can use green tea, herbal infusions, compotes, fruit drinks, juices, mineral waters without gas (depending on the acidity of urine). Food is prepared by boiling, baking, stewing.

• vegetarian soups;
• any cereals, pasta;
• greens and vegetables;
• dietary meat and fish;
• fresh berries and fruits;
• dairy and dairy products;
• vegetable and butter;
• sweets in the form of mousses, jelly, honey, jams.

The menu after renal colic should be easily digestible, fortified, natural

You need to remove the following products from the menu:

• salty, fatty, fried;
• muffins, sweet desserts, chocolate;
• legumes;
• broths;
• spicy vegetables - radish, onion, sorrel, spinach, garlic;
• heavy meat, offal, bacon;
• cocoa, coffee, strong tea;
• alcohol in any form.

Fatty, fried, salty must be removed from the diet

With urolithiasis, diet No. 6 is recommended, the essence of which is to limit salts, fats, proteins, purines, extractives and oxalic acid. This table consists mainly of dairy and vegetable dishes. Each type of kidney stones requires a personal menu with certain restrictions.

Renal colic during pregnancy and in children

Childhood and pregnancy are absolute indications for mandatory hospitalization for renal colic.

Before the arrival of the ambulance, the pregnant woman needs to ensure peace and apply approved antispasmodics, for example, No-shpu. You can't take any painkillers. The restriction also applies to the use of thermal procedures, since against the background of a violation of the urinary outflow in pregnant women, hydronephrosis and reactive pyelonephritis develop very quickly, in which heat cannot be treated.

The child can be relieved with the help of No-shpa, Cystenal, Papaverine or Baralgin (in tablets - from 5 years old). A warm heating pad for the lower back is recommended.

No-shpa is one of the approved remedies during pregnancy

What to avoid with renal colic

The patient should minimize all factors that can cause spasm of the ureter and its blockage. To avoid a relapse, you must:

• adhere to a diet with a reduced content of substances that promote stone formation;
To avoid recurrence of renal colic, it is necessary to change the lifestyle and follow medical recommendations.

Prognosis and possible complications

Timely elimination of the factors that led to the development of renal colic makes it possible to avoid relapse.

Prolonged occlusion of the urinary tract leads to hydronephrosis and irreversible changes in the kidney (parenchyma atrophy), secondary pyelonephritis. The attached infection can contribute to the development of urosepsis, bacteremic shock. In this case, the patient may die.

Prevention

It is necessary to exclude factors leading to urolithiasis and other pathologies of the genitourinary system:

• eat right, drink plenty of fluids;
• temper:
• timely treat systemic and urological diseases.

Video: how to avoid an attack

Strong, painful and unbearable spasms in the lumbar region may indicate kidney disease: if a person has started and how to relieve pain - it becomes the main question.

Severe back pain most often indicates various diseases of the kidneys and urinary system. If they are with spasms and have the character of an attack, then we can talk about. This condition occurs most often in people with the formation of kidney stones. Other causes of renal colic may be inflammatory diseases, tumors in the kidneys, etc.

Renal colic always occurs suddenly.

The pains are so severe that a person almost completely loses his ability to work, and in some cases, the ability to move normally.

With renal colic, it is very important to quickly eliminate pain.

First aid for renal colic

When colic occurs, most people lose their temper and begin to toss and turn. It is important that a person be near the patient at this moment, who will quickly help to cope with such an attack.

With renal colic, how to relieve pain at the very beginning of an attack?

Firstly, it is necessary to calm the patient, provide him with comfortable conditions: lay him on the bed or seat him in a comfortable position.

With renal colic, heat can quickly relieve spasm. If the spasms are very strong and painful, it is necessary to take a bath of warm water and place the patient there. It must be remembered that hot baths have a number of contraindications:

• they should not be used for any bleeding, for example, during menstruation in women;
• a hot bath should not be taken by pregnant women at any time;
• hot baths are prohibited for inflammatory diseases of the genitourinary system.

While taking a hot bath, blood circulation in the lumbar region increases. Due to the rush of blood to the kidneys, more natural painkillers secreted by the body come.

In addition, warm baths help to calm down and improve the functioning of the nervous system. In order to eliminate side effects, it is necessary to prepare Ammonium chloride and Corvalol.

When providing first aid, it is important to exclude other possible diseases and ailments that can lead to lower back pain. They have completely different methods of treating and relieving pain:

1. Appendicitis. With renal colic, pain is localized only in the right region of the lower back, often moving to right side peritoneum and abdomen. With appendicitis, they can gradually increase, while with colic, they immediately appear very strong.
2. Gynecological diseases of the ovaries in women. It is quite easy to distinguish between pains in gynecological diseases: women's pains are not so sharp, they are more nagging and rarely come in the form of attacks.

