Renal colic is an acute, paroxysmal pain caused by smooth muscle spasms. This is the name of the complex symptoms associated with blockage of the urinary tract, as a result of which the outflow of urine from the kidney to the bladder is difficult.

Description of the disease

Colic can be not only renal, but also intestinal or hepatic. In the case of the kidneys, under the influence of certain factors, the outflow of urine from the kidney to the bladder along the urinary tract is disturbed. Similar factors may include kidney disease, mechanical obstruction of the duct, and genetic factors.

Pathology is quite common and requires emergency assistance to the patient, since if no assistance is provided, severe complications can develop.

Colic etiology

Renal colic can be caused by:

• Urolithiasis - more than ninety percent of attacks of renal colic develop as a result of a disease of the upper urinary tract... The disease is characterized by the deposition of so-called stones or calculi in them, which impede the outflow of urine.
• An attack of renal colic can be caused by a focus of acute inflammation in the renal pelvis - such inflammation occurs as a result of blockage with pus or mucus in pyelonephritis.
• Renal colic can occur as a result of injury to the kidney, as well as renal tuberculosis.

The cause of renal colic can be squeezing of the urinary duct with extensive hematomas, or with neoplasms of any nature in the pelvic area.

Risk factors for urolithiasis

Renal colic and urolithiasis, according to medical research, most often develop after the age of thirty, and there are fewer cases of female urolithiasis than male ones.

The research data also indicate that the disease develops more often in those patients in whose diet there is not enough silicon and molybdenum.

In addition to these factors, urolithiasis can be provoked by:

• Congenital malformations of the urinary tract with chronic urinary stasis;
• Constant physical activity, for example, during professional sports;
• Genetic predisposition - in half of the patients, the family nature of the pathology is observed;
• Malabsorption syndrome - a condition accompanied by a chronic lack of water in the body;
• Parathyroidism or polycystic renal disease - multiple cysts on the surface of the kidneys.

Renal colic is more common in patients who are addicted to salty foods or meat, milk, eggs - excess animal protein also contributes to the formation of kidney stones.

Pathogenesis

Renal colic is accompanied by cramping, acute pain. It occurs as a result of reflex spasm of the smooth muscles of the ureter, the spasm, in turn, is a response to a violation of the outflow of urine.

Pain syndrome is complemented by a change in pressure in the pelvis, as well as a violation of microcirculation in the kidneys. The affected organ, as a result of impaired microcirculation, begins to increase in size, stretching the innervated areas.

Symptoms

The first symptoms in women and men are sudden and acute pain syndrome, without any foreshadowing signs. There is no pronounced relationship between an attack of renal colic and tension, stress, physical exertion.

Signs of renal colic are:

• Sharp pain, regardless of body position or movement.
• If the stone is in the pelvis, pain syndrome is found in the lower back, can be given to the abdominal cavity and rectum, accompanied by painful urge to empty.
• When the stones are located directly in the kidneys, the pain syndrome is localized in the area of ​​the affected kidney, gives it to the groin and external genitals.
• A characteristic sign of kidney stones is pain, accompanied by nausea, vomiting. Moreover, after vomiting, the feeling of nausea does not disappear and the condition is not relieved.
• Another clear sign is the presence of blood in the urine, moreover, it can be noticeable both with the naked eye and with laboratory diagnostics if blood is ingested in microscopic quantities.
• The closer the stones are to the bladder, the more often there is a painful urge to empty the bladder.
• An increase in temperature and fever indicate that the picture has been supplemented by an infectious lesion.

The severity of pain and other symptoms does not depend on the size of the stones and may be the same for different numbers and sizes of kidney stones.

Differential diagnosis

Only a qualified doctor can indicate the symptoms and treatment of renal colic, since the disease itself, in its symptoms, is masked by many other pathologies. This stage is intended to differentiate kidney pathologies from other diseases that can cause acute pain syndrome:

• Cholecystitis, appendicitis, pancreatitis, acute intestinal obstruction or perforated ulcer;
• Acute gynecological diseases in women;
• Urethritis, prostatitis and cystitis;
• Aneurysms and neurological pathologies;
• Sciatica, sciatica.

With various pain syndromes, different differential diagnostics... For example, inflammation in the renal pelvis can resemble acute surgical diseases, which are also accompanied by vomiting, nausea, and abdominal pain.

Symptoms gynecological diseases and renal colic in women are very similar, with the location of inflammation in the middle of the ureters or their lower part.

If the stones are located in the lowest part of the ureters, frequent urge to urination, accompanied by pain, while colic and cystitis, urethritis and prostatitis should first be differentiated.

Right-sided colic

Right-sided colic must be differentiated from acute appendicitis and biliary colic. Initial symptoms are quite similar, the pain appears abruptly and immediately has an acute paroxysmal character.

The difference between renal colic and appendicitis is that in acute appendicitis, the pain is relieved by lying on the right side in an embryonic position, which does not help with acute colic.

Hepatic colic can radiate to the lower back on the right, but it is often associated with the use of fried or fatty foods. Pain from hepatic colic usually radiates upward - under the scapula and to the shoulder, while pain from renal colic often radiates downward.

Acute intestinal obstruction at first can also be characterized by cramping pains, nausea and vomiting. In addition, just as with colic, any position of the body does not change the situation, and the pain is not relieved.

But for intestinal obstruction, constant vomiting is characteristic, while with colic it is rare. Diagnosis requires listening to the abdomen, as well as analyzing urine for the presence of blood impurities in it.

Abdominal disasters

Abdominal catastrophes are called acute pancreatitis, perforated ulcer, acute cholecystitis. In a quarter of cases, the appearance of renal colic is accompanied by atypical pain, therefore its diagnosis is difficult.

Atypical pains include:

• hypochondrium;
• Clavicle;
• abdominal area;
• Heart;
• Shoulders.

Symptoms can be supplemented by signs of peritonitis, for example, high sensitivity of the abdominal wall to palpation, absence of intestinal murmurs.

In this case, the doctor can infer from the patient's behavior. In abdominal catastrophes, the patient is in a supine position, as this somewhat relieves pain, while in renal colic mobility remains.

In addition to the examples of colic differentiation described above, the peculiarity of differential diagnosis in women should be taken into account. In this case, colic should be differentiated with the following pathologies:

• Tubal abortion;
• Rupture of the fallopian tubes;
• Ovarian apoplexy;
• Torsion of the cyst legs;
• Ectopic pregnancy.

Colic can be diagnosed by interviewing the patient about the date of the last menstruation, the activity of physical activity. The pulse is measured, blood pressure- with gynecological acute pathologies, there is a decrease in blood pressure, dizziness, increased heart rate.

Urgent care

First aid is indicated only if the diagnosis is established accurately and is not in doubt. Relief of renal colic before the arrival of an ambulance is carried out as follows:

• A warm heating pad is placed on the lumbar region to relieve spasms in the ureter;
• To relieve spasms, you can take Papaverine, Baralgin, Drotaverin;
• In the absence of the listed antispasmodics in the home medicine cabinet, use half of the Nitroglycerin tablet under the tongue;
• It is imperative to remember the number and name of the drugs taken so that the visiting doctor does not make erroneous conclusions about the patient's condition.

Observation of urine for the presence of kidney stones is required. If the attack is atypical, it is better to wait for the arrival of the doctor without taking any action, since the presence of urolithiasis does not exclude the development of appendicitis or infectious lesions of the peritoneum.

Drugs

Treatment of renal colic before the arrival of the doctor can be carried out with the following drugs:

• Baralgin is a non-steroidal anti-inflammatory drug with an analgesic effect. It is injected intravenously, slowly, the ampoule is preliminarily warmed in the hand. It is not used for kidney diseases - glomerulonephritis, pyelonephritis, renal failure. Contraindicated in patients allergic to Analgin.
• Ketorol is a non-steroidal anti-inflammatory drug used to treat pain syndrome high intensity. It is administered intravenously, no more than one milliliter. Contraindicated in patients under 16 years of age, as well as in bronchial asthma, ulcers and kidney failure.
• Drotaverin - antispasmodic drug, injected intravenously up to two milliliters. Contraindicated in renal failure, hypotension, glaucoma, atherosclerosis, prostatic hyperplasia.

Hospitalization

Hospitalization of patients with renal colic is carried out in the following situations:

• The patient is over fifty years old;
• Colic in both kidneys;
• Colic with only one kidney;
• Lack of effect after the use of drugs - non-stopping colic attack;
• Signs of complications - chills, serious condition, fever;
• The impossibility of outpatient treatment of the patient.

