Renal Colic Syndrome Renal colic: what it is, causes, symptoms, treatment, how to relieve pain by first aid. Symptoms of renal colic

Acute pain in the abdomen and lower back, which a woman may encounter, is one of the most dangerous symptoms. It is a sign of many diseases: each of them is extremely serious and requires medical attention. But if a person for a long time suffered from pathologies of the urinary system, the cause of the development of acute pain is renal colic. It is diagnosed in 80% of women admitted to various departments of medical institutions. That is why it is so important to know the first manifestations of the disease and the rules for providing assistance before the arrival of doctors.

What is renal colic in women?

Renal colic is a pathological condition that is most often triggered by the release of stone from the kidney and is accompanied by a pronounced spasm of the smooth muscles of the organs of the excretory system and acute pain syndrome. First aid for such an ailment should be provided immediately, otherwise it can lead to disastrous consequences for a woman. Renal colic alone is not a disease, but only complicates most ailments of the excretory system.

  Stone discharge is the most common cause of renal colic.

Symptoms

The main clinical manifestations of the pathological condition can be called:

• sharp, stitching pain in the lumbar region lasting up to several hours, which can give to the pubis, abdomen, groin, thigh, and can also be felt both on the right and on the left;
• an increase in body temperature to 38–39 degrees Celsius;
• nausea and vomiting without food intake;
• violation of the discharge of urine and feces;
• severe dizziness and;
• sleep changes (insomnia, frequent awakenings);
• loss of appetite;
• almost complete immobility.

Features of the pathological condition in pregnant women

During the period of bearing a child, the body becomes extremely sensitive to influences both outside and inside. That is why pregnant women are much more sensitive to an attack of renal colic. Since the enlarged uterus, in which the baby grows and develops, fills the entire abdominal cavity, the kidneys and ureters with the bladder experience more severe pressure. In most cases, doctors face such a pathology in the third trimester.

Organ displacement during pregnancy is due to an increase in the uterus and fetal growth

In practice in gynecology, the author studied the history of a woman in labor who suffered an attack of acute renal colic in the eighth month of pregnancy. It was accompanied by severe toxicosis: the woman had a fever, she was constantly nauseous, her back ached very much, and the baby was pushing much more actively than usual. According to ultrasound, a huge stone was found in the right kidney, which caused colic. On that day, the patient underwent two operations: to remove a pathological formation and a cesarean section. The patient and the baby felt satisfactory and were discharged after three weeks.

Video: manifestations of renal colic

Causes and factors of the formation of pathology

A similar ailment develops annually in more than a million women around the world. More often, renal colic affects pregnant and lactating mothers, adolescents, and people over 60 years of age.

Anything can provoke the formation of pain: prolonged stress, fear, a sharp push, riding in vehicles or active physical activity.

Causes and factors for the development of renal colic:

1. Urolithiasis is a pathological condition that is associated with the formation of stones in various parts of the excretory system that interfere with normal urine excretion. They can also injure the mucous membrane, to which the organ responds with severe spasm.
2. Inflammatory diseases: cystitis, urethritis, glomerulonephritis. They are formed under the action of bacterial microorganisms and are accompanied by severe soft tissue edema.
3. Poisoning by various substances, which may include industrial compounds, narcotic and medicinal products, poisons of plants, mushrooms or animals. They have a toxic effect on the whole body as a whole, but it is the kidneys that most often suffer.

Diagnosis of the disease and its differentiation

Renal colic has a clinical picture of acute pain syndrome, which is accompanied by severe muscle spasm. Quite often, this ailment is confused with the following pathological conditions:

• cholecystitis;
• appendicitis
• ectopic pregnancy;
• rupture of the fallopian tube;
• acute endometritis;
• an attack of gastritis or peptic ulcer;

To determine the cause of the pain, doctors resort to laboratory and instrumental methods.

Immediately upon admission to the hospital, a general urine test is taken from the patient: after hygiene of the genitals, a small amount of urine is collected in a special container. Then she goes to the laboratory, where her physical characteristics and cellular composition are studied. Normally, urine has a straw-yellow color, is transparent and does not contain pathological impurities. With renal colic, there is a pronounced turbidity and even redness of the urine (if the stone damages soft tissues), it contains sand and blood clots. The number of leukocytes, epithelium and cylinders is increasing, indicating a nascent inflammation.

  Turbid urine indicates a suspension

Next, each patient must undergo an ultrasound examination of the excretory system. The doctor studies the condition of the kidneys, ureters and bladder, while evaluating their patency. Thus, it is possible to detect many stones, bacterial emboli and foreign bodies, which can cause the development of pain. As well as ultrasound, you can choose the optimal tactic that allows you to eliminate the ailment.

  On the ultrasound image, you can see the expansion of the pelvis, which is characteristic of the inflammatory process

Rules for the treatment of renal colic in women

Therapy for an acute attack of pain consists of two stages:

• the first is to relieve spasm and relax the muscles of the urinary system;
• the second is aimed at eliminating the cause that provoked the development of the disease.

Currently, conservative treatment is widely used (includes following a strict diet, the use of drugs) and surgical: eliminating kidney stones.

Usually, after a few hours from the development of renal colic, the patient enters the hospital (department of urology or nephrology), where doctors conduct all the most important tests and issue a verdict on the need for surgical intervention.

First aid for the development of a pathological condition

If an acute attack of renal colic has taken you or your loved ones by surprise, no need to panic. It is necessary to call an ambulance as soon as possible and describe the condition of the victim to the dispatcher, without forgetting to give the address of his location. Next, you need to return to action.

Many people believe that a heating pad is the most effective way to get rid of an attack of acute pain. Its use can be justified only in those cases when you know for sure that the cause of the colic was not the development of an inflammatory ailment, but another pathology (for example, stone movement). If the patient has a similar disease, it is necessary to abandon the use of any heating.

Algorithm of actions in an emergency:

1. Reassure the victim. To do this, you can give her to drink a small amount of pure still water in small sips. It is forbidden to use juices, carbonated drinks, alcohol, coffee and energy. It is also recommended that you refuse to eat in the next few hours.
2. Carefully move the patient from a hard surface to a softer one. If she refuses to leave her place, it would be advisable to lay a blanket or blanket to avoid hypothermia.
3. Offer the victim the available antispasmodic drugs (No-shpu, Spazgan, Drotaverin) in the form of tablets. It is forbidden to independently administer intravenous and intramuscular injections.
4. If the patient has no history of inflammatory diseases, the victim can be placed in the bathroom with warm water waist-deep. The best option would be to attach a heating pad or any other warm object to the lumbar region.

Video: first aid for a person suffering from renal colic

Table: drug therapy of the disease

Name of drug group	Medication Examples	The main effects of the application
Antispasmodics	No-shpa; Pentalgin-N; Spazgan Spasmalgon; Papaverine; Drotaverine; Bicyclan; Bendazole	They relax the smooth muscles of the urogenital tract, helping to reduce the severity of soft tissue spasm.
Painkillers	Ketorol; Tramal; Tramadol; Tramalgin; Clonidine; Phenacetin; Carbamazepine; Promedol; Pyritramide; Morphine; Buprenorphine; Nalorfin; Naloxone	They prevent the transmission of pain impulses from receptors located in the kidney tissue to the brain, and increase thresholds of susceptibility.
Anti-inflammatory drugs	Butadione; Diclofenac Sodium; Ponstan; Ortofen; Voltaren; Brufen; Nurofen; Tamoxifen; Piroxicam.	Relieve inflammation from the tissues of the genitourinary system, allowing you to partially reduce discomfort.
Phytotherapy	Kanefron; Phytolysin; Kidney tea; Urolesan; Rovatinex.	They have a diuretic effect and are invaluable in removing small stones and sand from the kidneys, bladder and urethra.

Photo Gallery: Pharmaceuticals Used For Ailments

  Cyston removes sand from the kidneys   Baralgin relaxes the pelvic muscles   Ibuprofen relieves inflammation

As with other diseases, the body spends a huge amount of energy to recover from a pain attack and eliminate the negative effects of renal colic. That is why for all patients at risk of developing pathology, a special diet is prescribed, which will avoid many provoking factors. The most important principles of proper nutrition:

• rejection of preservatives;
• small portions of food weighing no more than three hundred grams;
• fragmentation of food intake;
• obligatory availability of breakfast, lunch, dinner and two snacks;
• using only fresh food for cooking;
• minimal use of salt and hot spices;
• all food should be stewed, boiled or baked;
• fried foods are completely excluded from the diet;
• daily, the patient should drink at least two liters of pure still water;
• slow absorption of the dish and thoroughly chewing it will help to better taste.

What products should be removed:

• canned food (fish, meat, fruit and vegetable);
• chips, crackers and other similar snacks;
• marmalade and chocolate;
• bakery products with protein cream;
• fatty varieties of meat and fish, lard;
• sausage and sausages;
• processed cheese;
• alcohol;
• carbonated drinks;
• packaged juices and fruit drinks;
• coffee and chicory;
• energy and other stimulants;
• fast food (hamburgers, nuggets, french fries);
• semi-finished products;
• instant products (noodles, mashed potatoes, cereals);
• sunflower seeds;
• homemade salting.

Photo Gallery: Junk Food

  Fast Food Rich in Fats and Fast Carbs   Canned food contains many additives.   Chips contain a lot of salt and trans fats

Be sure to add to your daily diet:

• vegetables and fruits (fresh and in the form of stews, salads, snacks);
• berries (as a dessert and the basis for dishes);
• homemade compotes and fruit drinks with a minimum sugar content;
• lean meat (chicken, turkey) and fish (pollock, hake, crucian carp);
• greens (spinach, dill, celery, basil, cilantro);
• milk, yogurt without fillers, cottage cheese, kefir, fermented baked milk, sour cream;
• homemade oatmeal baked goods;
• nuts and dried fruits;
• green and black tea without additives;
• natural honey;
• cereals on the water and cereals (buckwheat, oatmeal, rice, barley, millet, semolina);
• legumes and pea crops (lentils, chickpeas).