After it has been determined exact reason and heat is applied, you need to give the patient any pain medication and put him to bed.

In some cases, you should call an ambulance. It is necessary if:

• there is no way to take painkillers at home: a person has contraindications, is allergic to drugs, there is no medicine in the home medicine cabinet;
• painkillers for 30 minutes or the pain continues to increase;
• the patient has tumors or;
• the patient lost consciousness.

Professional medical care for renal colic includes the introduction of a concentrated solution of novocaine into the ureters in men or into the uterine ligament in women. After novocaine blockade, the patient needs hospitalization in order to diagnose the causes of the attack.

Secondary care for renal colic

During this attack, not only pain can occur, but also other symptoms that need to be dealt with.

Often causes pain severe nausea and vomiting. Vomiting in renal colic is primarily associated with severe irritation of the nervous system. To stop vomiting, you can use the drug Cerucal. In a serious condition of the patient, this medicine is administered intramuscularly.

After an anesthetic injection, it is necessary to take drugs that relieve muscle spasm of the smooth muscles of the kidneys or ureters. Most often, drugs based on drotaverine are used. They help to relax the internal organs and remove the stone faster.

Pain in renal colic can return after a few hours even with the introduction of a strong painkiller. Repeated pains cause a strong tension on the heart muscle. Therefore, it is necessary to additionally drink preparations with magnesium and B vitamins.

With repeated pains, it is also necessary to take a combination of Analgin and Pipolfen.

The strong sedative effect of the combination drug will help to soothe the pain, and after a while the patient will be able to sleep.

After sleeping, he is likely to become very thirsty, but drinking a large amount of liquid can cause a second attack of pain. To alleviate the patient's condition, he should drink a small amount of rosehip decoction without sugar or warm weak herbal tea.

After sleep, you can take No-shpu or Drotaverine again to avoid recurrent attacks.

If there is no urine for several hours or the pain recurs, you must go to the hospital.

Using injections to quickly eliminate renal colic

Injections of an anesthetic drug are the fastest way to improve the patient's condition in this situation.

Pain shock against a background of spasm is very unsafe for other body systems and can cause irreparable harm.

That is why, with a strong pain shock, it is necessary to use injections of drugs into soft tissues. The following medicines are suitable for this:

• Analgin. In injections, this drug is used to quickly eliminate pain, injections can be poured over burns and other wounds in order to eliminate pain shock. An injection of Analgin is a great way to relieve pain in renal colic. A quick positive effect occurs due to the fact that metamizole sodium is the main active substance Analgin - has an anti-inflammatory effect and relieves spasms of the smooth muscles of the urinary tract. With Analgin, you need to be careful, since it is prohibited for certain kidney diseases, it affects the functioning of the circulatory system. The drug should not be administered to young children and pregnant women. After the injection, it is necessary to be under medical supervision for some time.

• No-shpa (Drotaverine). This is an excellent remedy for relieving pain that is caused by any spasm. Renal colic can be anesthetized with Drotaverine in almost any case. This drug is prohibited only in case of renal insufficiency and small children.
• Combined drugs. Combination preparations for injection are used quite often. They help to quickly get rid of pain due to the action of several drugs at once and have several actions at once: they are able to relieve pain, stop spasms of smooth muscles and remove the cause of pain - inflammation. With renal colic, some combined drugs, such as Novigan, can be used. Such drugs act much faster and more efficiently than the first two, but they have a significant disadvantage - a huge number of contraindications and side effects.

The use of traditional medicine to relieve pain in renal colic

With renal colic, the sensations can be so painful that the patient is able to take any drug that will relieve him of spasms. But any painkiller has many contraindications and adversely affects the liver. 90% of pain medications are prohibited or not recommended for young children and pregnant women.

In such cases, traditional medicine can come to the rescue.

Doctors do not call to refuse folk ways getting rid of pain in the kidneys with colic, but they remind you that many of them are dangerous, like pills.

Traditional medicines do not relieve pain so quickly and effectively and are not capable. It is best to use them if the attack does not bring severe torment, and the pain is quite tolerable.

To improve the condition Oyaniya use many different lotions and means of warming.

One of the ancient ways to relieve pain is dry salt. To do this, it must be heated in a pan or in the microwave, wrapped in a linen bag and applied to the lower back. Salt must be kept until completely cooled.

You can make a warm lotion based on olive oil. To do this, the oil is brought almost to a boil, and then the herbs of yarrow, marshmallow and chamomile are added to it. Cook this mixture over low heat for 10 minutes. Then the plants are squeezed and thrown away, and linen wide “bandages” are soaked in oil, which are then wrapped around the lower back several times. It is best to use this method at night.