Treatment can also be carried out on an outpatient basis, if the patient is under fifty years of age and the use of stopping drugs shows a noticeable effect.

For the treatment of renal colic, bed rest is required, diet number ten according to Pevzner. Also, patients are required to constantly monitor urine - it is collected in separate vessels to monitor the discharge of calculi.

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

Separately, it should be mentioned that after an attack of renal colic, when the ureteral occlusion is eliminated, the pain syndrome becomes less pronounced ( the pains become aching) and a relatively large amount of urine ( the accumulation of which occurred in the pelvis of the affected kidney). Impurities or clots of blood, pus, and sand may be seen in the urine. Sometimes small stones may come out with the urine, a process sometimes called "stone birth." In this case, the passage of a stone through the urethra can be accompanied by significant pain.

Diagnosis of renal colic

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

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


Due to the pronounced pain syndrome that forms the basis clinical picture renal colic, people with this ailment are forced to seek medical help... During an acute attack of renal colic, a doctor of almost any specialty can provide adequate assistance. However, as mentioned above, due to the need to differentiate this ailment with other dangerous pathologies, first of all, one should contact the surgical, urological or therapeutic department.

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

When renal colic occurs, it makes sense to call ambulance, as this will allow earlier start of treatment aimed at eliminating pain and spasm, and will also speed up the process of transportation to the hospital. Also, the ambulance doctor medical care makes preliminary diagnostics and sends the patient to the department, where he will be provided with the most qualified assistance.

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

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

Survey

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

During the survey, the following facts are found out:

• Characteristics of pain sensations. 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 ( acute, dull, aching, constant, paroxysmal), the place of its distribution, the change in its intensity when changing the position of the body and when taking pain medications.
• Nausea, vomiting. Nausea is also a subjective sensation that a doctor can only learn about from the patient's words. The doctor must be informed when the nausea appeared, whether it is associated with food intake, whether it is aggravated in some situations. It is also necessary to inform about episodes of vomiting, if any, about their connection with food intake, about a change in the general condition after vomiting.
• Chills, increased body temperature. It is necessary to inform the doctor about the developed chills and about elevated temperature body ( if, of course, it was measured).
• Changes in urination. During the interview, the doctor finds out whether there are any changes in the act of urination, whether there is an increased urge to urinate, whether there was a discharge of blood or pus along with urine.
• The presence of attacks of renal colic in the past. The doctor must find out whether the attack is a new-onset or if there have been previous episodes of renal colic.
• The presence of a diagnosed urolithiasis. It is necessary to inform the doctor about the presence of urolithiasis ( if there is one now, or was in the past).
• Diseases of the kidneys and urinary tract. The fact of the presence of any pathology of the kidneys or urinary tract increases the likelihood of renal colic.
• Surgery or injury to the organs of the urinary system or the lumbar region. It is necessary to inform the doctor about the previous operations and injuries of the lumbar region. In some cases - about other surgical interventions, as this allows us to suggest possible risk factors, as well as speed up the differential diagnosis ( removal of the appendix in the past eliminates acute appendicitis in the present).
• Allergic reactions. It is imperative to inform your doctor about any allergic reactions.

To identify risk factors, the following data may be required:

• diet;
• infectious diseases (both systemic and organs of the urinary tract);
• bowel disease;
• bone disease;
• place of residence ( to determine climatic conditions);
• place of work ( to find out working conditions and availability 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), stool characteristic ( to exclude intestinal obstruction), social conditions, bad habits and much more.

Clinical examination

A clinical examination for renal colic provides little information, but nevertheless, when combined with a well-conducted survey, it suggests 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 ​​the twelfth rib. The occurrence of pain during this procedure ( Pasternatsky's symptom) indicates damage to the kidney from 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 during this procedure are rarely palpated ( sometimes only their lower pole), however, if it was possible to palpate them completely, then this indicates either their omission, or a significant increase in their size.

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

Ultrasonography

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


Since the quality of the image obtained during ultrasound examination is influenced by many factors ( bowel gases, subcutaneous fat, fluid in the bladder) it is recommended to prepare in advance 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, and also take activated charcoal or other drugs that reduce gas formation. The drinking regimen can be unlimited.

Ultrasound examination without preliminary preparation may turn out to be less sensitive, however, in emergency cases, when urgent diagnostics are needed, the information obtained 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-ray.

In renal colic, ultrasound can visualize the following changes:

• expansion of the calyx-pelvis system;
• an increase in the size of the kidney by more than 20 mm in comparison with the other kidney;
• dense formations in the pelvis, ureters ( stones);
• changes in the structure of the kidney itself ( antecedent pathologies);
• swelling of the kidney tissue;
• purulent foci in the kidney;
• changes in hemodynamics 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 diagnostics of renal colic includes:

• Plain X-ray of the abdomen. A general view of the abdomen allows you to visualize the area of ​​the kidneys, ureters, bladder, as well as the condition of the intestines. 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 into the body of a contrast X-ray-positive substance, which is excreted by the kidneys. This allows you to monitor the blood circulation in the kidneys, to assess the filtration function and urine concentration, as well as to monitor the excretion of urine through the calyx and ureters. The presence of an obstacle leads to the retention of this substance at the level of occlusion, which can be seen in the image. This method allows you to diagnose blockage at any level of the ureter, regardless of the composition of the stone.
• CT scan. Computed tomography can create images that help assess the density of stones and the condition of the urinary tract. This is necessary for a more thorough diagnosis before surgery.

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

Computed tomography is indicated for suspected urolithiasis caused by urate ( uric acid) and coral ( more often of a post-infectious nature) stones. In addition, tomography can diagnose stones that could not be identified by other means. However, due to the higher price, computed tomography is used only when absolutely necessary.

Excretory urography is carried out only after the complete relief of renal colic, since at the height of the seizure not only a stoppage of urine outflow occurs, but also 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 indicated in all cases of pain arising in urinary tract, with urolithiasis, with the detection of blood impurities in the urine, with injuries. Due to the use of a contrast agent, this method has a number of contraindications:

Excretory urography is contraindicated in the following patients:

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

Laboratory examination of urine

A laboratory study 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 analysis of urine allows you to determine the amount and type of impurities in the urine, to identify some salts and fragments of stones, to assess the excretory function of the kidneys.

In a laboratory study, an analysis of morning urine is carried out ( which accumulated in the bladder during the night, 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 you to assess the functional ability of the kidneys).

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

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

It is imperative to conduct an analysis chemical composition 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 eliminate the root cause of the disease.

First aid for renal colic

Before the arrival of doctors, you can perform a number of procedures and take some medicines, which will help reduce pain and somewhat 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 means that will not aggravate or cause complications for the course of the disease. Preference should be given to non-drug methods, as they have the least number 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 bath. A hot bath taken before the arrival of the ambulance can help reduce spasm of the smooth muscle of the ureter, which helps to reduce pain and the degree of blockage in the urinary tract.
• Local warmth. If the bathroom is contraindicated or cannot be used, you can apply a hot water bottle or water bottle to the lumbar region or to the abdomen on the affected side.
• Smooth muscle relaxants(antispasmodics). Taking medications that help relax smooth muscles can significantly reduce pain and, in some cases, even cause the stone to pass on its own. For this purpose, the drug No-shpa ( drotaverine) in a total dose of 160 mg ( 4 tablets 40 mg or 2 tablets 80 mg).
• Pain medications. Painkillers can be taken only with left-sided renal colic, since pain on the right side can be caused not only by this ailment, but also by acute appendicitis, cholecystitis, ulcers and other pathologies in which self-administration of painkillers is contraindicated, as it can lubricate clinical picture and make it difficult to diagnose. To relieve pain at home, you can use ibuprofen, paracetamol, baralgin, ketans.

Drug treatment

The main treatment for renal colic should be in a hospital. At the same time, in some cases, there is no need for hospitalization, since the release of the stone and the restoration of the outflow of urine suggest a positive trend. 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;
• have a blockage of the urinary tract of the only functioning or transplanted kidney;
• blockage of the urinary tract is combined with signs of an infection of the urinary system, a temperature of more than 38 degrees.