Photo Gallery: Healthy Food

  Honey - a natural sweetener
  Cereals contain a lot of healthy carbohydrates   Green tea gives a boost of energy for a day

Alternative recipes as an additional therapy

Even before the advent of traditional medicine, many diseases of the genitourinary system were treated with various plants and herbs. Currently, they can also be used for additional therapy, as they cope with the main symptoms. However, in no case should you give up traditional medicine: only it can eliminate the cause of the development of renal colic.

The author of the article attended a medical meeting, which examined in detail the history of one patient. A woman in the last stages of pregnancy with chronic urolithiasis constantly suffered from severe attacks of renal colic, which could be repeated regularly for whole days. She read on the Internet that most drugs cross the placenta and can have a negative effect on the fetus. That is why the patient neglected all pharmaceuticals and was treated only with decoctions and infusions. Unfortunately, after several days of such therapy, the stone damaged the ureter and caused a powerful attack of pain, which provoked a premature birth. Immediately after the baby was born, the victim was taken to the urology department and operated on.

Such recipes are used as an adjuvant:

1. Grate three large roots of ginger. Throw them into a pot with four liters of hot water and cook for half an hour, stirring constantly. Then you need to remove the container from the fire, cool, strain through a sieve and pour into small bottles. It is recommended to drink two glasses before each meal. Ginger has a pronounced anti-inflammatory and antiseptic effect, which contributes to the death of many pathogenic microorganisms. The course of treatment consists of twelve procedures with an interval of three days.
2. Four bags of pharmacy chamomile brew in a glass of boiling water. After cooling down, drink (recommended before bedtime). It is believed that this plant has a calming effect, reducing the activity of the nervous system. This, in turn, reduces hyper-excitability, and the risk of developing renal colic decreases several times. Therapy lasts at least three weeks.
3. Mix one hundred grams of lemon balm with a tablespoon of mint and lavender. Pour herbs with a liter of boiling water, then insist for a day. Use a sieve to remove excess raw materials and drink one glass each before meals. This infusion helps relieve spasm and prevents relapse.

Photo gallery: natural remedies for acute condition

  Ginger root kills bacteria   Chamomile has a sedative effect   Melissa relieves spasm

Surgical treatment of pathology

If a stone is the cause of a sudden renal colic, it is necessary to remove it and release the lumen of the organ. Usually, calculi not only impede or completely block the normal passage of urine, but also injure the walls of the ureter, causing a reflex spasm. In this case, even after the introduction of relaxing preparations, the stone continues to have a damaging effect, which leads to the need to remove it so that colic does not recur.

The choice of treatment methods is largely determined by the condition of the patient, the presence of other chronic diseases, as well as age. Older people, pregnant women and children are more likely to have less traumatic surgery.

What surgical treatment options are there:

1. Contactless stone removal. It is indicated for small formations. The patient is located on the couch in the operating room, after which a slight anesthesia is introduced and the exact location of the foreign body is determined under ultrasound control. Using a special device, remote crushing of stones located in the lumen or in the walls of the organ is carried out. They gradually break down into small particles, which are removed from the body along with urine.
     Contactless lithotripsy allows you to quickly and painlessly remove stones
2. Contact lithotripsy. It is carried out under local anesthesia, is an introduction to the woman’s urinary canal of a special tool - an ureteroscope. Using an ultrasound device, the doctor monitors the progress of the device to the stone, and upon reaching the goal, launches the program. Conglomerates are crushed using shock waves of high frequency and strength. This technique is used when a pathological lesion is located in the lower part of the ureter.
     In contact lithotripsy, the stone is crushed directly in the ureter
3. Percutaneous lithotripsy. It is carried out if the stone is located in the pyelocaliceal system of the kidneys. A narrow and long needle is inserted through a small hole in the lumbar region. Gradually, she reaches the organ and pierces its capsule, under the supervision of a doctor, penetrating directly to the stone. Its crushing is also carried out by means of a shock wave.
     Percutaneous (percutaneous) nephrolithotomy is performed when the stone is located in the pyelocaliceal system of the kidneys

The recovery period after all treatment techniques is from two to fifteen days. The first few days the patient is under the supervision of a doctor in the department of nephrology or intensive care. After discharge, they are prescribed a serious diet and recommendations are given on taking medications. Such patients will need to undergo a medical examination every six months, which will allow to track the dynamics of the disease.

Treatment forecasts and possible complications of the disease

Renal colic, like any other acute condition, disappears within fifteen to twenty minutes after the introduction of a relaxing agent. If this does not bring the desired effect, the injection is repeated. With competent help, the patient almost immediately comes to her senses and stops complaining of severe pain. However, do not forget that renal colic is prone to recurrence, especially if the patient violates the diet and does not take medications intended for the treatment of the underlying ailment.

In her practical activities, the author came across a patient who for twelve years suffered from constantly recurring pain attacks, but did not seek the help of a doctor, preferring to wait for them on her own. She had a history of urolithiasis, transferred twelve years ago, while the woman did not follow the diet, consuming a large amount of fatty, fried and salty foods. This behavior led to serious consequences - removal of the kidney, and the patient is constantly on hemodialysis (a procedure that provides artificial blood purification by passing it through a special filter apparatus). That is why doctors strongly recommend seeking help as soon as possible.

The main complications and negative consequences of renal colic:

1. The death of soft tissues. Due to prolonged vasospasm, hypoxia gradually develops - a pathological condition in which cells suffer from a deficiency of oxygen coming from arterial blood. If the compression lasts longer than fifteen minutes, ischemia and necrosis develops - the death of the renal substance. Gradually dead tissue is replaced by connective fibers, which cannot perform the function of filtering and reabsorbing fluid. Treatment of this pathology is carried out only surgically.
2. Urine infection and the development of pelvic inflammatory diseases. In the event that the cause of the formation of renal colic is stone, various pathogenic microorganisms gradually accumulate at the site of damage. They actively multiply, as a result of which part of the fluid below the spasm is infected. When it is thrown back into the kidney, the following inflammatory processes can develop: pyelitis, pyelonephritis, nephritis. To avoid the secondary infection, doctors use antibacterial drugs if the colic lasted more than an hour.
3. Chronic disease (insufficiency) of the kidneys is a serious pathological condition, which is characterized by a violation of the anatomical and physiological characteristics of the urinary system. The disease is often associated with prolonged and painful relapses of renal colic. Due to the death of parts of the organ and the replacement of their connective tissue substance, the excretory system can not cope with regular loads to remove toxins from the body. A person is constantly exposed to harmful metabolic products, which can provoke coma and even death.
4. Preterm birth with the development of renal colic during pregnancy. Acute pain is a strong irritant for the body of the expectant mother, which can provoke the passage of water and stimulate the contractile activity of the uterus. This contributes to the early birth of the fetus. Such children often suffer from neonatal jaundice and may lag slightly behind their peers in development in the first years of life, after which the situation normalizes.

Photo gallery: the main complications of an acute condition

  The death of the kidney leads to its removal   Jaundice may occur due to premature birth   Pyelonephritis - an inflammatory disease, after which scars remain in the organ tissue

Different ways to prevent renal colic

In itself, this ailment is a pronounced signal for the body, which calls for paying attention to the state of health.   Renal colic is a symptom of an acute or chronic disease that requires treatment. Medicine of the twenty-first century, unlike its predecessor, focuses on the prevention of pathological conditions and the prevention of their development, and not on treatment, as was customary before. That is why the creation of a health office in various medical institutions, where people can get the necessary information, has become so popular. All preventive measures aimed at protecting women from the formation of renal colic are divided into collective and individual. The former are carried out with the participation of doctors and pharmacists, while the latter are carried out by the patients themselves or their relatives.

While working in the Department of Nephrology, the author of this article and his colleagues participated in organizing an open seminar on the differential diagnosis of renal colic. The event was held on the territory of the medical university, and everyone could get on it. Professors and teachers gave a lecture to the population about the symptomatic manifestations and important signs of the disease, taught to distinguish colic from appendicitis, ectopic pregnancy and acute cholecystitis. Students at this time clearly demonstrated the sequence of first aid to the victims, while dwelling on the main mistakes. At the end of the seminar, testing was conducted, which showed awareness of the population in issues related to the development of renal colic. It was found that 80% of the students have fully mastered the material and will be able not only to distinguish one ailment from another, but also not to get confused in an emergency.

How to prevent the development of renal colic in women:

1. Do not violate the diet recommended by your doctor. Most instant foods (convenience foods, instant porridge and noodles) contain a huge amount of modified fats and carbohydrates, which are poorly broken down by the gastrointestinal tract and practically not excreted by the kidneys. It is scientifically proven that the use of hamburgers, french fries and carbonated drinks contributes to the formation of protein-fat and salt conglomerates, which can cause the development of renal colic. Inadequate consumption of pure water also leads to an imbalance in the acid-base balance. Patients with kidney diseases need to adhere to the prescribed diet all the time: even a slight deviation can provoke a shift in electrolyte balance, and excess fluid will begin to accumulate in the body.
     Semi-finished products contain a large amount of salt, harmful to the body
2. Visit your doctor regularly and do not delay the treatment of chronic diseases. Few people know that even those ailments that for many years were in remission and did not manifest themselves in any way need tight control. Long forgotten urolithiasis or pyelonephritis can remind yourself after a viral or bacterial infection. That is why it is so important to regularly take blood and urine tests, as well as visit your doctor.
3. Give at least three days a week to physical activity. Sport not only strengthens the body, but also prevents the development of many pathogenic infections in it. With a sedentary lifestyle, the risk of getting obesity, diabetes, hypertension and urolithiasis is much higher, which leads to the development of colic in the kidneys. Doctors strongly recommend abandoning the usual leisure time in front of a computer and TV, replacing it with a visit to the gym, dancing, wrestling, yoga.
     Yoga is a great form of physical activity for those who want to be in harmony with themselves.
4. Follow the intimate hygiene of the vagina and perineum. Most bacteria that provoke the development of inflammatory diseases live on the surface of the skin or mucous membranes. In violation of the integrity of the protective barrier, they easily penetrate the body, contributing to the formation of ailments. That is why it is so important to take a hygienic shower with a special soap every day: it will not break the fragile biocenosis of the vagina.
5. Get rid of bad habits. The abuse of alcohol, nicotine or drugs has a destructive effect on the body of any person, but women suffer much more. This is directly related to their lower resistance to environmental factors. Bad habits slow down the metabolic processes in the human body, and toxins damage the fragile kidney system, causing the development of colic.
6. Do not take drugs without a doctor’s prescription. Any remedy has a specific dosage, which is calculated based on the age and weight of the patient. An excess of the drug can cause serious poisoning and provoke the development of renal failure in women of any age. Patients with chronic ailments need to carefully monitor the compatibility of one drug with another, since the mixing of different substances provokes certain biochemical reactions in the body.