More about hot tubs

V traditional medicine There is a way that helps without the use of any drugs to get rid of excruciating pain.

This method is warm baths. Thanks to them, heat is evenly distributed over the surface of the lower back and at the same time affects the kidneys and urinary tract. Spasms in renal colic also go away due to a light massage and soothing effect.

Pain baths can be done in several ways.

Baths with essential oils are highly effective.

Best of all, the kidney calms down from the essential oil of lavender, sage, almond, and to eliminate pain, you need to add a few drops of citrus or mint oil to the water.

It is better to coordinate the use of essential oils with your doctor, as they have a number of contraindications.

In baths, you can add decoctions of various medicinal herbs. To do this, you need to make a separate decoction of birch leaves, oregano, lemon balm or mint, sage, chamomile, etc. Approximately 1 liter of strong herbal decoction is enough for 1 bath.

The temperature of the water in the bath should be hot, but tolerable. It is enough for the patient to stay in it for 10-15 minutes. In no case should you wait until the water becomes cold, so as not to aggravate the situation. Therapeutic hot baths for pain at bedtime.

How does renal colic occur, how to relieve pain? develops due to malnutrition- frequent use meat products containing purine bases, as well as insufficient or excessive fluid intake.

Heavy physical labor and physical inactivity often provoke an attack. The disease of urolithiasis is often inherited. The presence of endocrine and other chronic diseases has a negative impact on the state of the urinary system.

Scientists have proven that patients with a negative Rh factor of blood are diagnosed more often. from 20–30 years are more susceptible to morbidity.

Renal colic can provoke the following pathological conditions:

• oncological diseases of the urinary system;
• tuberculosis of the kidneys;
• narrow lumen of the ureters;
• kink of the ureter when the kidney is lowered.

Symptoms of the disease

Renal colic has a vivid clinical picture. The main symptom in this complication is pain. The pain during the exacerbation is very strong.

In some cases, it can provoke fainting in the patient. The pain is located in the area of ​​​​the projection of the kidneys and, it radiates to the following places:

• crotch;
• lower limbs;
• to a healthy kidney.

Other symptoms:

• frequent urge to urinate if the lower ureters are affected;
• lack of urine (the patient has one kidney);
• stool retention or diarrhea;
• hematuria;
• hypertension;
• false urge to defecate;
• hyperthermia up to 38–39 degrees;
• pain in the urethra;
• dyspeptic symptoms (nausea, vomiting);
• dizziness.

Therapeutic measures for renal colic

The goal of treating the disease is to reduce the intensity of pain and relieve spasms of the ureters. They also prescribe drugs that accelerate the passage of the stone through the urinary tract and destroy the structure of the calculus.

With the ineffectiveness of conservative therapy, the patient undergoes surgery, the purpose of which is to remove the stone from the urinary system. This avoids complications caused by blockage of the ureters and renal pelvis.

Conservative treatments

Conservative measures in the treatment of renal colic include: diet therapy, drug therapy, ultrasonic lithotripsy. Drug therapy includes: antispasmodics and painkillers, as well as agents that destroy the stone.

Features of the provision of first aid

If symptoms of renal colic appear, the patient must be reassured and put to bed. Several pillows are placed under the back of the patient so that the patient is in an elevated position.

This will facilitate and speed up the process of movement. After that, relatives (or the patient himself) should definitely call an ambulance.

What to do before the arrival of the doctor? To relax the smooth muscles of the ureters, a heating pad should be applied to the area of ​​the diseased kidney. It shouldn't be very hot. It is better to wrap the heating pad in a towel to prevent overheating of the tissues.

With the appearance of renal colic, home treatment is actively used warm baths. They help to calm the patient and expand the lumen of the ureters, which alleviates the patient's condition. Heat is an anesthetic for renal colic.

If the patient has risen heat heating cannot be used. In this case, it is better to inject an antispasmodic intramuscularly or into a vein.

With the appearance of renal colic, how to relieve pain? The following antispasmodics will help relieve pain:

• No-shpa (Drotaverine);
• Analgin with Dimedrol;
• Papaverine;
• Baralgin;

If there is no possibility of intravenous or intramuscular excretion of painkillers, tablets should be used.

You can not use a large number of drugs, as they smooth out the symptoms of the disease, this will make it difficult for the emergency doctor to make a diagnosis.

After the doctor confirms the diagnosis, doctors can make intravenous injection to reduce the intensity of pain. If the patient's condition allows outpatient management, the doctor will give a referral to a general practitioner, and also tell you how to relieve renal colic.

In a severe course of the pathological condition, the patient is hospitalized in the urological, therapeutic or surgical department.