Drug treatment involves the introduction into the body drugs, which can alleviate symptoms and eliminate the pathogenic factor. In this case, preference is given to intramuscular or intravenous injections, since they provide a faster onset of drug action and do not depend 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 are used with the following effects:

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

Pain medications

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

Antispasmodics

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

Antiemetic drugs

Drugs that reduce urine production

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

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

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

Drugs used to dissolve uric acid stones

In parallel with this, treatment of the pathology that has become the cause of stone formation is being carried out. For this, various vitamins and minerals can be used, nutritional supplements, drugs that reduce the concentration of uric acid, diuretics.

Surgery

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

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

• complicated urolithiasis;
• hydronephrosis of the kidney ( dropsy of the kidney);
• wrinkling of the kidney;
• inefficiency drug treatment;
• stones over 1 cm in diameter that cannot come out on their own.

Since the main cause of renal colic is urolithiasis, in most cases it becomes necessary to surgically remove stones from the urinary tract. To date, several have been developed effective methods that allow you to break and remove stones with the least injury.

Removal of stones can be done in the following ways:

1. extracorporeal lithotripsy;
2. contact lithotripsy;
3. percutaneous nephrolithotomy;
4. endoscopic stone removal;
5. ureteral stenting;
6. open kidney surgery.

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

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

Remote lithotripsy is contraindicated in the following situations:

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

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

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

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

Ureteral stenting
Ureteral stenting involves the introduction of a special cylindrical frame endoscopically, which is installed at the site of the 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 of removing stones, which is practically not used at the moment. This surgical intervention can be used with significant damage to the kidney, with its purulent-necrotic changes, as well as with massive stones that are not amenable to lithotripsy.

Preparation for surgical removal of stones involves the following activities:

• Delivery of analyzes. Before undergoing surgery, it is necessary to pass general analysis urine and complete blood count, fluorography, ultrasound and X-ray examination of the kidneys.
• Consultation of a therapist. To exclude possible contraindications and systemic pathologies, it is necessary to consult a therapist.
• Diet. The right diet avoids excess gas and congestion feces in the intestine, which greatly simplifies the intervention. To do this, a few days before the operation, you must refuse fermented milk products, fresh vegetables, legumes. No food is allowed on the day of the procedure.

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

Treatment with folk remedies

Alternative methods of treating renal colic should be resorted to only when there is no way to get qualified medical help.

The following remedies can be used to treat renal colic:

• Hot bathroom. As mentioned above, hot water helps to relax the smooth muscles of the ureter. You can add 10 g each ( 2 tablespoons) herbs of creeper, 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 infused for half an hour. The resulting broth should be consumed warm within an hour.
• Decoction of birch leaves. Eight tablespoons of birch leaves, twigs or buds must be poured with 5 glasses of water and cooked for 20 minutes in a water bath. Consume hot within 1 - 2 hours.

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

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

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

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

Uric acid stones can be treated with the following decoctions:

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

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

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

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

Prevention of renal colic

What do we have to do?

For the prevention of renal colic it is necessary:

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

What should i avoid?

In renal colic and urolithiasis, it is necessary to avoid factors that contribute to the growth of stones and spasm of the ureters. 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 for the following types of stones;

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

Avoid:

• hypothermia;
• drafts;
• systemic and urological infections;
• dehydration;
• lumbar injuries;
• a sedentary lifestyle.

Content

How can you help a person if he has an attack of renal colic, and he cannot find a place for himself because of the pain tearing him to pieces? Renal colic cannot be treated at home, but you need to know what to do in order to significantly alleviate the patient's condition and try to relieve acute spasms of the pain that torments him. Colic in the kidneys can be caused by a variety of reasons, and first aid measures should be known to relatives and friends of a person suffering from pathological diseases of the genitourinary system so that he does not suffer from painful shock at the acute stage of colic.

What is renal colic

The resulting sharp pain in the lumbar region, acute impairment of renal function, is called colic. The attack begins suddenly, at any time of the day or night. Colic develops when the cup cavity of the kidney overflows as a result of delayed outflow of urine. Stretching of the kidney and an increase in pressure in it contribute to the occurrence of severe pain syndrome, which is a consequence of the pathology that has arisen. Such an attack can last from several minutes to a week, turning a person's life into torment in the absence of therapeutic measures.

Renal colic symptoms

Kidney dysfunction syndrome can be accompanied by the following symptoms:

• acute pain attack in lumbar on one or both sides;
• the presence of blood, sandy suspension in the urine;
• frequent urination, pain when emptying the bladder;
• the spread of painful foci to the lower parts of the body - the inguinal zones, the inner surface of the thighs;
• deficiency of urination;
• bloating in the lower abdomen;
• nausea, vomiting, weakness;
• diarrhea, or vice versa, constipation;
• restless behavior.

Pain

Violation of the blood supply to the kidney, the loss of its functions leads to acute and sharp attacks of pain, the localization of which can manifest itself in different places - in the lower back on the right or left side. Painful sensations radiate (spread) to the groin area, to the lower abdomen, external genitals, inner thighs. Distinguish between left-sided and right-sided renal pain syndrome. If it is possible to relieve the attack, then the intensity of pain subsides, but weak painful sensations.

In children

In babies who themselves cannot yet speak, colic can be recognized by increased anxiety, tearing crying, and a swollen tummy. The attack can last 5-15 minutes, in some children vomiting appears. If the child knows how to speak, then, when asked about the place of localization of pain, the umbilical is indicated, lumbar region, inguinal zones. Since cramping pain can indicate serious pathologies that are fraught with serious complications, the child should be immediately shown to a doctor.

Causes

Colic can occur with the following pathologies:

• accumulation of kidney stones and blockage of the urinary tract by them;
• with bends and narrowing of the urethra, ureter (observed in men);
• in pregnant women, the fetus can provoke a pinching of the kidney;
• prolapse of the kidney (nephroptosis);
• acute pyelonephritis and other kidney diseases;
• tumors of internal organs;
• colitis;
• abnormal structure of the organs of the urinary system;
• allergies while taking various drugs;
• tuberculous kidney damage.

Diagnostics

To identify the pathology that caused the acute pain syndrome, the doctor must draw up an anamnesis of the disease, carry out differential diagnostics, ask the patient about the nature of the pain, the time of its occurrence, localization, and accompanying symptoms (was there blood in the urine, problems with urination). Also, a nephrologist can ask about illnesses suffered during his life, which were accompanied by a malfunction of the genitourinary system, the presence of pyelonephritis, about how much liquid the patient drinks, whether he has an addiction to salty foods.

After drawing up a medical history, the doctor proceeds to practical diagnostic methods:

• A primary visual examination of the patient is carried out, a careful palpation of the painful area is done.
• Blood and urine are taken for analysis. An acute inflammatory process may be indicated by an increase in the number of leukocytes in the blood and urine, the presence of creatinines and erythrocytes in the urine.
• An echographic examination of the kidneys is done in order to identify the location, structure, localization of the calculus in these organs.
• The study is carried out by the method of excretory urography.
• Sometimes computed tomography of the urinary tract is done in order to identify the cause of colic.

Treatment

To stop an attack of colic with renal dysfunction, you need to know what pathology caused this syndrome and eliminate it. Semi-fainting state of the patient, nausea, vomiting require immediate hospitalization and restoration of renal capacity in stationary conditions. If the presence of appendicitis, hepatic colic is not detected, then doctors simultaneously take measures to relieve pain and eliminate the cause of the disease.

The patient may be prescribed drugs that alkalinize urine and dissolve stones, a special diet. In this case, you will have to drink multivitamin complexes, diuretics, which eliminate the likelihood of kidney stones formation. If the cause of colic was renal tuberculosis, then special medications are prescribed to get rid of the pathology. Surgical invasive intervention is indicated in the absence of the effect of drug treatment.

First aid for renal colic

It is important to correctly diagnose the disease, since other, no less serious, formidable diseases can be mistaken for colic in renal dysfunctions - acute appendicitis, pancreatitis, intestinal obstruction. If it is established that the patient suffers from colic, then at home treatment of renal colic and first aid to eliminate the symptoms of the disease may consist of the following methods:

• Heating the sore spot with a heating pad or taking a warm bath. Heat causes the ureter and urethra to dilate, which reduces pain at home.
• Taking antispasmodic, NSAIDs that have a relaxing effect on smooth muscles and eliminate colic.
• An abundant warm drink.

Renal colic medications

To stop an acute attack, doctors prescribe the following groups of drugs:

• antispasmodics;
• pain medications;
• antiemetic drugs;
• medicines to reduce urine output (to reduce pressure in the renal pelvis);
• means that help dissolve stones and calculi.