Renal colic is an unpleasant and in some cases even dangerous condition that can develop in a woman against a background of various diseases or poisonings. Remember that when you or your loved ones are faced with this ailment, do not panic or be scared: all the consequences are easily eliminated if you correctly provide first aid. So that renal colic never bothers you again, you should definitely treat the underlying disease: this is the only way to protect yourself from new attacks. Do not forget about the rules of prevention and basic medical recommendations that allow you to protect yourself from the disease.

Usually, by the time the first attack of renal colic occurs, a person already has an established diagnosis of urolithiasis or other urological disease. However, sometimes calculus in the kidney does not make itself felt for years. And an unexpectedly started attack, provoked by the passage of a stone, a person takes for anything else. After all, there are quite a few similar conditions. Therefore, it will not be out of place for all people to know the mechanism of development of renal colic, its symptoms and distinguishing features.

What is renal colic?

Renal colic is an unexpected sharp pain in the ureter or in the kidney, which has a paroxysmal character, a special irradiation and is accompanied by digestive and urinary disorders. Its origin comes down to four main factors:

• stretching the cavity of the kidney and its outer capsule shell;
• irritation or compression of the intrarenal nerve receptors;
• reverse urine reflux from the ureter to the pelvis (reflux);
• increased intrarenal pressure due to obstruction of the outflow of fluid from the kidney.

Renal colic is a consequence of acute blockage of the ureter. It is usually caused by the passage of a stone or accumulation of salt crystals. Colic is both right- and left-handed, its course is the same and differs only in the direction of pain distribution. Sometimes this phenomenon occurs simultaneously on both sides.

The cause of the attack in almost 90% of cases is urolithiasis. However, an acute violation of the patency of the ureter does not necessarily imply its presence. Clogging can occur while moving through the urinary tract of a purulent or blood clot, as well as a fragment of a decaying tumor. Sometimes colic attacks are caused by an excess of the ureter when the kidney is lowered (nephroptosis).

Ureteric obstruction with stone is the most common but not the only cause of renal colic.

Complete obstruction (overlapping) occurs not only as a result of a mechanical obstacle. It may also have a functional character: at the level of blockage, a spasm of the ureter appears. Since the reduced wall of the latter periodically relaxes, some of its patency still remains.

Urine seeps between a foreign body and the inner surface of the ureter, as a result of this the pain decreases slightly, but with the resumption of the spasm it aggravates again. When the outflow of urine is completely blocked, it assumes a constant cramping character and is accompanied by chaotic and unproductive pelvis contractions.   This causes hydronephrotic expansion of the kidney cavity and overstretching of the outer shell of the organ.

  Violation of the outflow of urine leads to hydronephrosis - a progressive expansion of the renal pelvis, threatening not only the health but also the life of the patient

As the foreign body moves down, another factor is added to the origin of the pain attack: direct irritation of the nerve endings of the ureter. When the calculus is localized in the upper or middle third of this hollow organ, discomfort spreads along its course. But as soon as a foreign object reaches the point of intersection of the ureter tube with the common iliac artery, the pain begins to pass into the suprapubic zone and thigh.

  The red arrow in the figure indicates the intersection of the ureter and the common iliac artery; when the stone reaches this point, the pain begins to give to the thigh

The mechanism of pain irradiation is determined by the anatomical ratio of the common iliac artery and ureter. These hollow organs are in close proximity to each other and are in close contact. Therefore, irritation of the nerve receptors of the ureter is transmitted to the aforementioned blood vessel, and then to its continuation, the femoral (external) iliac artery on the affected side. The irradiation of pain down the abdomen and in the suprapubic zone is due to the transfer of its impulses to the branches of the internal iliac artery.

  The ureter is marked with a blue arrow, yellow - the common iliac artery, black - the internal iliac artery and green - the femoral

Irradiation of pain: the difference between men and women

Throughout its length, except for the pelvic segment, the ureter in women is no different from that in men, except that it is somewhat shorter. For those and others, the internal diameter of the lumen of this tube in different sections is from 6 to 15 mm.

Due to the elasticity and folding of the ureter wall, its inner lumen has the shape of a star

Interestingly, the walls of the ureter have very good extensibility. Due to its elasticity, the organ is able to expand up to 80 mm in the lumen. This property helps a person survive renal colic and acute urine retention associated with ureteral obstruction.

But in the pelvic part of women and men, the ureter has some anatomical features. In the former, it laterally bends around the uterus, passing along its wide ligament, is located behind the ovary and ends in the bladder at the level of the upper third of the vagina.

  Before connecting to the bladder, the female ureter bends around the ovary and cervix

In representatives of the stronger sex, the ureter goes forward and outward from the vas deferens. Curving the latter laterally, it flows into the bladder at a point located just above the upper edge of the seminal vesicle.

  The ureter of a man passes in the immediate vicinity of the vas deferens

Until the stone reached the pelvic part, the manifestations of renal colic in patients of both sexes are the same. With further advancement, the calculus reaches the point of intersection of the ureter:

• in women - with a round ligament of the uterus;
• in men - with the vas deferens.

In this section of the “journey” of a foreign body through the urinary tract, the nature of the irradiation of pain becomes different. In women, she now gives into the large genital lips, and in patients of the opposite sex - into the scrotum and testicle on the affected side.

If the calculus managed to get into the bladder, then it begins to irritate the nerve receptors of tissues in contact with the neck of this organ. Therefore, pain now spreads in the direction of the urethra: in women, they radiate on the eve of the vagina, and in male patients, into the head of the penis.

Features of renal colic in infants

Unfortunately, kidney diseases sometimes do not spare even the smallest children. In infants of the first year of life, an attack of colic can also occur. They have some features. Diagnosis is significantly difficult, because the child, due to his early age, cannot indicate where exactly he has pain.

In infants, an acute obstruction by the stone of the lumen of the urinary tract is characterized by sudden anxiety. The pain in infants is concentrated around the navel.  The child is actively moving, rushing around in the crib, banging his legs, screaming piercingly.

  Colic in infants is manifested by active motor anxiety and screaming

Parents should know that the following symptoms indicate kidney colic in a baby:

• severe bloating and tension of the tummy;
• sharp pain when touched - when trying to stroke the stomach, the child cries out;
• breast rejection;
• repeated vomiting;
• prolonged lack of stool;
• increase in body temperature to 38–39 о С.

Doctors explain the increase in body temperature (hyperthermia) by the appearance of urine reflux from the renal pelvis into the general bloodstream - pyelo-venous reflux. This fact has an irritating effect on the body's thermoregulation center, which is the cause of hyperthermia. Arising in this way, it does not depend on the presence of bacteria in the urine.

In the case of the penetration of pathogens into the urinary tract, the result of long-term renal colic in infants may be apostematic nephritis. This is a particularly dangerous kind of acute inflammation of the kidneys, characterized by numerous abscesses (apostems) in the organ parenchyma. Fortunately, in babies, the attack usually ends within 15–20 minutes.

  Apostematous nephritis - one of the forms of acute purulent pyelonephritis

Often, the clinical picture of renal colic in infants is taken by parents for bowel obstruction.  To differentiate these two conditions, it is necessary to put the baby an enema. With renal colic, a large amount of feces is released along with flushing fluid. With obstruction or inversion of the intestines, on the contrary, bowel movements with an enema cannot be obtained, but scarlet blood can be released from the anus.

With surgical pathologies of the abdominal cavity, such as appendicitis or cholecystitis, the child tries to lie still on his back.

Video: why there is pain with renal colic

Typical symptoms in adults and the nature of pain

An attack of renal colic most often begins during significant physical activity or human movement. Often the impetus for the passage of calculus gives riding on rough roads, shaking. But an attack can occur without a provoking factor - at rest or even in a dream.

Stone Departure

The duration of the attack, depending on the speed of movement and the size of the foreign body, varies from 20 minutes to several days. If the stone is small and smooth, then the pain attack ends within 2-3 hours. Most acute patient anxiety is caused by small acute-angled calculi: they are very mobile, move for a long time and easily injure the mucous membranes of the urinary tract.

Often, several medium-sized stones come out with urine during an attack of colic. After the departure of the first of them comes temporary relief, but with the beginning of the movement of the next, the pain resumes.

In some patients, stones are released painlessly.

Hematuria

With renal colic in urine, an admixture of blood is observed, sometimes quite intense; often with the naked eye, blood clots are visible in it. In a laboratory study of urine sediment, even if it visually has a normal color, an increased number of red blood cells (red blood cells) is detected.

  Blood in the urine with renal colic is noticeable to the naked eye, but may also be absent

For renal colic due to urolithiasis, it is typical that the pain precedes the appearance of bleeding and indicates the onset of calculus migration. With other urological pathologies, everything happens the other way around. First, a person develops hematuria, and later an attack of colic joins her, provoked by a blockage of the ureter with a large blood or purulent thrombus.