Indications for hospitalization

The patient must be hospitalized if the pain syndrome could not be stopped.

Hospitalization is indicated for patients in the following cases:

• the patient has one kidney;
• 2 kidneys are affected;
• the stone did not come out on its own within 3 days;
• the disease is found in a child;
• pathology was diagnosed in a pregnant woman;
• the patient is elderly.

Hospitalization is necessary to rule out:

• tubal pregnancy;
• acute appendicitis;
• intestinal obstruction;
• hydronephrosis of the kidney;
• neoplasms of the prostate.

These disorders can cause symptoms of renal colic.

diet therapy

V therapeutic measures important role is played by the nutrition of the patient. Doctors prescribe 10 treatment tables for people with kidney pathology. The patient should consume the required amount of proteins, fats, carbohydrates and fluids: up to 2 liters per day.

It will depend on the type of kidney stones.

Prohibited Products:

With phosphate formations, urine is acidified with Ascorbic acid and Methionine.

They require alkalization, for which mineral waters rich in alkalis are prescribed.

Medical therapy

Antispasmodics and analgesics act as painkillers for hepatic colic. good medicine is Metamizole sodium (Baralgin), which belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

It is prescribed to adolescents from 15 years of age and adults intravenously slowly. Before injection, the ampoule should be warmed by holding it in a fist. While taking this medicine, the urine becomes pink.

Painkillers are not prescribed for patients with chronic kidney failure, kidney pathology, aspirin asthma. The drug should not be combined with alcoholic beverages.

Antispasmodics are actively used in renal colic. The most popular is Drotaverin (No-shpa).

It relaxes the smooth muscles of the internal organs, including the ureters. The antispasmodic is injected into a vein slowly. No-shpa is not prescribed for glaucoma, enlarged prostate, low blood pressure, atherosclerosis of cerebral vessels.

If Drotaverine does not relieve pain, Ketorolac is used. It is an NSAID that has a strong analgesic effect. The drug is administered intravenously slowly. This drug is prohibited for use in bronchial asthma, peptic ulcer, as well as in children under 16 years of age.

How can you relieve pain in renal colic when painkillers do not help? In this case, the doctor prescribes a pararenal blockade.

Treatment is complex. It also includes antibacterial drugs, drugs that destroy the structure of stones.

Preparations that dissolve stones

Medicines designed to destroy stones are prescribed depending on the type of calculus.

Formed from salts of uric acid. Dissolving them is not difficult. To do this, it is necessary to make the urine more alkaline. With urates, the doctor uses citrate drugs.

These include drugs:

• Allopurinol (Hypoxanthin);
• Potassium citrate (appointed only with normal calcium levels);
• Magnesium citrate (used for violation of the absorption of the intestinal wall and after surgery);
• Prolit super septo (based on herbs).

With phosphate calculi, urine should be acidified with fruit drinks from wild rose, barberry.

Medicines used for this type of stones:

• Aluminum hydroxide gel (toxic, increases the risk of calcium oxalate formations);
• Madder tint extract (almost no side effects, effective for urate calculi);
• Cyston (contains moraine extract).

The next type of stones are oxalates. When they appear, the urine is alkalized. These dense formations are difficult to treat, so long courses are used to dissolve them.

Drugs for renal colic caused include:

• Asparkam;
• Cholestyramine (inhibits intestinal absorption of oxalates).

Lithotripsy using ultrasound

Ultrasonic lithotripsy is used quite often. It is prescribed for the ineffectiveness of conservative treatment and the appearance of contraindications to the surgical removal of stones.

This treatment technique is non-invasive, suitable for the destruction of stones in children. It is indicated when dense formations appear, the diameter of which does not exceed 1 cm. The technique cannot be used in obese patients, since destructive force ultrasound reaching the stones is too weak.

Surgical treatment of the disease

Surgical treatment is carried out when other methods have not helped. If the stones are large and cannot come out on their own, the following operational methods for removing stones are used:

• endoscopic method (extraction of dense formations from the bladder and lower ureter);
• operative lithotripsy (mechanical, laser, electrohydraulic);
• extended operation followed by resection or removal;
• laparoscopic surgery on the kidneys or ureter.

Forecasts

Urolithiasis is common throughout the world. Its frequency depends on the quality of water and food. There are many ways to deal with this disease, but it is better to try to prevent it.

To do this, you need to monitor the chemical composition of water. You can not drink water from wells, as it has a high hardness. If it is not possible to refuse to use it, the water must be filtered, settled and boiled.

It is also worth reducing the amount of salt and pickles, meat and dairy products. With a hereditary predisposition to urolithiasis, the patient must annually take a general urine test. All these activities help prevent the appearance of stones and renal colic.