Of the drugs that help get rid of stones in the urethra and ureter, the following can be distinguished:

• Potassium citrate. Helps maintain the desired salt balance urine to effectively dissolve stones. The dosage is assigned individually, with constant monitoring of urine analysis. You can take no more than 50 meq of medicine per day.
• Bicarbonate of soda. The solution will help dissolve the urates. The required concentration of the drug is prescribed by the doctor, you need to take a teaspoon three times a day for 2-3 months with constant monitoring of urine analysis.

Pain reliever

To relieve acute unbearable pain, doctors use the following drugs:

• Baralgin. Effectively helps to eliminate pain by relaxing muscle spasms. With colic of renal origin, 5 ml of intramuscular or intravenous administration is prescribed every 4-6 hours.
• Ketorolac. An excellent pain reliever that reduces inflammation and relieves fever. With colic, do i / m injections of 60 mg every 3-5 hours until the attack disappears completely.

Antispasmodics

Together with pain relievers, doctors use antispasmodics for renal colic, which effectively eliminate pain. This group of drugs includes the following drugs:

• Atropine. The use of the agent helps to relax the smooth muscles of the kidney, while the pain subsides, the patient feels better. Shown in / m injections with a concentration of up to 1 mg of atropine daily.
• Hyoscine butyl bromide. Reduces the tone of smooth muscles, relieves urinary tract spasm. In case of acute pain syndrome, a dropper is made with 20-40 mg of the active substance for adults, 5-10 mg for children, three times a day before the colic disappears.

No-shpa

Drotaverine has a hypotensive, antispasmodic effect, relaxes the smooth muscles of the kidneys. In an acute attack of colic, 3-4 tablets are shown at a time to relieve pain spasms. However, one should not count on the complete elimination of renal failure with a single dose of No-shpa at home. If colic is accompanied by vomiting, fever, then you should immediately call an ambulance for hospitalization of the patient.

Surgery

Surgery is indicated in the following situations:

• with complications of urolithiasis;
• dropsy of the kidney (hydronephrosis);
• stones and calculi of large diameter;
• lack of effect from previous therapy.

There are several methods of surgical treatment for colic:

• Contact and extracorporeal lithotripsy. The operation is performed on an outpatient basis, the stone is crushed by directional ultrasound remotely or by contact, with the introduction of a thin tube to the site of the stone dislocation.
• Percutaneous nephrolithotomy. A puncture is made on the skin, into which a special instrument is inserted, with which the stone is removed.
• Open operation. It is used only when the overflow of the renal pelvis has caused purulent lesions of the renal parenchyma and tissue necrosis.

Folk remedies

To stop colic, you can use the following folk recipes:

• Mix in a 1: 1 ratio dry birch leaves, mint, juniper fruits. Take 6 tbsp. l. mixture, pour a liter of boiling water, leave in the dark for 30 minutes. Drink the solution in 1 hour.
• 8 tbsp. l. pour fresh birch leaves and buds with a liter of water and cook in a water bath for 20 minutes. Drink the infusion in 1-2 hours.

Prophylaxis

You can try to avoid acute attacks of pain in renal dysfunction by observing the following rules:

• timely treat diseases of the genitourinary system;
• regularly undergo examinations by a nephrologist;
• avoid hypothermia and drafts;
• alternate sedentary and active lifestyles;
• drink at least 2 liters of clean water per day;
• take complexes containing calcium, vitamins A, C, E, D.

Video

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Acute, piercing pain in the lumbar zone can dramatically change the usual rhythm of a man's life. This is how renal colic is most often manifested. It is important to understand what this condition is and why it occurs, because a man faced with this painful condition needs help.

Characteristics 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 one side, in rare cases - on both. The pain is dictated by a spasm of the smooth muscles of the urinary organs.

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

Renal colic is most often caused by the movement of a stone from the kidney into the ureter and bladder

How does renal colic manifest?

Renal colic has a number of characteristic features:

• sharp, unbearable lower back pain (it can be cramping or persistent);
• increased anxiety;
• discomfort radiates to the side, abdomen, genitals, leg;
• hematuria (blood is present 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 painful shock. This condition is accompanied by a weakening of the pulse, profuse sweating, increased pressure, and pallor of the skin.

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

Renal colic - video

Causes and factors of development

Renal colic is classified as a nonspecific symptom because it can be triggered by various causes. Among them:

• Urolithiasis disease. Kidney stones can pass into the ureter with the flow of urine. The movement of the calculus along a narrow channel causes an intolerable attack of pain. Some stones have sharp "thorns" and can injure the ureter (which is why blood appears in the urine). And sometimes the calculus gets stuck in the canal. This leads to a deterioration in the outflow of urine and an expansion of the renal capsule.
• Jade. The appearance of renal colic can be caused by various inflammatory processes 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.
• Kidney tumor. A neoplasm in the structure of an organ may not bother the patient for a long time. Tumor growth over time leads to tissue compression. This irritates the kidney, which immediately responds with spasms.
• Kidney tuberculosis. An infectious disease affects the kidney tissue. This leads to organ irritation and spasm.
• ... This is a pathology in which a prolapse of the kidney 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 severe, bursting pains.
• Abnormalities of the urinary system. Severe discomfort may be based on congenital or acquired organ changes. For example, the outflow of urine is significantly complicated by narrowing of the urethra, ureter.
• Tumor processes in neighboring organs. Growth of neoplasms in prostate, the rectum may compress the ureter.

Provoking factors

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

taking spicy, spicy food the day before;

jumping;

lifting weights;

alcohol abuse;

shaking.

Eating spicy food can provoke an attack of renal colic

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

One summer, when I ran away from all the city worries to the dacha, at three o'clock in the morning I was awakened by the persistent ringing of my mobile. My neighbor, a 50-year-old man, asked me to visit him immediately. In his voice, one could hear that the man was feeling bad. But the state in which I found him just shocked me. The dream disappeared instantly. The neighbor was pale, he periodically vomited. He painfully clutched at the lower back, then at the stomach. The sufferer could not even properly explain what was bothering him. I immediately called an ambulance. Meanwhile, the man groaned again from the excruciating seizure. “We need to relieve spasms,” I thought. No-Shpa was in my medicine cabinet. Of course, the pills did not completely anesthetize, but the neighbor said that it became a little easier.

Diagnosis of pathology

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

A similar symptomatology is observed when:

• acute appendicitis;
• volvulus;
• stomach ulcer;
• biliary colic.

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

In order to diagnose the patient correctly, the doctor will initially ask about the diet, lifestyle, and existing diseases. Then the doctor will examine the patient, conducting the following studies:

• Palpation of the abdomen. During the palpation of the anterior abdominal wall with true renal colic, there is an increase in pain in the area of ​​the "problem" ureter.
• Symptom Pasternatsky. Light tapping on the lower back in the region of the kidneys increases the pain.

• Analysis of urine. It can contain erythrocytes (red blood cells) and various impurities (sand, pus, blood, fragments of stones, salt).
• Blood test. In the presence of inflammation, the analysis will show an increase in leukocytes. In addition, kidney pathology may indicate elevated levels urea and creatinine.
• Ultrasonography. An ultrasound scan can detect kidney or ureteral stones. This examination gives an idea of ​​structural changes (thinning tissue, enlargement of the urinary organs).
• X-ray. The measure identifies calculi, indicates their localization. Such a study does not show all types of stones (urate and xanthine stones are not visible on x-rays).
• Excretory urography. This is another x-ray examination. It is carried out after the injection of a contrast agent into a vein. After a while, they take pictures. If the ureter is blocked, the contrast medium will not be able to pass further.
• Computed tomography or magnetic resonance imaging (CT or MRI). The most informative and accurate diagnostic methods. They allow you to study the kidneys, ureters, bladder layer by layer and reveal the true causes of colic.

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

Treatment methods

If symptoms appear that resemble renal colic, you must immediately call an ambulance. The dispatcher must be informed about all the signs observed in the patient.

First aid

To alleviate the condition of a patient who is faced with renal colic, you can resort to the following measures:

1. Taking an antispasmodic. To slightly reduce the discomfort, it is necessary to remove kidney spasm... For this, the patient is given No-Shpu, Drotaverin, Spazmalgon. If possible, it is better to do intramuscular injection antispasmodic.
2. Thermal procedures. When it comes to true renal colic, warmth will bring significant relief. To do this, you can apply a heating pad to your lower back or take a bath.
3. Container preparation. It is better to empty the urea in a specially prepared container so as not to miss the exit of calculus. It is not the liquid that is of value, but the stone that comes out. In the future, it is handed over to the study of the chemical composition. This will allow you to determine exactly what disorders occur in the body and select the optimal treatment methods.

You can take a hot bath to relieve 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 about the diagnosis, it is better not to resort to this method... The use of heat for appendicitis or peritonitis can be serious.

First aid for renal colic - video

Drug therapy

To stop acute symptoms and restore urodynamics, the following means can be prescribed to the patient in a hospital setting:

• Antispasmodics and analgesics. Such drugs can reduce pain and stop spasms. The most commonly recommended remedies are:
  • Baralgin;
  • Platyphyllin;
  • No-Shpu;
  • Papaverine;
  • Atropine;
  • Promedol.
• Novocaine blockade. If the attack is prolonged and does not stop antispasmodics then the doctor may resort to blockade help. In this case, the spermatic cord is cut off from the man.
• Antimicrobial agents. For cupping inflammatory processes uroseptics or antibiotics may be recommended. Therapy includes such medications:
  • Nitroxoline;
• Fosfomycin.

Angioprotectors. These medicines are prescribed to restore blood microcirculation. The most commonly recommended drugs are:

• Trental;

NSAIDs. Sometimes nonsteroidal anti-inflammatory drugs may be prescribed for severe pain. They have analgesic, anti-inflammatory and antipyretic properties. Treatment may include:

• 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 capable of leaving on its own, without any surgical intervention. To facilitate the exit process, diuretics are prescribed:

Lasix.

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

• Glucagon;
• Nifedepine;
• Progesterone.

Further treatment tactics depend on the patient's condition and the stage of the pathology. If it was possible 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 may prescribe medication intramuscularly or intravenously.

These medications include:

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

These medicines need to be taken for several months to ensure the necessary dissolution of calculi.

The doctors took the neighbor to the hospital. I could not leave him alone, so I went with him. After all the studies, the doctors concluded - renal colic. The man spent the rest of the night under an IV. Little by little, his condition recovered. In the morning, the neighbor was operated on because the stone could not come out on its own. And after 2 days we were already sitting with him at the dacha, drinking aromatic tea and laughing heartily, remembering the events we had experienced.

Medicines - gallery

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

Surgery

Sometimes, with renal colic, it becomes necessary 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 stones (more than 4 mm in diameter) that cannot come out on their own.

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

• Remote lithotripsy. This operation involves the destruction of kidney stones with 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 required 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 tract and ureter. The device is brought 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 the surgical removal of the stone. The doctor makes a small puncture of the skin through which the instrument is inserted into the cavity and carefully removes the stone.
• Endoscopic removal of calculus. A special tube with an endoscopic system is inserted through the urethra. Such a device is equipped not only with a camera that allows visualizing calculi, but also with special forceps, grasping and removing the stone.
• Ureteral stenting. This operation is used when the ureter is narrowed. Its essence lies in the restoration of the normal lumen in the canal. With the help of endoscopic equipment, a special cylindrical frame is inserted into the narrow place.
• Open surgery. This is the most traumatic method. Open kidney operations are performed only in extreme cases (purulent-necrotic processes, significant organ damage, the presence of massive stones that cannot 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 take 5-7 days.

Types of operations to remove stones - video

Diet

A man who is faced with renal colic is advised to adhere to a dietary diet in the future. P Nutrition is prescribed by the doctor depending on the type of calculi.

Basic principles of the diet:

• Frequent use. 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 give up sweets and flour products.
• Water regime. It is important not to forget about drinking clean drinking water. Doctors recommend drinking 2.5-3 liters of liquid per day.
• Nutrition with oxalates. With such stones, it is necessary to limit the intake of meat, sorrel, sour fruits and berries. Do not overuse citrus fruits, legumes, beets, tomatoes.
• Diet with urates. The following products are subject to an exception: chocolate, cheese, nuts, legumes. Salty foods are harmful. It is not recommended to drink strong tea or consume sour berries.
• Nutrition with phosphates. In this case, it is necessary to exclude cottage cheese, potatoes, milk, fish from the diet. Do not overuse sweet berries and fruits.
• Nutrition for cystine stones. It is recommended to limit the intake of beans, chicken meat, peanuts, eggs, corn.

Harmful products - gallery

Sorrel should not be consumed with oxalates Nuts will do harm with urates Curd is not recommended for phosphates
Corn is prohibited for cystine stones

Folk remedies

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

• Herbal bath. Hot water helps to relax the smooth muscles of the ureter, making the attack go away faster. To enhance the effectiveness of the therapeutic bath, it is recommended to add 10 g of birch leaves, sage, dried cress, linden, chamomile flowers to the water.
• Birch broth. Leaves, buds or tree twigs can be taken as raw materials. A birch blank (8 tbsp. L.) Is poured with water (5 tbsp.). The mixture is boiled for 20 minutes in a water bath. They are filtering. The finished broth should be drunk hot for 1-2 hours.
• Healing infusion. It is necessary to combine juniper fruits, birch leaves, mint and steel roots in equal proportions. The resulting mixture (6 tbsp. L.) Is poured with boiling water (1 l). Infuse the drink for 30 minutes. Then filter. The resulting infusion should be drunk warm within 1 hour.

Forecast and consequences

The prognosis depends on the reasons that provoked renal colic, the patient's condition, the timeliness of seeking medical attention. Most often, unpleasant discomfort can be stopped with medication or with the help of low-traumatic surgical interventions. In such situations, the patient quickly returns to normal life.

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

The prognosis of pathology largely depends on the timeliness of visits to doctors.

Possible complications

Improper treatment or untimely access to doctors can lead to the development of serious consequences. The most common complications are:

• Painful shock. Against the background of severe pain, pathologies of the cardiovascular, nervous or respiratory systems can develop.
• Urosepsis. Generalization (spread throughout the body) of a urinary infection can be fatal.
• Pyelonephritis. In the parenchyma and pelvis of the kidney, inflammatory processes can develop.
• Bladder pathology. Prolonged disturbance of urination can lead to the inability to completely empty the bladder in the future.
• Hydronephrosis. Retention of urine provokes pathological expansion of the renal calyx-pelvis.
• Pathology of the urethra. The mucous membrane is replaced by scar tissue. This leads to urethral atrophy and narrowing of the urethra.
• Nephrosclerosis. Renal parenchyma is gradually replaced connective tissue... This significantly impairs the functioning of the kidney. In the future, this phenomenon leads to organ atrophy.
• Pyonephrosis. Purulent-destructive processes take place inside the kidney.

Prophylaxis

Prevention of renal colic includes a few simple rules:

• Water regime. A healthy person needs to consume at least 2–2.5 liters of water per day. In the summer heat, the amount of liquid increases to 3 liters.
• Proper nutrition. Eliminate junk food from the diet: fatty, fried, salty, smoked foods. Avoid foods 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 hypothermia or overheating. These extreme conditions trigger the development of kidney disease.
To eliminate the risk of developing urolithiasis, you must drink at least 2 liters of water per day.

A painful condition called renal colic can result from 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, it is imperative to consult a doctor. In this case, the patient's chances of healing are significantly increased.

Renal colic is a cramping pain caused by spasm of smooth muscles due to problems with urine flow. Basically, the symptom develops as a result of blockage of the ureters by calculi. Icb code 10-23.

Colic causes

In about 90% of cases, it becomes a provocateur of renal colic. Until now, medicine does not know exactly why sand and stones are formed in paired organs. The defeat can be found both on the right and on the left. 15-30% are diagnosed with bilateral ICD.

The main factors

The manifestations of renal colic are often associated with injury or disease that narrows or squeezes the lumen of the ureter. In this case, the blockage of the passage has a different localization - the excretory canal itself, the bladder, the renal pelvis.

The provocateurs of renal colic include:

Cause	Pathogenesis
Urolithiasis disease	The most common factor. The exit of calculus from the renal pelvis is able to block the ureter.
Pyelonephritis	An infectious process caused by streptococci, staphylococci, influenza, Escherichia coli. It is caused by desquamation of the epithelium, the appearance of purulent foci, which become an obstacle that interferes with the movement of urine.
Trauma	It is characterized by hematomas and blood clots that compress the canal.
Structural features	The risk of renal colic increases with anatomically abnormal development of the organ - dystonia, nephroptosis, abnormal attachment of the ureter to the bladder. They rarely lead to pathology; a person may not even know about the presence of such problems. Violation of the outflow is provoked by mechanical damage, infections. In this case, the attack develops unexpectedly for the patient.
Oncology	The proliferation of a benign or malignant nature compresses the ureter or pelvis of the organ. But only with a local neoplasm of the kidney, the excretory canal, or in the case of tumor growth in close proximity to them.
Tuberculosis	In about 30% of patients with this disease, pathogens are present outside the lung tissue. Often, pathogens also penetrate the kidney.
Kinked ureter	Along with the impossibility of urine outflow, there is an increase in pressure in the pelvis. It manifests itself due to mechanical damage, congenital structural anomaly, changes in the position of organs, oncology, proliferation of fibrous tissue in the retroperitoneal zone.
Additional vessel	The presence of "extra" bloodstream near the ureter can lead to a gradual narrowing of the canal.
Allergic reaction	An extremely rare symptom. Puffiness of the ureter develops due to the use of certain drugs - iodine, Codeine. It is accompanied by vasodilatation, the penetration of plasma beyond their walls, which is the cause of a negative clinic.
Blood clots	Getting into the lumen of the outflow tract, they cause a blockage. A large clot is formed due to injury, proliferation of tumors, ICD, which provoke the destruction of mucous tissues and, as a result, bleeding.
Paranephritis	It is characterized by a lesion of the kidney parenchyma, in the future, the process affects the peri-renal tissue. A large amount of pus is produced, which fills the urinary canal, causing colic.
Cystitis	Inflammation of the bladder is often caused by an infection that can spread upward, affecting the ureter.
Vesicoureteral reflex	There is a throwing of urine from the bladder into the lumen of the canal. It provokes an increase in pressure in the pelvis of the paired organs, stagnation of fluid, which becomes a provocateur of the formation of stones.
Gout	Metabolic disorders, including uric acid. Its accumulation increases the risk of the formation of urate compounds.
Cholelithiasis	The presence of calculi in gallbladder increases the likelihood of ICD by 26–32%.
Immobilization	Prolonged immobilization negatively affects all systems. The kidneys are also endangered, as the level of calcium and phosphate, vitamin D, necessary for normal metabolism, decreases.

These are not all provocateurs of the renal clique. The characteristic clinical picture develops due to the admission sulfa drugs, excessive use of ascorbic acid, gastrointestinal problems, Paget's and Crohn's diseases. Even barometric changes during a voyage by plane can cause an attack.

Associated factors

The risks of developing renal colic are divided into 2 types:

• are common;
• private.

The first group includes:

1. Floor. More often, the pathology is diagnosed among men.
2. Number of years. People in the 30-50 age group are more susceptible. In children, boys and girls, the elderly, the problem occurs much less often.

To the second:

1. Heredity.
2. Profession. Often, pathology is diagnosed in workers in hot shops.
3. Climatic conditions. People living in northern and southern regions are more at risk.
4. Active physical activity. Sometimes ICD is detected in athletes.
5. Lack of fluid in the diet, water composition in the region.
6. Frequent consumption of animal proteins, salty foods, smoked meats, chocolate.
7. Limited level of vitamin A. Causes desquamation of epithelial cells, which become the nuclei of crystals.
8. Lack or excess of vitamin D. This substance affects the ability of calcium to bind oxalic acid in the intestine, which accumulates in the kidneys and leads to the formation of oxalates. The body needs 600 IU of vitamin per day.
9. Dehydration. It is noted both against the background of a low moisture intake, which leads to an increase in urine density, and as a result of intense evaporation through the skin surface.

Important! In 55% of patients, attacks of renal colic have a family history.

Signs of renal colic in men and women

Renal colic symptoms appear suddenly in seemingly healthy person... They are not preceded by special physical activity, the picture is almost independent of external factors.

Symptom	Description
Pain	Unbearable, cramping, painful, sharp, stabbing. Dangerous, which can lead to seizures and shock. It is impossible to accept a position in which the painful sensations are weakened, it is difficult to take a breath. It can radiate to the side, lower back, anterior femoral surface, rectum, groin, genitals and abdomen - this is due to the localization of the affected area of ​​the ureter or kidney. Unlike hepatic colic, it is constant.
Hematuria	Blood in the urine may be visible to the naked eye or detected by laboratory examination of the sample.
Dysuria	Difficulties with urine output are possible. It is characterized by false desires, a small volume of fluid. The process is painful. With complete bilateral obstruction, the outflow of urine stops. If one kidney is affected, the second intensively accumulates and passes fluid through itself, so the pathology is not accompanied by a lack of urine.
Vomit	It is provoked by severe pain, leading to vegetative disorders - sweating, general weakness and nausea. Also, the reason is insufficient functioning of nerve endings directly at the site of pain localization, which causes problems in the work of the gastrointestinal tract. Symptoms of this type are not related to food, drink. It is impossible to eliminate vomiting with sorbents.
Increased flatulence	It develops against the background of an intestinal motility disorder.
Hypertension	During the period of renal colic, blood filtration by paired organs decreases, therefore, a slight increase in blood pressure is noted. Also, blood pressure rises as a result of the brain's reaction to painful sensations.
Heart rate change	Both a decrease and an increase in heart rate are likely.
Chills	There is a subfebrile temperature, 37–37.5 С.

The duration of the signs of renal colic depends on the speed of movement of the stone, it can be measured in minutes and days.

Important! If the clinical picture is observed for more than 5 days, the consequence is irreversible changes in the organs.

After eliminating an attack of renal coli, the malaise quickly disappears. Urine is excreted in a large volume, since during this time there was an accumulation of fluid in the affected kidney.

During pregnancy

The development of renal colic in a pregnant woman at a later date is often perceived as the onset of labor. And the risk of pathology is quite high - during pregnancy, urolithiasis is diagnosed in 0.2–0.8% of patients. At the same time, the conception and development of the baby does not affect the likelihood of calculus formation in any way. Most likely, even before this moment, the process of stone formation began, but the pathology proceeded latently, without a pronounced clinical picture.

More often, signs appear in the third trimester:

• cramping pain;
• the presence of blood in the urine;
• exit stone.

The symptomatology is really similar to labor and usually the diagnosis of ICD is made already in the hospital. I must say that an attack is quite capable of leading to the discharge of water and the premature birth of a baby into the world.

The main problem is to relieve pain. Pregnant women are prohibited from using most medications, as they lead to negative side effects of fetal development. Warming up is also contraindicated. Therefore, the treatment is carried out trying to minimize the risks.

Usually appoint:

1. Injections of papaverine hydrochloride 2 ml of a 2% solution, Noshpy, platifillin hydrotartrate 0.2% subcutaneously.
2. If the attack began at home, you can take 2 Avisan tablets or 20 drops of Cistenal on a piece of sugar under the tongue - the drugs stop renal colic and at the same time have an anti-inflammatory effect.

Important! It is advisable to immediately call emergency help, since the risk of labor pains and infection with renal colic increases significantly.

In children

V younger age pathology is atypical, which leads to medical errors. You can identify the problem by carefully observing the child's behavior.

1. Often, the baby incorrectly points to the navel as a place of pain localization. But sometimes the symptom really manifests itself throughout the abdomen.
2. Cries, behaves restlessly, does not allow touching the painful area.
3. Loose stools or constipation is present.
4. Bloating is noted abdominal cavity due to the accumulation of gas, reflex vomiting.

To make a correct diagnosis, you need to check for back pain, as well as examine muscle tone, especially when it comes to infant... To do this, they resort to the definition of Pasternatsky's symptom - fingertips are applied to the kidney area and shake the tissues with them.

But it is worth remembering that this method helps to suggest renal colic, and not to make a definitive diagnosis. A confirmatory result is also obtained in the case of appendicitis with an incorrect location of the appendix, thrombosis of the mesenteric vessels, and intestinal obstruction. Therefore, a thorough examination in a hospital setting is necessary.

Emergency care only stops an attack when there is no doubt. Before her arrival, parents can independently reduce the pain symptom by placing the child in a bath with a water temperature of 37–39 ̊С. If this measure does not work, Noshpu or Baralgin are used. But it is advisable to know exactly the permissible dosage.

With renal colic, the child is hospitalized. Surgical treatment is not excluded.

Important! The formation of stones in babies is usually triggered by a hereditary factor and illiterate nutrition. If the baby is breastfed, the mother should be careful about her own diet.

Complications

If treated promptly, complications do not develop. With delayed therapy or, for example, the use of medicines, the use of folk remedies without the consent of a doctor, an unfavorable outcome, even fatal, is possible.

An acute attack of renal colic is dangerous, as it provokes:

1. Obstructive pyelonephritis is one or two-sided inflammation of paired organs, accompanied by suppuration.
2. The appearance of strictures in the walls of the ureter, which leads to persistent narrowing of the lumen.
3. Urosepsis is a toxic damage to the tissues of the urinary system.
4. Nephrosclerosis or kidney atrophy.

In order not to complicate the process, at the slightest sign of renal colic, you should contact a urologist or call an ambulance.

Diagnostics

To clarify the clinical picture, the patient must describe the symptoms present in detail to the doctor. In addition, it is important to clarify the place of work, diet, the likelihood of an allergic reaction. It is advisable for women and girls to remember when the last menstruation was - this will help to exclude an ectopic pregnancy.

Both laboratory and hardware methods are used.

1. Clinical diagnostics includes analysis of urine samples to detect changes in composition. For research, provide a portion of the morning urine and daily. In the first case, the presence of impurities is determined, in the second, the functionality of the kidneys is assessed.
2. The liquid may contain leukocytes, erythrocytes or their destroyed fragments, pus.
3. The concentration of salts increases - oxalates, calcium, cysteine, urates.
4. Check the reaction to acids and alkalis.
5. During the infectious process, pathogenic bacteria are detected.
6. The creatinine rate is increasing.

Important! If a stone comes out, it is advisable to hand it over to laboratory assistants. The composition of the calculus affects the scheme of further therapy.

Hardware diagnostics:

1. Ultrasound - penetrating into the body, ultrasonic waves are reflected from dense areas, allowing you to see the features of the structure of the kidneys, bladder and the channel connecting them, calculi.
2. X-ray - helps to identify oxalate and calcium deposits.
3. Excretory urography - the introduction of a contrast solution to determine the condition blood vessels as well as the ureter. Thanks to this, it is possible to visually assess the degree of narrowing of the passage, the ability of the kidneys to maintain the required level of filtration and fluid concentration. It is used after the relief of an attack, when blood circulation and outflow of urine are restored.
4. CT is recommended to determine the density of calculi and the degree of damage to the ureter.

The program of procedures largely depends on the alleged cause of the pathology, it can be significantly expanded. But first of all, x-rays are usually taken, since in most cases, a patient with renal colic has calcium stones and oxalates. Computed tomography is not cheap, therefore it is used with insufficient information content of other methods.

Differential diagnosis

Recommended to clarify the diagnosis. Renal colic has no symptoms characteristic only of this disease. A similar clinical picture develops in many pathologies of the gastrointestinal tract, genitourinary system. With the help of laboratory tests of the provided blood and urine samples, problems with such symptoms are excluded.

Treatment tactics for men and women

The main task in renal colic is to relieve severe painful sensations, normalize fluid withdrawal, as well as find out the cause of the malaise and carry out its therapy. At the last stage, narrow specialists are involved.

First aid

The patient can independently try to anesthetize the stone outlet before the arrival of the "ambulance".

Algorithm for pre-medical therapy:

• Inhale deeply with each spasm, remain calm.
• Take an antispasmodic or analgesic - an adult is allowed to swallow 2 tablets of Drotaverin or Noshpa 80 mg each or 4 40 mg tablets. If possible, it is better to inject solutions intramuscularly. The herbal preparation Urolesan in capsules, in the form of syrup or drops will help.
• In the absence of the listed funds, Nitroglycerin placed under the tongue will do.
• With left-sided colic, Baralgin, Paracetamol, Citramon, Ketanov, Revalgin are taken. If the pain manifests itself on the right, which is characteristic of appendicitis, such drugs are prohibited, since anesthesia will lubricate the symptoms and complicate the diagnosis.
• If you are confident that the discomfort is caused by the advancement of the calculus, you can apply a heating pad to the painful area or take a hot bath.

Important! Thermal procedures are strictly prohibited in case of a clinical picture of an unknown character to the patient, as they can lead to a worsening of the condition.

In general, hospital therapy is recommended for patients with renal colic. Vital indications include:

1. Severe complications - blood pressure below 100/70 mm. rt. Art, temperature exceeding 38 ̊С.
2. Bilateral pain.
3. The presence of only one paired organ.
4. Elderly age.
5. Lack of positive effect in the provision of first aid.

In these cases, hospitalization is necessary, since doctors will restore the function of urinary excretion, which will help to avoid irreversible changes in the structure of the kidneys, and prevent a tragic outcome.

Also, patients with an unexplained nature of renal colic are sent to the hospital.

Urgent care

The arriving doctor or paramedic makes a preliminary diagnosis, on the basis of which he administers an analgesic or antispasmodic, taking into account possible contraindications... The drugs of choice include:

1. Baralgin M - incompatible with alcohol and Analgin.
2. Ketorolac - prohibited for children under 16 years of age, with asthma, acute ulcers, severe renal failure.
3. Noshpa - can not be used for renal failure and hypersensitivity. Use with caution in atherosclerosis coronary arteries, open-angle glaucoma, prostatic hyperplasia.

After providing emergency care, the patient is offered hospitalization. If agreed, transported to the inpatient department on a stretcher.

If the stone has left by the arrival of the medical team, the person often refuses to travel to the hospital. But in the first 1-3 days, medical monitoring of the condition and high-quality nursing care are necessary. It is possible that more than one calculus has undergone a shift and in the future an attack of renal colic will recur.

Inpatient drug therapy

With renal colic, treatment is carried out in a complex manner. Prescribe medicines to relieve symptoms:

Group	Action	Dosage
Pain relievers	Eliminate pain	Ketorolac i / m 3-4 times a day, 60 mg for no longer than 5 days. Diclofenac intramuscularly, 75-100 mg, with further transfer to tablets. Paracetamol 500-1000 mg. Baralgin 5 ml 3-4 times a day i / m or i / v. Codeine 1% in combination with Atropine 1%, 1 ml of each solution. Lidocaine or Novocaine for local blockade of nerve endings, if other methods do not work.
Antispasmodics	Relieve spasms of smooth muscles of the ureter	Drotaverin i / m 1–2 ml until the symptoms disappear. Atropine 0.25-1 ml / m. Hyoscine butyl bromide orally or rectally, 10–20 mg three times a day.
Reducing urine production	Reduce pressure in the renal pelvis	Desmopressin - in / in 4 mcg or in the form of a nasal spray of 10-40 mcg.
Antiemetic	Block reflex	Metoclopramide i / m 10 mg 3 times a day, further in the form of tablets.
Alkalizing urine	Dissolve uric acid stones	Sodium bicarbonate in an individual dosage, which is determined by the reaction of urine.

When joins bacterial infection, pus is present, antibiotics are introduced into the therapy program.

Average course 1-3 days.

Surgery

The operation is performed if conservative methods it is not possible to eliminate the blockage of the ureter, severe consequences of the underlying pathology have developed.

Indications:

• complicated urolithiasis;
• the size of the stones is more than 1 cm;
• lack of effect after therapy.

Modern methods provide gentle surgery with minimal risk of injury.

1. Contact lithotripsy - exposure to compressed air, ultrasound, laser beam on salt deposits. It is accompanied by a puncture of the skin or the tube of the apparatus moves through the urethra to the ureter.
2. Remote lithotripsy - ultrasound is used to destroy calculi larger than 2 cm in diameter, localized in the upper or middle part of the pelvis. It is performed without damaging the skin, but under general anesthesia for high-quality relaxation of muscle tissue. Contraindications: pregnancy, blockage of the ureter, densely packed stones, bleeding disorder.
3. Endoscopy - a flexible instrument is inserted into the ureter through the urethra to capture and remove the calculus.
4. Stenting - a metal frame is installed in the narrowed lumen, which makes it possible to widen the passage and prevent renal colic in the future.
5. Percutaneous nephrolithotomy - stones are removed through a puncture. The procedure is monitored using an X-ray unit.

Open-cavity kidney surgery is rarely used, as it is the most traumatic. It is indicated for a purulent-necrotic process, damage to organ tissues, in the presence of especially large stones.

If the surgical intervention was performed using a sparing method, the patient can leave the inpatient department after 2–3 days.

Renal colic and acute intestinal obstruction

Often, against the background of renal colic, volvulus develops. It is accompanied by severe pain, but the person's condition is considered satisfactory.

Symptoms include nausea with no relief from repeated vomiting, which can lead to a diagnosis of ileus. With renal colic, a single attack is more common.

For examination, listening to the abdominal zone is used - intense noises in the intestinal region are characteristic. Urinalysis reveals hematuria.

Diet

Meat and fish are consumed only in boiled form.

Shown to be excluded from the menu:

• salt;
• rich pastries;
• fresh bread;
• broths;
• smoked meats and sausages;
• fatty cheeses;
• fried and boiled eggs;
• salinity;
• marinades;
• canned food;
• radishes, mushrooms, spinach, legumes, sorrel, radishes, onions and garlic;
• hot spices;
• chocolate and coffee;
• fatty meats, liver, duck, brains, kidneys;
• fruits with coarse fiber.

After diagnosis, the diet is adjusted with the help of a nutritionist, who will take into account the cause and develop an optimal nutritional program.

For example, with urolithiasis, it is shown to introduce more foods with dietary fiber, which prevent the formation of stones, in the menu. To do this, it is enough to use daily:

• 100 g of coarse flour bread;
• 200 g potatoes;
• 70 g carrots;
• 30 g of beets;
• 100 g pears.

But at the same time it is necessary to know exactly the composition of calculi. Otherwise, an incorrectly selected diet can worsen the patient's condition.

• With urate compounds, they consume more dairy products, juices, fruits and vegetables, reduce the volume of meat, fish, legumes, cereals, eggs.
• In the presence of oxalates, bread made from wholemeal flour, rye and wheat bran, millet, pearl barley, oatmeal and buckwheat, dried fruits.
• If phosphaturia is detected, the diet is diversified with bakery products, poultry, fish, meat, cereals without milk, pumpkin, honey and weak coffee or tea, compotes, confectionery sweets.

The differences in the menu are huge and you cannot do without the help of a specialist.

Effective folk methods

If it is not possible to resort to medicine, renal colic therapy is performed at home. There are several recipes for reducing pain.

1. Hot bath with the addition of sage or birch leaves, dried cress, linden or chamomile flowers. For one session, 10 g of herbal raw materials is enough.
2. Infusion of steel roots, mint and birch leaves, juniper fruits. Mix the components in equal volumes and brew with 1 liter of boiling water 1 tbsp. l. collection. After half an hour, the folk remedy is filtered and drunk.
3. To soften the withdrawal of oxalates and phosphorus calculi, inflorescences of immortelle, blue cornflower and black elderberry, budra grass, burnet roots and bearberry leaves are used. A glass of boiling water is poured over 2 tbsp. l. funds and insist 15 minutes on a steam bath. Pass the solution through a sieve after 4 hours. In a warm form, drink 4 times a day after meals, 50 ml.
4. Good healing effect provide against uric acid stones fruits of barberry in combination with juniper, steel root and shepherd's purse. Steamed in a liter of boiling water 2 tbsp. l. mixture and continue heating for 15 minutes. After removing from the stove, incubate for 4 hours in a closed container. Take 50 liters four times a day before meals.

Folk recipes will help not to get sick, if you first consult with a urologist about the possibility of their use. It is necessary to take into account the characteristics of salt deposits, the risk of an allergic reaction to the ingredients, discuss the duration of the course. Otherwise, home therapy will not be beneficial.

Forecast and prevention

If you seek medical attention in a timely manner, the prognosis of renal colic is favorable. With a delay in the diagnosis and visit to the doctor, the disease becomes more complicated, which increases the likelihood of death as a result of shock, sepsis, and organ failure.

You can prevent the development of renal colic by adhering to simple recommendations:

1. The predisposition should be the basis for regular examinations and consultations with a urologist.
2. It is necessary to consume a sufficient amount of vitamins A and D. If it is not possible to replenish their reserves using natural products, use special complexes.
3. Do not interfere with sunbathing, thanks to which the body produces vitamin D on its own.
4. Do not neglect the moderate physical activity.
5. Food must contain calcium.
6. Drink at least 2 liters of fluid daily.
7. It is necessary to correct metabolic problems, treat diseases of the urinary system.
8. Be sure to follow the principles diet food to reduce the likelihood of renal colic - exclude foods that contribute to the formation of stones from the menu.
9. Do not expose the body to hypothermia.
10. Avoid injury to the lumbar region.

Preventions are adhered to constantly, if necessary, changing the usual way of life and diet.

Questions From Readers

Naturally, a person with a predisposition to renal colic is concerned about the peculiarities of the process and therapy itself. Here is the information to get the answers.

How are vomiting and renal colic related?

The reason must be sought in the placement of nerve fibers. Both the kidneys and the digestive tract receive signals from the same area. When the advancement of the stone leads to a problem with the outflow of urine, at the same time the solar plexus is irritated. This becomes a provocateur of attacks of nausea and vomiting, flatulence, difficulty with the passage of feces.

Why does the bladder seem to be full all the time?

This sensation with low urine secretion is explained by the structure nervous system... When a stone descends into the lower part of the ureter, the receptors become irritated, causing the urge to empty. The symptom is both positive and negative at the same time. In the first case, it is noted that the calculus has passed the most extended segment and will soon exit into the bladder. However, the junction of the organs is narrow and a stone of considerable size easily gets stuck in it.

Could something trigger the onset of renal colic?

As a rule, an attack of renal colic begins suddenly. Sometimes it is preceded by a long trip by car, train, or flight. The appearance of a clinical picture against the background of taking herbal remedies designed to destroy salt deposits is possible, they become provocateurs of the movement of stones. Also, the reason is back injury, prolonged abstinence from drinking fluids, after which the patient prefers to drink abundantly.

Can renal colic be confused with some other disease?

Other pathologies have similar symptoms, for example:

• intestinal colitis;
• radiculitis;
• renal infarction;
• acute pleurisy;
• appendicitis;
• torsion of the ovarian cyst;
• ectopic pregnancy.

Therefore, it is strictly prohibited self-treatment... A thorough examination is necessary to identify the cause of the pain. Differential diagnosis helps to accurately establish the type of disease.

Can a stone enter the bladder and not leave it?

This situation is quite likely when it comes to calculi of significant size, exceeding the diameter of the ureter, or the disease is complicated by a narrowing of the lumen, which prevents the stone from coming out.

What does the physical examination of the patient show?

What is ultrasound for?

Ultrasound is an affordable, inexpensive and quite informative method for the study of renal colic. Allows you to detect a stone in the ureter, its location, expansion of the renal pelvis. But with obesity and increased flatulence, anomalies of the urinary organs, ultrasound examination often does not work. Therefore, preference is given to complex hardware diagnostics.

Why is excretory urography done and what does it show?

This method for renal colic is recognized as the most informative. It takes place in 3 stages:

1. First, a picture is taken using an X-ray unit.
2. The patient is injected with a contrast solution, which penetrates into the urine.
3. Re-render the image.

Thus, a visual representation of the size of the calculus, localization in the renal pelvis or urinary canal is obtained.

There are also contraindications to the procedure. This allergic reaction on iodine, which is used to prepare the coloring liquid, and thyrotoxicosis - a pathology thyroid gland.

What is the essence of lithokinetic therapy?

This technique is based on the use of medicines that facilitate the release of large elements. Non-steroidal anti-inflammatory drugs are also used, which relax the muscle tissues lining the canal, as well as antispasmodics that expand the lumen.

How long can a stone come out with lithokinetic therapy?

It takes several days to withdraw. But expectant tactics for renal colic are interrupted if the calculus does not leave the ureter after 2-3 days. Delay is dangerous with fibrosis of the clogged area.

What is meant by extracorporeal lithotripsy

So in urology they call the "gold standard" of treatment of urolithiasis. The method has been used for 30 years and consists in using a directed flow of mechanical waves that act on salt deposits and destroy them. The procedure is performed under the control of an X-ray unit or an ultrasound machine. According to statistics, lithotripsy helps to get rid of pathology in 95% of cases.

If the painful sensations have passed, but the stone has not come out, what should be done?

Despite the disappearance of the signs of renal colic, therapy is needed. The calculus remaining in the ureter is dangerous, as it injures the walls of the passage and can move at any time. This means that the attack of renal colic will resume.

In addition, blockage of the passage leads to the accumulation of urine in the kidney and to the development of hydronephrosis, damage to the organ parenchyma. Therefore, the calculus must be removed.

At the first sign of renal colic, you need to call an ambulance. It is not worth treating yourself without knowing the exact cause of the pain, since with an erroneous "diagnosis" complications are likely to develop that will require prolonged therapy. Therefore, turning to official medicine is mandatory.