Gastrointestinal, general and dysuric disorders

Due to the fact that during colic there is irritation of not only the kidney, but also the celiac nerve plexus, nausea and vomiting are typical symptoms of this condition. There is bloating caused by a delay in the passage of gas and stool.

  Nausea and vomiting during renal colic caused by irritation of the celiac nerve plexus

The patient becomes pale, covered with cold sweat. His temperature rises, often headache, weakness, dryness of the oral mucosa join.

In the case of a stop of a foreign body in the final (bladder) segment of the ureter, a person has frequent, painful and unproductive urination. During an attack of renal colic, sometimes there is even an acute delay in urine caused by blockage of the urinary tract by solid foreign bodies.

  A stone that stops in the neck of the bladder can cause acute urinary retention

Nature of pain

A large calculus that is densely "stuck" in the kidney, as a rule, does not prevent the outflow of urine and does not cause renal colic. For an attack, an incomplete closure of the ureter with a small stone or an accumulation of crystals of urine salts is sufficient.

A pain attack with renal colic overtakes a person suddenly. Intolerable pain makes him rush about and change his position every minute in the hope of finding a position in which it will become smaller. Most often, the patient lies on his side with his knees raised to his stomach. Such restless behavior of the patient is explained by the fact that each new change of posture for a short time brings some relief.

Sometimes a person during renal colic takes the most sophisticated, bizarre body positions. People say about such behavior "climbs on the wall."

By the nature of the spread of pain, you can approximately determine which part of the urinary tract at the moment the stone is located. The lower the foreign body moves along the ureter, the more intense the pain radiates to the leg on the affected side and in the genitals.

While the obstacle is in the pelvis or in the upper segment of the ureter, the pain is localized in the lumbar region. But as soon as the stone descends into the lower segment of the urinary tract, it moves into the ileum or inguinal zone of the body.

Video: symptoms of renal colic

Diagnostics

Classical renal colic has a typical clinical picture, and its recognition for an experienced urologist does not present any special difficulties. There are several methods to eliminate all doubts about the diagnosis.

Palpation and percussion

Healthy kidneys usually do not react at all to their palpation.  With typical leaking colic, two-handed palpation of the lumbar region intensifies the attack. During pressure on the abdominal wall in the direction of the affected ureter, sharp pain is noted. With a quick coup of a person on the other side, an increase in painful sensations is also observed.

  With colic, palpation of the kidney area increases the attack

A classic manifestation of renal colic is Pasternatsky’s symptom, which is identified in this way: the examiner puts one hand on the patient’s kidney area with the palm down, and the second rib lightly but surely taps on it. If at the same time the pain intensifies, then Pasternatsky’s symptom is considered positive. If the patient does not notice discomfort, the sign is negative. Often, after determining Pasternatsky’s positive symptom, a patient with renal colic develops blood in urine.

Laboratory research

Deviations from the norm in the results of laboratory analyzes of body fluids cannot be considered as a reliable sign of renal colic. Characteristic for it is only an increased number of red blood cells (red blood cells) in the urine - hematuria.

Typical laboratory symptoms of the inflammatory process (an increase in ESR, a shift in the leukocyte count to the left, leukocytosis in the blood) are indirect and can be both in renal colic and in other acute diseases of the abdominal organs.

Changes in urine, characteristic of urolithiasis, during an attack of renal colic may not be observed due to complete blockage of the affected ureter by a foreign body.

Instrumental methods

A decisive role in the recognition of renal colic belongs to urgent x-ray studies.

X-ray radiography

First of all, a simple survey radiography of the abdominal organs is performed on the patient. Already at this stage, a shadow of a foreign body in the urinary tract is often detected, which allows diagnosis to be made with almost 100% accuracy. However, you should consider the likelihood of stones and blood clots in the veins or any inclusions in the intestine visible on the x-ray.

  The picture shows a large stone located in the renal pelvis

The presence of colic is indicated by an important radiographic sign - the rarefaction area surrounding the shadow of an enlarged kidney. It is the result of edema of the perinephric tissue.

Excretory urography

The second stage of instrumental diagnosis is excretory urography. In this case, the patient is given an intravenous radiopaque solution, which is excreted by the kidneys with urine and makes the urinary tract visible on the urograms. The method also allows you to distinguish the outlines of the stone in the pictures.

  The picture shows that the urine path in the ureter is blocked on the right

According to the results of excretory urography, the degree of impaired renal function is assessed. At the height of an attack of colic on the affected side, the organ may not work at all. However, there is an increase in the shadow of the diseased kidney due to the fact that its parenchyma is saturated with a contrast solution. This phenomenon suggests that the function of this organ is preserved and can be restored.

The urographic method reveals the release of a contrast drug with both kidneys. During an attack of colic on the affected side, an expansion of the pelvis and the upper part of the ureter is observed. The lumen of the latter is filled with a contrast solution to the level of overlap with calculus.

Differential diagnosis

There are many conditions that mimic renal colic. Therefore, it is necessary to know their main distinguishing features. For example, perforated gastric ulcer, appendicitis, acute diseases of the gallbladder and liver have to be distinguished from right-sided renal colic, pancreatitis - from left-sided, and inflammation of the female reproductive system - from bilateral.

Unlike renal colic, other diseases with a clinic of “acute abdomen” are characterized by the patient’s desire for peace, because the slightest movement intensifies the pain. As the saying goes, a person "lies in bed." And no matter how severe the pain in renal colic, the general condition of the patient suffers little. During it there are no manifestations of general intoxication, typical of diffuse peritonitis.

Table: differential signs of renal colic and related diseases

Disease	Localization and irradiation of pain	Patient Behavior	Nature of pain	Associated phenomena	Urination disorders
Renal colic	In the lumbar region; gives to the inner and front surface of the thigh and external genitalia	Restless	Acute, sudden, often with amplifications and remissions	Nausea, vomiting, paresis of the intestine; with a low location of the calculus - urge to urinate	When the stone is in the bladder segment of the ureter or in the bladder
Acute appendicitis	In the right inguinal region or in the navel; gives to the upper abdomen	Motionless	Sudden, gradually increasing	Symptoms of peritoneal irritation	Only with pelvic localization of the appendix
Acute inflammation of the uterus	In the lower abdomen; radiating to the lower back, groin, external genitalia	Usual	Gradually increasing	Symptoms of irritation of the peritoneum and pelvic floor	Sometimes
Acute lumbar sciatica	In the lower back, along the nerves; gives to the back of the thigh	Motionless	Sudden, sharp or gradually increasing	Characteristic of neurological diseases	Not
Hepatic colic	In the right hypochondrium; radiates to the shoulder blade, shoulder, back	Restless	Sudden, sharp	Tension of the anterior abdominal wall, often jaundice, diarrhea	Not
Acute pancreatitis	In the region of the left kidney	Motionless; often shock of varying severity	Sudden, sharp, piercing	Signs of general intoxication and peritonitis	Not
Intestinal obstruction	Most often - throughout the abdominal cavity, without a distinct localization	Restless; often shock of varying degrees	Sudden, cramping	Depend on the level of obstruction	Not

Prognosis and complications

If the stones are small and smooth (up to 6 mm in diameter), then in the vast majority of cases during renal colic they go outside on their own, and there is no need for surgical aids. The prognosis is worse with large stones with spike-like growths.

With prolonged, non-stopping medication pain attacks, in order to restore the outflow of urine in a hospital, one has to resort to catheterization of the urinary tract. In the most severe cases, with the ineffectiveness of all conservative measures, the patient will have surgery: dissection of the anterior abdominal wall and ureter with stone extraction. Fortunately, such a need is extremely rare.

The following factors directly affect the possibility of complications:

• the underlying disease against which renal colic has occurred;
• the degree of overlap of the lumen of the ureter;
• general condition of the patient’s body and his age;
• timeliness and accuracy of rendered first aid and medical care.

Bilateral obstruction of the ureters with stones can cause a complete stop of urination and anuria, lasting up to several days. The same complication can also occur if the outflow of urine is prevented by a foreign body on one side only, accompanied by a reflex or nerve spasm of the second ureter. Anuria is extremely life-threatening and requires emergency medical attention.

The most common severe consequences of a prolonged attack of renal colic include:

• the development of acute purulent pyelonephritis;
• uremic coma;
• septic shock;
• hydronephrosis and decreased kidney function;
• the formation of cicatricial narrowing of the ureter.

After the end of the attack, the patient's health improves, but for some time he may experience a dull sense of discomfort in the lumbar region.

Prevention

Prevention of renal colic consists in the exclusion of all possible risk factors, primarily urolithiasis. To avoid relapse, a person will have a stubborn, often long-term treatment of the underlying pathology that caused the attack.

• drinking plenty of fluids (2.5 liters of fluid per day) to maintain urine in a diluted state;
• balanced diet;
• limiting salt intake;
• the use of urological herbs, lingonberry and cranberry fruit drinks.

Video: How to Prevent Renal Colic Attacks

The topic of anatomy, physiology and human health is interesting, loved and well studied by me since childhood. In my works I use information from medical literature written by professors. I have my own extensive experience in the treatment and care of patients.

  Chills occur in the case of a sharp increase in pressure in the pelvis of the kidney, which leads to the development of pyelovenous reflux ( reverse flow of blood and urine from the pelvis and calyx 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 tremendous chills.

Separately, it is necessary to mention that after an attack of renal colic, when the occlusion of the ureter is eliminated, the pain syndrome becomes less pronounced ( pains become aching) and a relatively large amount of urine ( the accumulation of which occurred in the pelvis of the affected kidney) In the urine, impurities or blood clots, pus, and sand can be seen. Sometimes separate small stones may come out with urine - a process that is sometimes called the “birth of a stone." In this case, the passage of 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 supposed even during a conversation with a doctor ( which in some cases is enough to diagnose and start treatment), and is confirmed by conducting an examination and a series of instrumental and laboratory analyzes.

