Renal colic - causes of development, symptoms and treatment principles
Jun 07, 2018
By renal colic is understood as a sharp onset of pain in the lumbar region.Often this condition is associated with urolithiasis, but in fact, renal colic doctors are considered one of the symptoms of many pathologies of the urinary system of the body.Table of Contents: Reasons for the appearance of renal colic Symptoms of renal colic Diagnostic measures for renal colic First aid for renal colic Treatment of renal colic Preventive measures
Reasons for the appearance of renal colic
Doctors claim that the pain syndrome under consideration manifests itself against a blockage of ureter and disorderUrine flow.But the following reasons can lead to this condition:
- urolithiasis, moreover, only if the stone has closed the ureter and does not allow the urine to come out;
- tumors( benign or malignant) of the kidneys - the ureter can be blocked by a clot of blood or pus;
- necrotizing papillitis;
- pyelonephritis, flowing in a purulent form;
- kidney injury;
- is a benign and / or malignant tumor of the ureter or bladder.
Very rarely, the cause of renal colic is the compression of the ureter, which can occur during an operation on the pelvic organs, against the background of an increase in closely located lymph nodes or a tumor of the retroperitoneal space.
To cause renal colic, we need provoking factors, as the above pathologies themselves are not characterized by pain syndrome. The provoking factors in this case are:
- a long road in a car or on a train( shake);
- drugs for the treatment of urolithiasis;
- drastic limitation of the amount of liquid used, or, conversely, a sharp increase in this amount;
- a strong blow in the back.
If a blockage of the ureter occurs with a stone, the consequence is a violation of the outflow of urine.At the same time, new portions of urine continue to be produced in the renal tubules, there is no escape of this fluid from the body, and the kidney-and-pelvic renal system dilates.The longer the ureter is blocked, the faster the compression of the kidneys and the violation of its blood supply.
Please note: the size of the stone / bunch does not affect the presence or absence of renal colic.There are cases when even a small stone / clot size( 1-1.5 mm) provokes a powerful attack of pain.
Symptoms of renal colic
The main symptom of this condition is intense, severe pain in the lumbar region. To it may join:
- blood in urine - not always observed, but if the stone in the ureter has sharp edges or too large a dimension, haematuria is unavoidable;
- rapid urination occurs only if there is an obstruction to outflow of urine in the lower parts of the ureter;
- nausea and vomiting;
- complete absence of urine excretion - occurs with bilateral renal colic or in the presence of only one kidney.
Doctors emphasize that there are many pathologies that can mimic renal colic.For example, these include torsion of ovarian cysts in women, sciatica, acute appendicitis, kidney infarction, acute pleurisy, ectopic pregnancy.Therefore, independent treatment can not be carried out in any case - only a specialist will be able to make an accurate diagnosis and provide qualified medical care.
Diagnostic measures for renal colic
To determine the true causes of the pain syndrome and confirm renal colic, a number of examinations are prescribed to the patient.
The doctor reveals the soreness in the area of the anatomical location of the kidneys in the course of the ureteral points.At the same time, differential diagnosis is performed with a number of acute surgical diseases - for example, a specialist in the initial examination will distinguish an attack of acute appendicitis from renal colic.
With this type of examination, the doctor will see the enlargement of the collecting space in the kidney, stones in the ureters and kidneys and their exact location.Ultrasound examination in renal colic is considered quite informative, but in some cases it will not yield results - for example, in abnormal structures of the genitourinary system, or in obesity in the patient.
This method of examination is considered the most informative, consists in conducting radiography.First they take a picture of the kidney system, then the patient is injected with a contrast agent into the vein, which gets into the urine fast enough.After a certain period of time, the patient is taken another X-ray picture - the doctor can assess the level of urine filling with the contrast of the renal pelvis, ureter, the size of the stone and the level at which it is located in the urinary system.
Excretory urography also has contraindications - an allergy to iodine( it is contained in the used contrast substance) and thyrotoxicosis.
First aid for renal colic
If this pain syndrome occurs at home, the emergency team should be called immediately.Prior to the arrival of specialists, it is acceptable to take a warm bath or shower - this will reduce the intensity of renal colic.
Note: if there is a pregnancy in the anamnesis( even the smallest period), then the bath is contraindicated!Most likely, such an intense pain attack will indicate an ectopic pregnancy, and exposure to it with heat can lead to rupture of the fallopian tube and the exit of the fetal egg.
If the pain is unbearable, then before the arrival of specialists, you can take an anesthetic - for example, Baralgin or No-shpu.But this is an extremely undesirable act - similar drugs "smear" the clinical picture and the doctor will be difficult to diagnose.
Treatment of renal colic
If the patient is confirmed with a diagnosis of "renal colic," the treatment will be selected.Based on the etiology of the syndrome.For example, if the cause of the condition under consideration is urolithiasis, then lithokinetic therapy is possible.The essence of such treatment consists in the appointment of specific drugs that accelerate the process of the exit of the stone from the ureter.But the doctor can make such appointments only after the survey confirms the presence of a small stone. Within the framework of lithokinetic therapy, the following medications can be prescribed:
- antispasmodic - they not only reduce the intensity of pain, but also contribute to the expansion of the ureter;
- alpha blockers - relax the smooth musculature of the ureter wall;
- non-steroidal anti-inflammatory drugs - reduce edema of the ureter and have a good analgesic effect.
Usually, during this type of therapy, the stone leaves the ureter for 2-3 days, but if this does not happen, the doctors conduct an additional examination of the patient and decide to change the tactics of therapy-prescribe a remote lithotripsy.This method is considered the "gold standard" for urolithiasis - a directed beam of mechanical waves acts exactly on the stone and destroys it.This procedure is carried out necessarily under the control of ultrasound or X-ray, the effectiveness of such treatment is 95%.
Note: if the stone is standing in one place for a long time, it can result in the development of ureter fibrosis just in the place of its localization.Therefore, even knowing about urolithiasis, the patient should not take a kidney colic at home - taking strong drugs will not change the position of the stone.
To prevent the development of renal colic, the recommendations of specialists should be observed:
- daily drink at least 2, 5 liters of water;
- adhere to a balanced diet;
- to limit the use of salt( the best option would be to completely abandon it);
- avoid overheating;
- regularly eat cranberry and cowberry fruit drinks, special urological collections of medicinal herbs, but only after consulting with the urologist.
Renal colic is not just pain, it is the "signal" of the body that there are problems in the kidneys and ureters.Even if the pain was removed, it is necessary to undergo a medical examination and understand the cause of the condition in question, which will prevent the occurrence of renal colic in the future.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category