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 number 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 who have a similar clinical picture ( acute appendicitis, hepatic or intestinal colic, perforated ulcer, mesenteric vascular thrombosis, adnexitis, pancreatitis), and prevent improper and untimely treatment.


In connection with a pronounced pain syndrome, which forms the basis of the clinical picture of renal colic, people with this ailment are forced to seek medical help. During an acute attack of renal colic, adequate help can be provided by a doctor of almost any specialty. However, as mentioned above, in connection with the need to differentiate this ailment from other dangerous pathologies, you should first contact the surgical, urological or therapeutic department.

Be that as it may, the urologist is the most competent specialist in the treatment, diagnosis and prevention of renal colic and the causes that caused it. It is to this specialist that you should contact first of all if you suspect renal colic.

If renal colic occurs, it makes sense to call an ambulance, as this will allow you to start treatment earlier aimed at eliminating pain and spasm, as well as speed up the process of transportation to the hospital. In addition, the emergency doctor makes a preliminary diagnosis and sends the patient to the department in which he will be provided with the most qualified help.

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

• poll;
• clinical examination;
• ultrasound procedure;
• x-ray research methods;
• urine laboratory tests.

Poll

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

During the survey, the following facts are clarified:

• Characterization 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 only from the words of the patient. The doctor needs to be informed when nausea has appeared, whether it is associated with eating, whether it is exacerbated in some situations. It is also necessary to report episodes of vomiting, if any, about their connection with food intake, about a change in general condition after vomiting.
• Chills, fever.   It is necessary to inform the doctor about the developed chills and increased body temperature ( if, of course, its measurement was made).
• Urination changes.   During the survey, the doctor finds out if there are any changes in the act of urination, whether there are frequent urges to urinate, whether there was a discharge of blood or pus along with the urine.
• The presence of bouts of renal colic in the past. The doctor should find out whether this attack was the first to occur or have previously experienced episodes of renal colic.
• 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 that there are any pathologies of the kidneys or urinary tract increases the likelihood of renal colic.
• Surgery or injury to the urinary system or lumbar region. It is necessary to inform the doctor about the operations and injuries of the lumbar region. In some cases - about other surgical interventions, as this suggests the possible risk factors, as well as accelerate the differential diagnosis ( removal of appendix in the past eliminates acute appendicitis in the present).
• Allergic reactions.   Be sure to inform your doctor about the presence of any allergic reactions.

The following data may be required to determine risk factors:

• diet;
• infectious diseases ( both systemic and urinary tract);
• bowel disease;
• bone disease
• place of residence ( for determining climatic conditions);
• place of work ( to clarify 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 menstruation ( to exclude ectopic pregnancy), characteristic of the chair ( to eliminate intestinal obstruction), social conditions, bad habits and much more.

Clinical examination

Clinical examination for renal colic provides a fairly small amount of information, but, nevertheless, in combination with a well-conducted survey, it suggests the renal colic or its cause.

During the 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 with a hand on the back in the area of \u200b\u200bthe twelfth rib. The occurrence of pain during this procedure ( pasternatsky's symptom) 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 can be tense during an attack) The kidneys are rarely palpated during this procedure ( sometimes only their lower pole), however, if it was possible to palpate them completely, then this either indicates their omission, or a significant increase in their size.

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

Ultrasound procedure

  Ultrasound procedure ( Ultrasound scan) is an extremely informative non-invasive diagnostic method, which is based on the use of ultrasonic waves. These waves are able to penetrate into the tissues of the body and be reflected from dense structures or the boundary between two media with different acoustic resistance. 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 the quality of the image obtained by ultrasound is influenced by many factors ( intestinal gas, subcutaneous fat, fluid in the bladder) It is recommended that you first prepare for this procedure. To do this, a few days before the examination, you should 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 mode can not be limited.

An ultrasound scan without preliminary preparation may turn out to be less sensitive, however, in urgent cases when urgent diagnosis is necessary, the information received is quite enough.

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 x-rays.

With renal colic, ultrasound can visualize the following changes:

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

X-ray research methods

  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:

• Panoramic x-ray of the abdomen.   A panoramic picture of the abdomen allows you to visualize the area of \u200b\u200bthe kidneys, ureters, bladder, as well as the condition of the intestine. However, using this research method, only x-ray positive stones can be detected ( oxalate and calcium).
• Excretory urography.   The method of excretory urography is based on the introduction of a contrasting radiopositive substance into the body, which is excreted by the kidneys. This allows you to monitor blood circulation in the kidneys, evaluate the function of filtration and urine concentration, and also monitor the excretion of urine through the pyelocaliceal system and ureters. The presence of an obstacle leads to a delay in the substance at the occlusion level, which can be seen in the picture. This method allows you to diagnose blockage at any level of the ureter, regardless of the composition of the stone.
• CT scan.   Computed tomography allows you to create images that help assess the density of stones and the state of the urinary tract. This is necessary for a more thorough diagnosis before surgery.

  Despite the shortcomings of the panoramic x-ray picture, during an attack of acute renal colic, it is he who is primarily done, since in the overwhelming majority of cases, kidney stones formed are radiopositive.

Computed tomography is indicated for suspected urolithiasis caused by urate ( uric acid) and coral ( more often - post-infectious nature) stones. In addition, tomography allows you to diagnose stones that could not be identified in other ways. However, due to the higher price, computed tomography is used only in case of emergency.

Excretory urography is carried out only after complete relief of renal colic, since at the height of the attack not only a stop of the outflow of urine occurs, but the blood supply to the kidney is disrupted, which, accordingly, leads to the fact that the contrast agent is not excreted by the affected organ. This study is shown 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 contrast medium, this method has several contraindications:

Excretory urography is contraindicated in the following patients:

• with an allergic reaction to iodine and contrast medium;
• patients with myelomatosis;
• with blood creatinine levels above 200 mmol / l.

Urinalysis

  Laboratory testing of urine is an extremely important research method for renal colic, since with this ailment, changes in urine always occur ( which, however, may not be present during the 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, an analysis of morning urine ( which overnight accumulated in the bladder, and the analysis of which allows you to objectively judge the composition of impurities) and daily urine ( which is collected during the day, and the analysis of which allows 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 red blood cells or their fragments;
• the presence and quantity of bacteria;
• level of cysteine, calcium salts, oxalates, citrates, urates ( stone-forming substances);
• creatinine concentration ( kidney function indicator).

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

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

Renal Colic Treatment

The goal of treating renal colic is to eliminate pain and spasm of the urinary tract, restore urine flow, and also 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 medications that will help reduce pain and slightly improve the general condition. In this case, one should be guided by the principle of least harm, that is, it is necessary to use only those funds that will not aggravate or cause complications during the course of the disease. Preference should be given to non-drug methods, since they have the least amount of side effects.


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

• Hot tub. A hot bath, taken before the ambulance arrives, reduces spasm of the smooth muscles of the ureter, which helps to reduce pain and blockage of the urinary tract.
• Local heat. If the bathroom is contraindicated or cannot be used, you can attach a hot heating pad or a bottle of water to the lumbar region or to the stomach from the affected side.
• Smooth muscle relaxants(antispasmodics). Taking medications that promote smooth muscle relaxation can significantly reduce pain and, in some cases, even cause the stone to pass away independently. 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 be taken only with left-sided renal colic, since pains on the right side can be caused not only by this ailment, but also by acute appendicitis, cholecystitis, an ulcer and other pathologies in which self-administration of painkillers is contraindicated, as it can lubricate the clinical picture and make diagnosis difficult. To stop the pain at home, you can use ibuprofen, paracetamol, baralgin, ketans.

Drug treatment

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

The following categories of patients are subject to compulsory hospitalization:

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

  Drug treatment involves the introduction of drugs into the body that can alleviate symptoms and eliminate the pathogenic factor. In this case, preference is given to intramuscular or intravenous injections, since they provide a more rapid onset of the drug and are not dependent on the work 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 intrapulmonary pressure.

Painkillers

Pharmacological group	Key representatives
Nonsteroidal anti-inflammatory drugs	Ketorolac	Intramuscular injections in a dose of 60 mg every 6 to 8 hours for no more than 5 days ( until the pain stops)
	Diclofenac	Intramuscular injections in a dose of 75 - 100 mg per day with a further transition to tablets
Non-narcotic pain medications	Paracetamol	Inside a dose of 500 - 1000 mg. Often used in combination with narcotic painkillers, as it enhances their effect.
	Baralgin	5 ml intravenously or intramuscularly every 6 to 8 hours as needed.
Narcotic painkillers	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 spasm of smooth muscles are prescribed in combination with atropine in a dose of 1 ml of 0.1% solution.
Local anesthetics	Lidocaine   Novocaine	With these tools, a local nerve block is carried out in order to interrupt the transmission of a pain impulse with the ineffectiveness of other methods of anesthesia.

Antispasmodics

Pharmacological group	Key representatives	Dosage and method of use, special instructions
Myotropic antispasmodics	Drotaverine   Papaverine	Intramuscularly, 1 to 2 ml before relieving colic.
m-anticholinergics	Hyoscine butyl bromide	Inside or rectally, 10 to 20 mg 3 times a day
	Atropine	Intramuscularly 0.25-1 mg 2 times a day

Antiemetic drugs

Urine-lowering drugs

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

In addition to the listed drugs, drugs from the group of calcium channel blockers ( nifedipine), nitrates ( isosorbide dinitrate), alpha-blockers and methylxanthines, which are able to reduce smooth muscle spasm and eliminate pain, but whose effectiveness in renal colic is still not well understood.

In some cases, medication 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. To do this, use alkaline urine preparations.

Drugs used to dissolve uric stones

  In parallel with this, treatment of the pathology that caused 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 remove the obstruction that caused obstruction 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;
• kidney hydronephrosis ( dropsy kidney);
• wrinkling of the kidney;
• ineffectiveness of drug treatment;
• stones more than 1 cm in diameter that cannot come out 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 have been developed that allow you to break and extract stones with the least injuries.

Removing stones can be carried out in the following ways:

1. distance lithotripsy;
2. contact lithotripsy;
3. percutaneous nephrolithotomy;
4. endoscopic removal of stones;
5. ureteral stenting;
6. open kidney surgery.

Remote lithotripsy
  Remote lithotripsy is a modern method of destroying stones using a focused high-energy beam of ultrasound, which, when exposed to a stone, causes its crushing. This method is called remote because it can be used without disturbing the skin, by applying the device to the skin in the corresponding region ( for the best result and muscle relaxation, this procedure is performed under general anesthesia.).

This method of destroying stones is used when the size of the stones is less than 2 cm and their location in the upper or middle part of the pelvis.

Remote lithotripsy is contraindicated in the following situations:

• bleeding disorders;
• tightly spaced stones;
• ureteral obstruction.

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

Percutaneous nephrolithotomy
  Percutaneous nephrolithotomy is a surgical method for the removal of kidney stones, in which a small puncture is made ( about 1 cm) skin and through it a special tool is introduced, 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 removal of stones involves the introduction of a special flexible or rigid instrument equipped with an optical system through the urethra to the ureter. Moreover, due to the ability to visualize and capture the stone, this method allows you to immediately extract it.

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

Open kidney surgery
  Open kidney surgery is the most traumatic method for removing stones, which is currently practically not used. This surgical intervention can be used with significant damage to the kidney, with its purulent-necrotic change, as well as with massive stones resistant to lithotripsy.

Preparation for surgical removal of stones involves the following measures:

• Testing. Before surgery, it is necessary to pass a general urine test and a general blood test, do a fluorography, and perform an ultrasound and x-ray examination of the kidneys.
• Therapist consultation. To exclude possible contraindications and systemic pathologies, it is necessary to consult a therapist.
• Diet. A proper diet allows you to avoid excessive gas formation and accumulation of feces in the intestine, which greatly simplifies the intervention. To do this, a few days before the operation, it is necessary to abandon dairy products, fresh vegetables, and legumes. No food is allowed on the day of the procedure.

  The time of rehabilitation after surgery depends on the volume of the operation. With non-invasive and minimally invasive procedures ( lithotripsy, endoscopic and percutaneous stone removal) a 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 if there is no way to get qualified medical help.

The following agents can be used to treat renal colic:

• Hot bath. As mentioned above, hot water helps to relax the smooth muscles of the ureter. 10 g can be added to water ( 2 tablespoons) herbs of dried cinnamon, sage leaves, birch leaves, chamomile and linden flowers.
• Medicinal infusion. Six tablespoons of a mixture of birch leaves, steel root, juniper fruits and mint leaves must be poured with 1 liter of boiling water and insisted for half an hour. The resulting broth should be consumed in a warm form for an hour.
• Decoction of birch leaves. Eight tablespoons of leaves, twigs or buds of birch must be poured with 5 cups of water and boiled for 20 minutes in a water bath. Use it hot for 1 to 2 hours.

  Some medicinal plants can be used for the treatment and prevention of urolithiasis, as they help dissolve and slow 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 alternative methods:

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

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

Urate stones can be treated with the following decoctions:

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

Oxalate and phosphate stones
  The 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.

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

• Decoction of barberry flowers.   Two tablespoons of a mixture of barberry flowers, immortelle flowers, lingonberry leaves, black elderberry flowers, sweet clover grass, motherwort herb, pour a glass of boiling water, boil in a water bath for 10 minutes and insist 2 hours. Use 50 ml 3 times a day before meals.
• A decoction of grass budra. Two tablespoons of budra grass, blue cornflower flowers, pear leaves, peppermint leaves, pour one and a half glasses of boiling water, boil for 5 minutes and insist for an hour. Use 50 ml 4 times a day before meals.
• Decoction of immortelle flowers.   Two tablespoons of a mixture of immortelle flowers, budra grass, black elderberry flowers, blue cornflower flowers, bearberry leaves, hemorrhage rhizomes are poured with a glass of boiling water, boiled in a water bath for a quarter hour and insisted for 4 hours. Use in the form of heat 50 ml 4 times a day before meals.

Renal Colic Prevention

What do we have to do?

For the prevention of renal colic, it is necessary:

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

What should be avoided?

  With renal colic and urolithiasis, factors that contribute to the growth of stones and spasm of the ureters must be avoided. For this purpose, it is recommended to follow a diet with a reduced content of stone-forming substances.

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

• Oxalate stones. It is necessary to reduce the intake of oxalic acid, which is contained in lettuce, spinach, sorrel, potatoes, cheese, chocolate, tea.
• Cysteine \u200b\u200bstones.   Since cysteine \u200b\u200bstones are formed as a result of impaired cysteine \u200b\u200bmetabolism, it is recommended to limit the use of eggs, peanuts, chicken, corn, and beans.
• Phosphate stones. It is necessary to reduce the use of dairy products, cheese, vegetables.
• Urogenic stones. With the formation of uric acid stones, a decrease in the flow of uric acid, which is found in meat products, smoked meats, legumes, coffee and chocolate, is necessary.

It is necessary to avoid:

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

Acute, piercing pain in the lumbar region can dramatically change the usual rhythm of a man’s life. This is how renal colic most often manifests itself. It is important to understand what this condition is and why it occurs, because a man who has encountered this painful condition needs help.

Characteristic of renal colic

Renal colic is an acute attack of pain provoked by pathologies in the urinary system. Discomfort occurs in the lumbar region on the one hand, in rare cases - on both sides. The pain is dictated by a spasm of the smooth muscles of the urinary organs.

Colic is a response of the body to a violation of the outflow of urine from the kidney or a change in blood circulation. Most often, such phenomena are observed with urolithiasis, in which stones emerging from the kidneys damage the walls of the ureter and block (completely or partially) the urinary canal.

Renal colic most often occurs as a result of stone movement from the kidney to the ureter and bladder

How does renal colic manifest

Renal colic has a number of characteristic features:

• sharp, unbearable pain in the lower back (it can be cramping or permanent);
• increased anxiety;
• discomfort gives to the side, stomach, genitals, leg;
• hematuria (there is blood in the urine);
• nausea, vomiting;
• temperature increase;
• increased urination (if the stone blocked the ureter, then there is very little urine);
• bloating;
• diarrhea or constipation.

With severe attacks, a man may experience pain shock. This condition is accompanied by a weakening of the pulse, profuse sweating, increased pressure, pallor of the skin.

The attack can last from 3 hours to 18, sometimes with short breaks.

Renal colic - video

Reasons and development factors

Renal colic is classified as nonspecific symptoms, since various reasons can provoke it. Among them:

• Urolithiasis disease. Stones formed in the kidneys with the flow of urine can enter the ureter. The movement of the calculus along a narrow channel causes an intolerable attack of pain. Some stones have sharp “spikes” and can injure the ureter (which is why blood appears in the urine). And sometimes the calculus gets stuck in the channel. This leads to a deterioration in the outflow of urine and the expansion of the renal capsule.
• Jade The appearance of renal colic can be caused by various inflammatory processes that occur in the kidneys (for example,). Such ailments provoke irritation of the bean-shaped organ, as a result of which the latter reacts with intense spasms.
• Tumor of the kidney. A neoplasm in the structure of the organ may not bother the patient for a long time. Tumor growth over time leads to tissue compression. This causes irritation of the kidney, which immediately responds with spasms.
• Tuberculosis of the kidney. An infectious disease affects the kidney tissue. This leads to organ irritation and spasm.
•   . This is a pathology in which kidney prolapse is diagnosed. The mobility of the bean-shaped organ can provoke an attack of severe pain.
• Kidney injury. Any damage, blows to the lumbar region can lead to the appearance of strong, bursting pain.
• Anomalies of the urinary system. Congenital or acquired organ changes may underlie severe discomfort. For example, outflow of urine is significantly complicated by narrowing of the urethra, ureter.
• Tumor processes in neighboring organs. The growth of neoplasms in the prostate gland, rectum can compress the ureter.

Provocative factors

The appearance of renal colic can be caused by the following events:

eating spicy, spicy food on the eve;

jumping

weight lifting;

alcohol abuse

shaking.

  Spicy foods can provoke an attack of renal colic.

But sometimes excruciating discomfort occurs without any previous factors. Some patients note that renal colic appeared at rest, interrupting a night's sleep.

One summer, when I ran away from all the city worries to the cottage, at three in the morning I was woken up by the persistent ringing of a mobile phone. My neighbor, a 50-year-old man, asked me to call on him immediately. In his voice it was heard that the man was ill. But the state in which I found him simply shocked me. The dream instantly disappeared. The neighbor was pale, periodically vomited. He painfully clutched his lower back, then his stomach. The sufferer could not even normally explain what was bothering him. I immediately called an ambulance. Meanwhile, the man groaned again from a painful attack. Need to relieve cramps, I thought. No-Shpa was in my medicine cabinet. Of course, the tablets were not completely anesthetized, but the neighbor said that it became a little easier.

Pathology Diagnostics

It is not easy to determine renal colic, since the pathology is manifested by those signs that are characteristic of a number of diseases.

Similar symptoms are observed with:

• acute appendicitis;
• inversion of the intestines;
• stomach ulcer;
• biliary colic.

  Initially, the doctor will examine the patient, palpate the abdomen, check the symptom of Pasternatsky

To make the patient the correct diagnosis, the doctor will initially ask about nutrition, lifestyle, existing diseases. Then the doctor will examine the patient by conducting the following studies:

• Palpation of the abdomen. During palpation of the anterior abdominal wall with true renal colic, there is an increase in pain in the area of \u200b\u200bthe "problem" ureter.
• Symptom of Pasternatsky. Slight thumping in the lower region of the kidneys causes increased pain.

• Analysis of urine. In it, red blood cells (red blood cells) and various impurities (sand, pus, blood, stone fragments, salts) can be observed.
• Blood analysis. If there is inflammation, the analysis will show an increase in white blood cells. In addition, elevated levels of urea and creatinine may indicate kidney disease.
• Ultrasound procedure. The ultrasound procedure allows you to identify stones in the kidneys or ureters. This examination gives an idea of \u200b\u200bstructural changes (thinning of the tissue, expansion of the urinary organs).
• X-ray The event reveals calculi, indicates their localization. Such a study does not show all types of stones (urate and xanthine are not visible on x-rays).
• Excretory urography. This is another X-ray examination. It is carried out after the contrast medium is injected into a vein. After a while, take pictures. If the ureter is clogged, then the contrast medium will not be able to go further.
• Computed or magnetic resonance imaging (CT or MRI). The most informative and accurate diagnostic methods. They allow a layer-by-layer study of the kidneys, ureters, bladder and identify the true causes of colic.

  Ultrasound of the kidneys allows you to identify stones, determine their location

Treatment methods

When symptoms resembling renal colic appear, you must immediately call an ambulance. The dispatcher must be informed of all the signs observed in the patient.

First aid

To alleviate the condition of a patient who has experienced renal colic, you can resort to the following measures:

1. Acceptance of an antispasmodic. To slightly reduce discomfort, it is necessary to relieve renal spasm. For this, the patient is given No-Shpu, Drotaverin, Spazmalgon. If possible, it is better to do an intramuscular injection of an antispasmodic.
2. Thermal treatments. If we are talking about real renal colic, then significant relief will bring warmth. To do this, you can attach a heating pad to the lower back or take a bath.
3. Cooking containers. It is better to empty the urea in a specially prepared container so as not to miss the exit of calculus. The value is not liquid, but the emerging stone. In the future, he is handed over to study the chemical composition. This will allow you to determine exactly which disorders occur in the body and choose the best treatment methods.

  You can take a hot bath to reduce pain in renal colic.

You can practice thermal procedures only if you are 100% sure of renal colic. If there is even the slightest doubt in the diagnosis, it is better not to resort to this method. The use of heat for appendicitis or peritonitis can lead to serious consequences.

First aid for renal colic - video

Drug therapy

To stop acute symptoms and restore urodynamics, a patient in a hospital can be prescribed such drugs:

• Antispasmodics and analgesics. Such drugs can reduce pain and relieve cramps. Most often, such means are recommended:
  • Baralgin;
  • Platifilin;
  • No-Shpu;
  • Papaverine;
  • Atropine;
  • Promedol.
• Novocainic blockade. If the attack has a protracted course and does not stop with antispasmodics, the doctor may resort to blockade. In this case, the man splits the spermatic cord.
• Antimicrobial agents. For relief of inflammatory processes, uroseptics or antibiotics may be recommended. The therapy includes the following drugs:
  • Nitroxoline;
• Fosfomycin.

Angioprotectors. These drugs are prescribed to restore blood microcirculation. Most often recommend drugs:

• Trental;

NSAIDs. Sometimes with severe pain, non-steroidal anti-inflammatory drugs can be prescribed. They have analgesic, anti-inflammatory and antipyretic properties. The treatment may include such funds:

• Diclofenac;
• Lornoxicam;

Diuretics. They are prescribed only if the outgoing stone does not exceed 4 mm in diameter. In this case, the calculus is quite able to exit on its own, without any surgical intervention. To facilitate the exit process, diuretics are prescribed:

Lasix.

Complementary medicines. With renal colic (if the calculus does not exceed 4 mm), medications that can help remove stones can be prescribed. The following preparations possess these properties:

• Glucagon;
• Nifedepine;
• Progesterone.

Further treatment tactics depend on the patient's condition and stage of the pathology. If you managed to stop the attack, the doctor will prescribe drugs that dissolve the remaining stones and prevent their re-formation.

  To quickly relieve excruciating discomfort, doctors can prescribe medications intramuscularly or intravenously

These medicines include:

• Asparkam - acts on oxalates;
• Marelin - helps with phosphate stones;
• Blemaren - effective against urates and oxalates;
• Uralit - affects cystine stones;
• Allopurinol - helps fight urate.
• Cyston - has an effect on mixed types of stones (which are soluble).

These medicines must be taken for several months so that they provide the necessary dissolution of calculi.

Doctors took the neighbor to the hospital. I could not leave him alone, and therefore went with him. After all the studies, the doctors concluded - renal colic. The man spent the rest of the night under a dropper. Little by little, his condition recovered. In the morning, the neighbor was operated on, since the stone could not come out by itself. And after 2 days we were already sitting with him in the country, drinking fragrant tea and laughing heartily, remembering the events that had happened.

Medications - Gallery

  No-Shpa allows you to quickly relieve spasms
  Levofloxacin is prescribed for the relief of inflammation   Pentoxifylline restores blood microcirculation   Novocaine is used for procaine blockade for very severe pain.
  Furosemide accelerates the outflow of urine, as a result of which the stone leaves the ureter faster   Ksefokam relieves inflammation, relieves pain   Asparkam promotes the breakdown of oxalates   Blemaren helps with oxalates and urates   Allopurinol dissolves urate

Surgery

Sometimes, with renal colic, there is a need to resort to surgical intervention. The main indications for surgery are the following conditions and pathologies:

• hydronephrosis (or dropsy of the kidney);
• ineffectiveness of drug therapy;
• complications of urolithiasis (blockage, rupture of the ureter);
• large calculi (more than 4 mm in diameter) that cannot come out on their own.

The tactics of the operation depend on the reasons that provoked renal colic, the condition and individual characteristics of the patient. The most commonly used methods are:

• Remote lithotripsy. This operation involves the destruction of kidney stones by ultrasound. In this case, the skin is not damaged. That is why the method is called remote. The device is applied to the body in the necessary area and stones are crushed through the skin.
• Contact lithotripsy. In this case, crushing of the stone occurs during direct contact. A special tube is inserted into the urinary canal and ureter. The device is led directly to the stone and the calculus is split using a laser, compressed air or ultrasound. This technique allows you to act more efficiently and accurately. In addition, during the operation, all destroyed fragments are removed.
• Percutaneous nephrolithotomy. This is a surgical stone removal. The doctor makes a small puncture of the skin through which he inserts the instrument into the cavity and carefully removes the stone.
• Endoscopic calculus removal. A special tube with an endoscopic system is inserted through the urethra. Such a device is equipped not only with a camera that allows you to visualize calculi, but also with special forceps, capturing and extracting the stone.
• Uterine stenting. This operation is used to narrow the ureter. Its essence lies in restoring the normal clearance in the channel. Using endoscopic equipment, a special cylindrical frame is inserted into the bottleneck.
• Open operation. This is the most traumatic method. Open kidney operations are performed only in extreme cases (purulent-necrotic processes, significant damage to the organ, the presence of massive stones that can not be crushed).

The duration of rehabilitation depends on the volume of surgical interventions. On average, recovery takes 2-3 days. If an open operation was performed, then rehabilitation may be delayed for 5-7 days.

Types of stone removal operations - video

Diet

A man faced with renal colic is recommended to adhere to a diet in the future. P it is prescribed by the doctor, depending on the type of calculus.

The basic principles of the diet:

• Frequent reception. It is recommended to eat food in small portions every 4 hours. It is important not to overeat, so as not to overload the body.
• Junk food. Smoked, fried, fatty foods should be excluded from the diet. It is recommended to refuse sweets and flour products.
• Water mode. It is important not to forget about drinking clean drinking water. Doctors recommend drinking 2.5-3 liters of fluid per day.
• Nutrition for oxalates. With such stones, it is necessary to limit the intake of meat, sorrel, sour fruits and berries. Do not abuse citrus, legumes, beets, tomatoes.
• Diet for urate. The following products are subject to exclusion: chocolate, cheese, nuts, and legumes. Salty foods are harmful. It is not recommended to drink strong tea, eat sour berries.
• Food with phosphates. In this case, it is necessary to exclude cottage cheese, potatoes, milk, fish from the diet. Do not abuse sweet berries and fruits.
• Nutrition with cystine stones. It is recommended to limit the intake of beans, chicken, peanuts, eggs, corn.

Harmful products - gallery

  Sorrel should not be used with oxalates   Nuts will hurt urata   Cottage cheese is not recommended for phosphate
  Corn banned with cystine stones

Folk remedies

If there is no way to get medical help, then you can use the power of folk recipes. To remove renal colic, you can use the following tools:

• Herbal bath. Hot water helps relax the smooth muscles of the ureter, making the attack faster. To enhance the effectiveness of the therapeutic bath, it is recommended to add 10 g of birch leaves, sage, cinnamon, linden, chamomile flowers to the water.
• Birch decoction. As raw materials, you can take leaves, buds or tree branches. The birch billet (8 tbsp. L.) Is poured with water (5 tbsp.). The mixture is boiled for 20 minutes in a water bath. Filter. Ready broth should be drunk hot for 1-2 hours.
• Healing infusion. It is necessary to combine the fruits of juniper, birch leaves, mint and steel roots in the same proportions. The resulting mixture (6 tablespoons) is poured with boiling water (1 liter). Insist a drink for 30 minutes. Then filter. The resulting infusion should be drunk in a warm form for 1 hour.

Forecast and consequences

The prognosis depends on the reasons that provoked renal colic, the condition of the patient, the timeliness of contacting doctors. Most often, unpleasant discomfort can be stopped with medication or with less traumatic surgery. In such situations, the patient quickly returns to a normal lifestyle.

In the future, if the cause is hidden in urolithiasis, a person is recommended to adhere to a diet that protects against the formation of stones for life.

  The prognosis of pathology largely depends on the timeliness of contacting doctors

Possible complications

Improper treatment or untimely treatment by doctors can lead to serious consequences. Most often, such complications are observed:

• Pain shock. Against the background of severe pain, pathologies of the cardiovascular, nervous or respiratory systems may develop.
• Urosepsis. Generalization (spread throughout the body) of urinary infection can be fatal.
• Pyelonephritis. In the parenchyma and pelvis of the kidney, inflammatory processes can develop.
• Bladder pathology. Long-term urinary impairment can lead to the inability to completely empty the bladder in the future.
• Hydronephrosis. Urinary retention provokes a pathological expansion of the pyelocaliceal apparatus of the kidney.
• The pathology of the urethra. The mucous membrane is replaced by scar tissue. This leads to atrophy of the urethra and narrowing of the urethra.
• Nephrosclerosis The renal parenchyma is gradually replaced by connective tissue. This significantly impairs the functioning of the kidney. In the future, this phenomenon leads to atrophy of the organ.
• Pyonephrosis Purulent-destructive processes occur inside the kidney.

Prevention

Prevention of renal colic includes a few simple rules:

• Water mode. A healthy person needs to drink at least 2–2.5 liters of water per day. In the summer heat, the amount of fluid increases to 3 liters.
• Proper nutrition. Eliminate junk food from your diet: fatty, fried, salty, smoked foods. Refuse products that promote stone formation (soda, coffee, alcohol, sorrel).
• Physical exercise. Try to lead an active lifestyle, play sports, walk in the fresh air. At the same time, remember that physical activity should be feasible.
• Dress for the weather. Avoid overcooling or overheating. Such extreme conditions serve as a trigger for the development of kidney ailments.
  To eliminate the risk of urolithiasis, you must drink at least 2 liters of water per day

A painful condition called renal colic can occur as a result of various pathologies of the urinary system. But most often, according to statistics, the source of the problem is urolithiasis. It is impossible to predict in advance what renal colic will lead to. Therefore, be sure to consult a doctor. In this case, the patient has a significantly increased chance of healing.

Renal colic is an acute attack of discomfort that forms against a blockage in the urinary tract, a violation of the outflow of urine from the kidney into the bladder. Trouble requires urgent medical attention in order to avoid serious complications.

Colic in the kidney area is the most common pathology that is referred to a nephrologist. The prevalence of an unpleasant syndrome is associated with a large number of patients suffering from the root cause of the phenomenon - urolithiasis, since often renal colic is provoked by blockage of the urinary canal with stones of various sizes.

Probable causes of pathology

About 90% of all cases of renal colic occur in the course. The exact causes of the formation of the disease are not yet known to doctors. It is believed that the disease appears against the background of several negative factors.

The likelihood of developing urolithiasis, therefore, the appearance of renal colic, is associated with the age of the patient. The risk group includes children, elderly ladies. The peak of diagnosis of the disease occurs in 30-50 years. Women suffer from the disease less often than men, due to the negligent attitude of the stronger sex to their health, the presence of many bad habits.

The remaining 10% of the total weight of patients suffer from renal colic against the background of the course of more serious pathologies that are not associated with urolithiasis:

• the course of the inflammatory process in the renal pelvis (in acute and chronic form). Urinary tract blockage occurs due to the accumulation of a large amount of pus, disruption of the excretory system;
• kidney cancer. The lumen is closed with pieces of the tumor, blood clots;
• various injuries in the kidney area lead to hematomas, urinary canals are blocked by blood clots;
•   . Unpleasant sensations are provoked by a fragment of a caseous focus;
• "Vagus kidney" (omission of the organ). In such cases, colic occurs against the background of an inflection of the ureter, discomfort intensifies during running, a sharp change in body position;
• gynecological diseases. Rupture of the fallopian tube, cyst in the ovary can lead to pain in the lower back;
• the course of acute neurological diseases (sciatica, herniated disc). Symptoms of these diseases are similar to attacks of renal colic.

Depending on the root cause of the discomfort, the physician should build a further plan for the treatment of renal colic in women. It is almost impossible to independently identify a negative factor without carrying out diagnostic manipulations.

Renal colic ICD code 10 - N23.

First signs and symptoms

Pathology is the most severe type of pain, which does not decrease with a change in body position. An attack of renal colic appears suddenly, a person may not suspect the presence of any health problems.

Signs of renal colic include:

• pain is often localized on one side of the gingerbread department (both kidneys are rarely affected at the same time);
• discomfort are paroxysmal in nature;
• pain intensifies during urination;
• sensations can spread to the perineum, inner thigh;
• urine may include blood clots, impurities of pus, which indicates damage to the urinary tract;
• serious pathological conditions are characterized by a sharp increase in the body, blood pressure;
• many patients complain of vomiting, stool disorders;
• urine volume decreases significantly against the background of blockage of the excretory canals;
• with problems of a gynecological nature, renal colic accompanies bleeding from the vagina, pain in the uterus, appendages.

Often come out with blood. After eliminating the blockage of the excretory canals, the pain usually subsides, but this does not mean that you need to forget about the incident. Any pathology requires diagnosis, timely therapy.

Note!  The pain attack can be so strong that some women lose consciousness, the skin becomes pale, blood pressure decreases significantly. In such a situation, you must immediately call an ambulance.

Diagnostics

A number of specific studies will help to make the correct diagnosis, prescribe the appropriate course of therapy:

• general examination of the patient, the study of complaints. Localization of unpleasant sensations, concomitant signs can tell what the cause of the pathology is;
• medical history of the patient. In most cases, severe renal colic appears after improper treatment or lack of therapy for urolithiasis. Data on all existing ailments of the patient is recorded in his medical record;
• family history. If urolithiasis is diagnosed in the immediate family of the patient, the likelihood of a similar disease in the patient is more than 60%;
• laboratory tests (blood test, urine of the patient), other studies (of nearby organs, if necessary, the woman is sent to a gynecologist).

The set of diagnostic manipulations is aimed at identifying the causes of the patient's malaise, finding the best treatment method.

General rules and methods of treatment

What to do with renal colic? Depending on the underlying cause of the pain, the treatment regimen varies. Give up self-medication  Follow the doctor’s recommendations.

First aid for renal colic

• provide complete peace, any movements (even walking) increase pain;
• thermal procedures (warming up the lumbar region) are allowed only if there are no inflammatory processes. If the cause of the pathology is unknown, use antispasmodics, medications help relax muscles, stop unpleasant symptoms;
• before the ambulance arrives, you can take analgesics (remember the name of the medicine, dosage, tell this information to doctors).

On a note!  The use of any liquids leads to a worsening of the situation and negative consequences.

When is hospitalization necessary?

Inpatient treatment is necessary in the following cases:

• increased body temperature, blood pressure;
• lack of urine output;
• loss of consciousness, blood / pus in the urine.

Specific therapy depends on the disease that triggered the discomfort. In most cases, doctors diagnose urolithiasis, treatment is aimed at removing stones, preventing their reappearance.

Medications

Effective medicines:

• taking antispasmodics and painkillers for renal colic (No-Shpa, Spazmalgon). Medications relax the muscles, which contributes to the natural removal of stones;
• analgesics (Ketanov, Diclofenac) are used for all diseases, narcotic painkillers are administered only by doctors;
• herbal remedies increase the effectiveness of the two previous groups of medicines (Uroholum,);
• protracted bouts of colic are stopped with novocaine blockades;
• the course of inflammatory processes - an occasion to prescribe antibiotics or antiseptics to the patient, corresponding to pathogenic microorganisms that hit the woman's kidneys or urinary tract.

The presence of a large number of stones obliges doctors to find a way to crush them. Small stones are crushed using special preparations, devices or instrumental methods. The lack of a positive result leads to the use of surgical methods for removing stones. Operations are also indicated for certain gynecological diseases, kidney cancer, and serious organ damage.

Important!  Do not delay going to the doctor, limiting yourself to painkillers. Unpleasant sensations - the body's way of asking for help. Refuse self-medication, only a specialist will help identify a negative factor and prescribe the necessary medications.

Diet and nutrition rules

An important role in therapy is played by a change in diet and diet with renal colic:

• consume at least two liters of water per day, it is allowed to take decoctions of chamomile, calendula, mineral water without gas;
• if the cause of the pathological process is not established, exclude chocolate, smoked meats, alcohol, pickles, garlic, mustard, all products irritating the mucous membranes from the diet;
• each type of stone requires a specific diet (the doctor will indicate the specific menu);
• an important role is played by the number of meals. Eat five times a day in small portions, it is strictly forbidden to starve.

After eliminating the discomfort, go in for sports, choose light physical exertion, for example, Pilates. Pay attention to the mode of rest and work, sleep at least eight hours a day. The totality of changes in lifestyle and nutrition in the best way will affect the course of chronic ailments and help to avoid relapses.

Forecast and possible complications

After the termination of an acute attack of renal colic, the patient's condition normalizes, there are slight unpleasant sensations in the lumbar region. The prognosis depends on the nature of the disease that triggered the ailment, the actions of the physician and the victim himself.

Lack of therapy, neglect of health leads to sharply negative consequences:

• decreased function of the affected kidney, up to the loss of a diseased organ;
• the transition of pyelonephritis in a chronic form;
• formation of stricture of the ureter.

  See the list of cystitis in women and the rules for their use.

The rules for preparing for kidney urography and procedure are described on the page.

Go to the address and learn about the first signs of pyelonephritis and about methods of treating the disease at home.

As a prevention of pathology, doctors recommend adhering to simple rules:

• in the absence of any complaints, visit a doctor, take a urine test once a year. The presence of a history of urinary tract diseases requires the patient to be examined every quarter;
• in the watermelon season, lean on these berries, clean the kidneys from accumulated toxins;
• treat diseases of the genitourinary system and other organs in time;
• if you suffer from urolithiasis, follow the diet, follow a special diet.

Simple rules can protect you from kidney cramps, the reasons that cause them. Protect your health, if necessary, seek help from a doctor.

Hell pain for a long time is how women describe their condition with renal colic. All about the causes of the attack and the rules for first aid for renal colic - in the next issue of the section “About medicine”: