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What is renal colic?

Traditionally in medicine colic called an acute attack of excruciating cramping pains (hepatic colic, intestinal colic) caused by spasms of smooth muscle muscles.

Renal colic - complex symptomsassociated with obstruction (blockage) of the upper urinary tract, and impaired outflow of urine from kidneys into the bladder.

This is a serious pathology that requires emergency medical care and hospitalization, since with an unfavorable course, severe complications may develop.

Separately, one should single out such a rare pathology as a wandering (lowered) kidney. In such cases, attacks of renal colic are caused by kinking of the ureter, and have certain characteristics: as a rule, they occur after shaking driving, long walking, physical exertion, etc. The pain is worse in the upright position and subsides in the supine position.

What is the mechanism of pain during an attack of renal colic?
(pathogenesis of renal colic)

Cramping pain during an attack of renal colic is caused by reflex spasms of the smooth muscle of the ureter in response to an obstruction of the outflow of urine.

In addition, a significant role in the development of severe pain syndrome is played by a violation of the outflow of urine, leading to an increase in intralocal pressure, venous stasis and impaired renal microcirculation. As a result, there is an increase in the size of the affected organ, accompanied by overstretching of the richly innervated capsule.

The above pathological processes cause an extremely strong pain syndrome in renal colic.

Symptoms of an attack of renal colic

A typical attack of renal colic begins suddenly, against the background of complete health. As a rule, its development cannot be associated either with physical activity, or with nervous overstrain, or with any other unfavorable factors.

An attack of renal colic can begin at any time of the year and at any time of the day, at home or while traveling, at work or on vacation.

The main and constant sign of renal colic is excruciating pain of a cramping nature. The pain does not depend on movement, so the patient rushes around the room in the vain hope of finding a position that could alleviate his suffering in some way.

Localization and irradiation of pain, as well as some additional symptoms of renal colic, depend on the level of urinary tract obstruction.

When the stone is located in the renal pelvis, the pain is localized in the upper part of the lumbar region (in the corresponding costal-vertebral angle). In this case, the pain often radiates to the abdomen and rectum, and may be accompanied by painful tenesmus (painful urge to empty the bowel).

If the obstruction occurs in the ureter, the pain is localized in the lower back or in the side from the side of the affected kidney, and radiates along the ureter and down into the inguinal ligament, urethra, and the external genitals.

Pain syndrome is often accompanied by nausea, and vomiting that does not bring relief. This kind of symptoms are especially characteristic when the obstruction is located in the upper sections (renal pelvis, upper sections of the ureter).

A very characteristic symptom of renal colic is hematuria (blood in the urine), which can be obvious (visible to the naked eye) and microscopic (determined by laboratory tests of urine).

When the obstruction is located in the lower parts of the ureters, dysuric phenomena (frequent painful urge to urinate) may appear.

It should be noted that the severity of pain and other symptoms of renal colic does not depend on the size of the calculus, while an increase in body temperature may indicate the addition of infectious complications. A high fever with chills should be especially alert.

Differential diagnosis

General rules

Most often, renal colic has to be differentiated from the following diseases:

acute abdominal disasters (acute appendicitis, acute cholecystitis, acute pancreatitis, perforated stomach ulcer, acute intestinal obstruction);
acute gynecological pathology in women;
damage to the lower urinary tract (cystitis, in men - prostatitis and urethritis);
dissecting aortic aneurysm;
neurological pathology (herniated disc, sciatica, intercostal neuralgia).

At different levels of obstruction, it is necessary to carry out differential diagnostics with different diseases.

So, with obstruction in the renal pelvis and the upper part of the ureters, renal colic often occurs with symptoms characteristic of acute surgical diseases of the abdominal cavity (abdominal pain, nausea, vomiting, fever).

When the obstruction is located in the ureters, especially in their middle part and below, pain syndrome often radiates to the genitals, so differential diagnosis with acute diseases of the pelvic organs is necessary.

If calculi are located in the lowest segment of the ureters, the clinical picture is complemented by signs of dysuria (frequent painful urination, pain in the urethra, urge to urinate), so cystitis should be excluded, and in men also prostatitis and urethritis.

Therefore, in the differential diagnosis, you should carefully collect anamnesis, pay attention to the patient's behavior and conduct additional research in a timely manner.

Differential diagnosis of right-sided renal colic

An attack of renal colic and acute appendicitis
Right-sided renal colic should be distinguished primarily from an attack of acute appendicitis, since the initial clinical picture is largely similar. In both cases, the attack occurs suddenly, against the background of complete well-being.

In addition, when the calculus is located in the right ureter, pain in renal colic can be localized in the right iliac region - just as in acute appendicitis.

However, in the case of acute appendicitis, the pain is relieved by lying on the affected side, and worse when walking, so that patients move with a characteristic tilt forward and to the affected side.

It should also be noted that the pain syndrome in acute appendicitis is localized, and in the case of renal colic, the pain radiates down to the thigh, to the inguinal ligament and to the external genital area.

Renal and hepatic (biliary) colic
Pain with hepatic (biliary) colic may radiate to the right lumbar region. In addition, the nature of the pain syndrome is largely reminiscent of renal colic (extremely severe pain, accompanied by vomiting, which does not bring relief). As in the case of renal colic, patients with hepatic colic rush about the ward, since the intensity of the pain syndrome does not depend on the position of the body, and the general condition of the patients is relatively satisfactory.

However, an attack of hepatic colic is characterized by a connection with the intake of fatty or fried foods (as a rule, the attack occurs two to three hours after errors in the diet). In addition, pain in hepatic colic radiates upward - under the right shoulder blade, into the right collarbone, and in renal colic - downward.

Renal colic and acute intestinal obstruction

Quite often it is necessary to carry out differential diagnosis of renal colic and acute intestinal obstruction (volvulus). Acute intestinal obstruction also at the beginning of the development of pathology is characterized by the unexpected appearance of cramping pains and vomiting, which does not bring relief.

In addition, in the first phase of the development of acute intestinal obstruction, patients behave in the same way as in renal colic, since the pain is strong, does not depend on the position of the body, and the general condition is still relatively satisfactory.

However, volvulus is characterized by debilitating repeated vomiting, while in renal colic, vomiting is usually single. Auscultation of the abdomen will help to establish the diagnosis (intense intestinal murmurs are characteristic of the initial phase of acute intestinal obstruction), as well as urinalysis, which determines hematuria in case of renal colic.

Differential diagnosis of atypical renal colic and abdominal catastrophes (acute pancreatitis, gastric ulcer perforation, acute cholecystitis)

It should be noted that renal colic in 25% of cases proceeds with atypical irradiation, so that pain can spread throughout the abdomen, radiating to the hypochondrium, and even to the subclavian regions.

In addition, an acute attack of renal colic is often accompanied by symptoms of local peritonitis on the affected side, such as a sharp pain in the abdominal wall and the absence of intestinal murmurs when listening to the abdomen.

Therefore, it is difficult to carry out differential diagnosis with abdominal catastrophes, such as acute pancreatitis, perforation of a stomach ulcer, acute cholecystitis.

In such cases, attention is paid to the behavior of the patient. In case of "acute abdomen", patients, as a rule, due to their serious condition, are in bed, while patients with renal colic rush about the room, since their severe pain syndrome is combined with a relatively satisfactory general condition.

You should also pay attention to the characteristic symptoms of diseases that caused the clinic "acute abdomen".

So, the clinical picture of perforation of a stomach ulcer begins with a characteristic dagger pain, which is first localized in the epigastrium, and only then takes on a diffuse character. A specific sign of this pathology is an unusually strong reactive tension of the abdominal muscles ("board-like belly").

First of all, the doctor conducts a survey, during which he asks about the characteristics of pain - when the pain began, how did it change over time, where it is felt, where it is given, what is the nature of the pain (acute, dull, aching, is constantly present or occurs in episodic attacks), changes whether the intensity of pain when changing posture, whether pain decreased after taking pain medication. Also, the doctor asks if there was nausea and vomiting, what they provoked, whether they brought relief from the condition. The doctor is sure to be interested in the changes in urination - were there any and what character they are (for example, blood in the urine, pain during urination, etc.). After that, the doctor asks whether there have been similar attacks in the past, whether a diagnosis of urolithiasis has been made in the past, whether a person has urinary tract diseases and whether he has had injuries or operations in the lumbar region during his life.

After completing the interview, the doctor proceeds to a clinical examination, which includes the following steps:

Body temperature measurement.
Percussion of the kidneys, which is a light tapping with the edge of the palm on the twelfth rib from the back. If pain occurs during such tapping, then this is a sign of renal colic, and is called a positive Pasternatsky symptom.
Palpation of the kidneys (probing) through the anterior abdominal wall. If it is possible to palpate the kidneys, then they turn out to be enlarged, or slightly lowered.

In some cases, palpation of the abdomen is additionally performed, gynecological examination (sign up) for women and digital examination of the rectum in order to exclude other diseases that may show similar symptoms.

After the interview and clinical examination, the doctor sees the complete clinical picture, on the basis of which, in fact, the diagnosis of renal colic is made. And then, to confirm the doctor's clinical diagnosis, laboratory and instrumental examinations are prescribed.

What examinations and tests can a doctor prescribe for renal colic?

With renal colic, a general urine test is mandatory. If red blood cells are found in the urine in large quantities or blood is visible with the naked eye, then this is a sign of renal colic.

In addition, with renal colic, an ultrasound of the kidneys and urinary tract is prescribed and performed, which allows you to see and measure stones in the renal pelvis and ureters, which becomes an undoubted confirmation of the clinical diagnosis. In addition, ultrasound allows you to identify purulent foci in the kidneys, if any. Ultrasound is not a mandatory examination method for renal colic, therefore, it may or may not be prescribed depending on the level of technical equipment of the medical institution. That is, ultrasound is more of an auxiliary method for diagnosing renal colic.

Without fail, with renal colic, along with a general urine analysis, an overview X-ray of the abdomen and excretory urography are prescribed. Survey x-ray of the abdomen (sign up) allows you to identify oxalate and calcium stones (X-ray positive) in the kidneys and ureters, as well as assess the state of the intestine. Although plain radiography is not a highly informative method, since it allows only two types of stones to be detected, in renal colic, first of all, this is done from instrumental examinations, since in most cases kidney stones are X-ray positive. And if stones can be detected by plain radiography of the abdomen, other instrumental examinations may not be prescribed.

After a general urinalysis and plain radiography, an excretory urography is prescribed, which is an x-ray of the kidneys and urinary tract after the introduction of a contrast agent into them. Urography allows you to assess the blood flow in the kidneys, the formation of urine, and also to identify where the stone is located (in which part of the ureter), which provoked renal colic.

The computed tomography method is highly informative in the diagnosis of renal colic, and can replace excretory urography. Therefore, if technically feasible, computed tomography is prescribed instead of urography. But, unfortunately, in many cases, tomography is rarely prescribed due to the high cost of the method, the lack of the necessary equipment and specialists in medical institutions.

Forecast

Stones up to 5 mm in size in 98% of cases move away on their own, so the need for surgical intervention is rare.

After the cessation of an attack of renal colic, dull pain in the lumbar region persists for some time, but the patient's general condition improves significantly.

Further prognosis depends on the cause of renal colic. In the case of urolithiasis, a long, practically lifelong treatment is required.

Complications

The likelihood of complications depends on the degree of obstruction of the lumen of the urinary tract, the cause of the development of renal colic, the general condition of the body, the timeliness and adequacy of primary pre-medical and medical care.

The most common complications include:

acute obstructive pyelonephritis;
urosepsis and bacteremic shock;
decreased function of the affected kidney;
the formation of a stricture of the ureter.

Which doctor should i contact for renal colic?

With the development of renal colic, you can do two things. Firstly, you can use your own transport to get to any hospital where there is a department of urology, nephrology or surgery, and contact, respectively, to urologist (sign up), nephrologist (sign up) or surgeon (sign up)... It is optimal to contact a urologist or nephrologist, since it is these specialists who are engaged in the diagnosis and treatment of diseases of the urinary system. However, if there is no urologist or nephrologist, then a surgeon who is also qualified to diagnose and treat renal colic can be consulted.

Secondly, you can call an ambulance, and the arrived medical team will take the person to the hospital on duty around the city, where patients with a similar diagnosis are admitted and where there are appropriate specialists.

Renal colic treatment

First aid

First first aid for renal colic is performed in cases where the diagnosis is not in doubt, that is, with repeated typical attacks in patients with an established diagnosis of urolithiasis.

A warm bath or heating pad on the lumbar region helps relieve ureteral spasm and discharge of calculi. You can use antispasmodics from your home medicine cabinet. Most often, Baralgin is recommended (a medicine containing antispasmodics and an analgesic). Instead, you can take No-shpa or papaverine (antispasmodics).

In the absence of these drugs, you can use nitroglycerin (half a tablet under the tongue), which also relaxes the smooth muscle muscles, and is able to relieve spasm of the ureter.

Before the arrival of the doctor, the patient is advised to write down the medications taken, and monitor urine for the discharge of calculi (it is best to collect urine in a vessel).

It should be noted that the presence of urolithiasis does not exclude the possibility of developing another acute pathology (for example, appendicitis). Therefore, if the attack is atypical, it is better not to do anything until the doctor arrives. Heat and antispasmodics can aggravate infectious and inflammatory processes in the case of acute appendicitis or another disease from the group of pathologies with the "acute abdomen" clinic.

Emergency medical care

Drugs that help relieve pain in renal colic
After making a preliminary diagnosis of renal colic, first of all, it is necessary to relieve the pain syndrome. To do this, the patient is injected with antispasmodics or analgesics.

Drugs of choice:
1. Metamizole sodium (Baralgin M). Non-steroidal anti-inflammatory agent, analgesic. It is used for moderate pain syndrome. Adults and adolescents over 15 years of age are administered intravenously, slowly (at a rate of 1 ml / min). Before the introduction, the ampoule should be warmed in the hand. After injection, urine may be stained pink (it has no clinical significance). It is not compatible with alcohol, so chronic alcoholism is a relative contraindication to the administration of the drug. It is also better not to prescribe Baralgin M to patients with chronic kidney disease (pyelo- and glomerulonephritis), and renal failure is an absolute contraindication. In addition, the drug is contraindicated in case of hypersensitivity to pyrazolones (Analgin).
2. Ketorolac. Non-steroidal anti-inflammatory agent, analgesic. It is used for severe pain syndrome. The drug is administered at a dose of 1 ml intravenously, slowly (1 ml / 15 seconds). Age under 16 is a contraindication to prescribing the drug. In addition, the drug is contraindicated in bronchial asthma, severe renal failure and peptic ulcer disease in the acute stage.
3. Drotaverin (No-shpa). Antispasmodic. Injected intravenously, slowly 2-4 ml of a standard solution (2%). Contraindicated in case of hypersensitivity to the drug and severe renal failure. Use with caution in case of a tendency to hypotension, open-angle glaucoma, severe atherosclerosis of the coronary arteries, prostatic hyperplasia.

Indications for hospitalization with renal colic syndrome
Patients with renal colic syndrome are subject to emergency hospitalization in the following cases:

bilateral renal colic;
renal colic with a single kidney;
elderly age;
the lack of positive dynamics after the administration of drugs (intractable renal colic);
the presence of clinical signs of complications (high fever with chills, anuria (absence of urine discharge), a severe general condition of the patient);
lack of conditions for the possibility of outpatient monitoring and treatment.

Transportation of patients with renal colic is carried out on a stretcher, in the supine position.

In cases where the diagnosis of renal colic is in doubt, patients are admitted to the emergency department of a multidisciplinary hospital.

Recommendations for the relief of renal colic for patients left at home
Renal colic can be treated on an outpatient basis when there are conditions for examination and treatment, and the diagnosis is not in doubt. So with a positive effect of the administration of analgesics in young and middle-aged patients, they can be given recommendations for stopping the renal clinic at home.

With renal colic, bed or semi-bed rest is prescribed, a strict diet (table N10, with diagnosed urate urolithiasis - table N6).

For further relief of pain, thermal procedures are recommended. As a rule, a heating pad on the lumbar region or a hot bath give a good effect.

It is necessary to empty the bladder in a timely manner, using a special vessel for subsequent control of the discharge of calculi.

Patients should be aware that an ambulance should be called in the following cases:

repeated attack of renal colic;
the appearance of a fever;
nausea, vomiting;
decrease in the amount of urine discharge;
deterioration of the general condition.

All patients left for outpatient treatment are advised to visit a urologist at a polyclinic and undergo additional examination. Often in the future, treatment in a hospital is prescribed.

Diet

In cases where the cause of renal colic is not fully understood, the N10 treatment table is usually prescribed. This diet is designed to improve the functioning of the cardiovascular system, liver and kidneys, as well as to normalize metabolism.

Treatment table N10 implies a slight decrease in the energy value of the diet by reducing the consumption of fats and carbohydrates. The amount of sodium chloride is significantly limited (food is prepared without salt). Exclude heavy, indigestible food (meat and fish are served boiled), as well as products that irritate the liver and kidneys, promote flatulence, excite the nervous system, such as:

fresh bread, pastry and puff pastry products, pancakes, pancakes, pastries;
legume soups, meat, fish, mushroom broths;
sauces based on meat, fish, mushroom broth;
fatty meats, goose, duck, liver, kidneys, brains;
smoked meats, sausages, canned meat;
fatty, salted, smoked fish, caviar, canned fish;
meat and cooking fats;
salty and fatty cheeses;
hard-boiled and fried eggs;
salted, pickled, pickled vegetables;
legumes, spinach, sorrel, radish, radish, mushrooms;
spicy, fatty and salty snacks;
garlic, onions, mustard, pepper, horseradish;
chocolate, natural coffee, cocoa;
fruits with coarse fiber.

After stopping an attack of renal colic, it is necessary to undergo an examination, after which the diet should be adjusted in accordance with the diagnosis.

If the cause of renal colic is established, then during the attack, nutritional therapy is prescribed, taking into account the underlying disease. Of course, concomitant pathologies (obesity, diabetes mellitus, hypertension, etc.) are also taken into account.

Nutritional therapy as prevention of attacks of renal colic in urolithiasis (Urolithiasis)

It is statistically established that the risk of recurrent attacks with an established diagnosis of urolithiasis is about 80%.

Even the surgical removal of stones cannot guarantee recovery, since the cause of the disease - the tendency to form calculi in the upper urinary tract due to impaired metabolism - is not eliminated.

Therefore, the best prevention of new attacks is to find out the cause of stone formation and treatment. It should be remembered that inflammatory processes contribute to the formation of calculi, so that diseases such as pyelonephritis must be treated in a timely manner.

In addition, the water regime has a significant effect on the formation of stones, therefore, the amount of liquid drunk in the absence of contraindications should be increased to 3-3.5 liters or more.

The risk of stone formation is significantly reduced by the use of so-called dietary fiber (DF) - plant substances that are not exposed to digestive juices and are not absorbed.

The amount of PV required for the body can be compensated for by daily consumption of wholemeal bread 100 g, beets - 30 g, carrots - 70 g, potatoes - 200 g, apples or pears - 100 g.

With urolithiasis, a properly selected diet is one of the best means of preventing renal colic. However, the composition of the stones must be confirmed by laboratory tests, as improper diet can cause significant damage.

Diet for the prevention of renal colic caused by urate-prone ICD
If urolithiasis occurs with the formation of stones from uric acid (urate), then a diet is necessary that has an alkalizing effect on the urine.

Thus, if there is no additional indication, the N6 table, designed for patients with gout, is well suited.

Diet for the prevention of renal colic caused by urolithiasis with a tendency to form oxalates
When oxalate stones form, they try to limit foods containing oxalic acid and increase the consumption of foods containing a calcium antagonist, magnesium. Foods rich in magnesium include wheat and rye bran, wholemeal bread, oatmeal, buckwheat and pearl barley, millet, and dried fruits.

Based on the mechanism of development of pathology, carbohydrates, salt, ascorbic acid, gelatin are limited.

Thus, the following are banned:

liver, kidneys, tongue, brains, salted fish, jellies and jellies on gelatin;
meat, mushroom and fish broths and sauces;
salty snacks, smoked meats, canned food, caviar;
legumes;
sorrel, spinach, rhubarb, mushrooms;
pepper, mustard, horseradish;
chocolate, cocoa, strong coffee.

In addition, they limit beets, carrots, onions, tomatoes, black currants, blueberries, sweets, jams, confectionery, and figs.

With a combination of an increased amount of oxalates and calcium in the urine, as well as with a high alkaline reaction of urine and exacerbation of pyelonephritis, products containing calcium (primarily milk and its derivatives) are limited.

Diet for the prevention of renal colic caused by KSD with a tendency to phosphaturia
If the study has shown the phosphorus-calcium nature of stones, a tendency to phosphaturia and an alkaline reaction of urine, then it is necessary to increase the acidity of urine by increasing the proportion of "acidic" meat products.

In addition, it is necessary to limit foods that contain large amounts of phosphorus and calcium, and have an alkalizing effect.

Renal colic is the medical term for acute cramping pain in the lower back and lower abdomen. More often it is a symptom of the disease and occurs under the influence of many factors. The appearance of colic does not depend on body position or time of day.

We have already written about it, but let's take a closer look at its causes and the disease itself as a whole.

Renal colic is characterized by a violation of the outflow of urine when squeezed or obstructed in the urinary tract. At the same time, there is a sharp spasmolytic contraction of the smooth muscles of the urinary tract, which contributes to the growth of intra renal pressure. As a result of such violations, there is a feeling of sharp and sudden pain.

Contributing factors to the development can be a genetic predisposition, mild urolithiasis, infectious, bacteriological, fungal diseases, increased body temperature for a long period, lack of fluid in the body, dehydration, intense or excessive physical activity.

Renal colic and their causes:

the output of calculi with urolithiasis;
accumulation of pus, mucus, blood in the ureters;
tumor neoplasms;
inflammatory pathologies: pyelonephritis, nephritis, hydronephrosis;
kidney tuberculosis;
inflammatory diseases: urethritis, periureteritis;
blockage or other vascular pathologies of the kidneys (thrombosis, heart attack)
nephroptosis, etc.

In men, inflammatory diseases of the prostate, prostate cancer, etc. can also cause a spasm in the kidney. In women, an attack of renal colic can be caused by inflammatory processes in the uterus, appendages, fallopian tubes, cysts or ruptured ovaries, abnormalities of pregnancy, spontaneous abortions, miscarriages. Let's take a closer look at the main reasons.

Urolithiasis disease

In almost 85% of cases of pain caused by a spasm in the kidney, falls on. The formation and accumulation of calculi in the urinary system is caused by a violation of metabolic processes in the body: salt, water, electrolyte balance. This leads to an increase in the density of urine and the formation of calculi.

The state of urine is influenced by urea, creatinine, sodium, magnesium and citric acid. In this case, calcium, oxalates, uric acid contribute to the formation of calculi in urine, an increased amount of which leads to the formation of stones.

Also, the causes of kidney stones are:

Hot climatic living conditions.
High hardness of water, which is subject to daily use and its composition.
A healthy diet is the foundation of a healthy metabolism. With a lack or excess of any vitamins or minerals, the risk of calculus formation increases.
Insufficient fluid intake leads to dehydration, disruption of metabolic processes in the body and an increase in urine density.
Abnormalities in the structure and location of the organs of the urinary system.
The throwing of urine into the kidney promotes urinary stagnation.
Infectious, bacteriological or fungal agents that negatively affect the absorption of nutrients. As well as water-salt and electrolyte balances.
Gout leads to metabolic disorders and accumulation of uric acid in the body.

Urolithiasis, renal colic, accompanies only at the stage of blockage of the ureters or urinary canals, in the process of excretion of calculus, which is accompanied by pain, uremia and stagnation of urine. At the initial stages, urolithiasis pathology proceeds with the absence of a clinical picture.

Pinching or narrowing of the ureter is accompanied by an increase in pressure in the calyx-pelvic system in the kidneys. Renal colic in children often occurs for this reason.

Pathological mobility of the kidney leads to pinching or stretching of the renal vessels and ureter. occurs with dysfunction of the apparatus supporting the kidney. It is often diagnosed in women during pregnancy.

Neoplasms of a malignant (oncology) or benign (hemangioma) nature. Such obstacles can lead to a change in the direction and nature of the outflow of urine, as well as a narrowing of the lumen of the urinary tract.

Injuries in the peritoneal region, lower back can seriously harm the internal organs. With a strong blow or mechanical stress, the surface tissues are hit, on which scars are formed, causing the ureter to narrow.

With a hereditary predisposition to diseases of the urinary system, as well as genetic anomalies in the structure and location of the organ, the likelihood of colic in the kidneys increases.

Uremia

The formation of blood and its blockage of the lumen of the ureters and urethra, possibly after injuries, unsuccessful operations, tumors. Injury to the lower back and peritoneum can rupture blood vessels and open internal bleeding. When blood gets into the urine, there is a high probability of its clotting.

The cause of uremia is stones, which, while moving through the organs of the urinary system, injure them with the release of blood. Tumors, benign and malignant, reaching large sizes, put pressure on the vessels, which gradually burst and let blood flow into the urine.

Accumulation of pus

The formation of pus occurs when the kidneys are damaged by inflammatory diseases. Most often it is pyelonephritis. Large volumes of pus in the urine environment form clots and, moving along the urine, narrow the lumens of the ureters. The main causes of purulent discharge in pyelonephritis are staphylococcus viruses, Escherichia coli, Proteus and others. These infections come across the urinary organs with the flow of blood, lymph, or from other affected urinary organs. Also, the likelihood of kidney infection increases if the rules of personal hygiene are not followed, hypothermia, a decrease in the body's immune forces or diseases of the endocrine system.

Allergy

The clinic of renal colic can also occur during edema of the mucous membranes of the kidney, urethra and ureters. When the allergen enters the urinary organs, the vessels and lymph nodes expand, which put pressure on the ureters, preventing the normal outflow of urine.

Symptoms of the disease

The clinical picture depends on the underlying disease: the main symptoms of renal colic in men and women are the same - the first is a feeling of acute, piercing pain.

Bilateral renal colic is accompanied by pain on both sides of the lumbar, groin, and abdominal regions. Left-sided renal colic is manifested by pain from the side of the location of the left organ. Right-sided renal colic is manifested by pain on the right, which is often confused with inflammation of the appendix or liver pathologies.

Acute renal colic and its signs of renal colic in men leads to the appearance of a sharp cutting pain in the navel and radiating to the side of the diseased organ when the ureter flows into the pelvis. If the pain that appears in the navel radiates to the femoral region, then the problem may be in the ureter. Renal colic in men, accompanied by pain in the penis, and in women in the clitoris, indicates problems in the area of \u200b\u200bthe ureter's flow into the bladder.

The next sign is a disorder of the digestive system. These disorders are accompanied by nausea, flatulence, a feeling of not emptying the intestines. Also, single vomiting often occurs with renal colic.

Diuretic disorders manifest as a strong cutting sensation of pain during urination, which is accompanied by cuts in the groin, lumbar and pelvic regions. With renal colic, blood, blood clots, streaks, or purulent and mucous discharge are observed in the urine.

Renal colic symptoms in men and women of general intoxication: an increase in body temperature, fever and chills. An increase in blood pressure may occur, which is affected by increased kidney pressure inside or as a result of severe pain, which affects the functioning of the nervous system, causing malfunctioning of the heart.

Diagnostics

Renal colic diagnosis is carried out by interviewing and examining the patient, conducting laboratory and instrumental research methods.

Questioning and inspection

Interviewing the patient helps to determine the nature and duration of the pain syndrome, concomitant symptoms and disorders of the digestive system, cardiovascular system, as well as diuretic dysfunctions. Special attention is paid to the issue of hereditary predisposition to any pathology and the abnormal structure of the organs of the urinary system. During the survey, it is determined whether the patient had a history of inflammatory diseases, urolithiasis, tumors or nephroptosis.

Also, an important point in the process of collecting anamnesis is data on the diet, the amount of fluid consumed, the region of residence, and the place of work. The urologist also takes into account the pathology of the gastrointestinal tract, the musculoskeletal system.

Examination consists in palpation of the area of \u200b\u200bpain syndrome.

Laboratory diagnostics

Laboratory diagnostic methods involve the study of general indicators of urine, the bacteriological environment and its resistance to antibacterial drugs. For research, it is necessary to hand over the morning and daily portions of urine. In the course of laboratory diagnostics, the volume and density of urine, the presence of mucus, blood, salts, minerals, the concentration of urea and creatinine in it are determined. The data obtained helps to determine the condition of the kidneys and other urinary organs. With colic, against the background of other diseases, there is an increase in calcium, oxalates, uremia, and pus.

Instrumental research

The main research methods are ultrasound and X-ray diagnostics. These methods allow you to determine the state of the urinary system, their structure. In the course of instrumental diagnostics, it is necessary to examine the intestines, the accumulation of gases in which can cause intestinal colic, which is often confused with the renal.

Kidney pathology will be indicated by the increased size of the PCS, the growth of the boundaries of the organ, the formation and accumulation of sand, salts and stones, edema, pus.

X-ray diagnostics have clearer data in comparison with ultrasound. To make the correct diagnosis, an X-ray examination of the abdomen is performed, which helps to visualize the internal organs. If necessary, a contrast method of research can be used - it involves the introduction of an intravenous dye, which is absorbed by the organs of the urinary system and excreted in the urine.

Distinctive diagnostics

Differential diagnosis of renal colic is necessary in acute abdominal pathologies, gynecological diseases, genitourinary pathologies in men and in neurological disorders.

Renal colic and differential diagnosis is carried out by excluding the disease, which is not accompanied by the symptoms that are present in the patient.

Renal colic on the right can be an attack of appendicitis, as they have a similar symptomatic picture. Differences in pathologies:

with colic, the pain is mobile and can be given to the femoral and groin areas; with appendicitis, the pain is localized only in the right side;
in the supine position, the feeling of pain with appendicitis subsides, with colic there is no improvement.

It is necessary to distinguish between renal and hepatic colic, which are accompanied by the same clinical picture. However, with spasm in the kidney, there is a connection with the way of eating (when eating fried, fatty foods, the likelihood of spasm and pain increases three hours after eating), which is not observed with hepatic. Also, pain in pathology is directed upward, with hepatic - downward.

It is also necessary to distinguish between intestinal disorders, including obstruction or colic from a spasm in the kidney. During the exclusion study, attention is drawn to the nature of the vomiting. The first is accompanied by repeated vomiting, which does not bring relief. With the second pathology, vomiting occurs only once.

Pain associated with problems of the musculoskeletal system can be differentiated using the patient's behavioral responses to pain attacks: with problems of the musculoskeletal system, the patient freezes with spasm. The pain spreads all over the back and buttocks.

First aid

First aid for renal colic involves the use of elementary techniques to reduce pain. First aid for renal colic includes:

taking a hot bath - helps relieve spasm and eliminate pain;
the bath can be replaced with local heat by attaching a heating pad or a bottle of warm water to the sore spot;
taking antispasmodics, the most suitable drug for reducing spasm and pain is No-shpa;
pain relievers (Ketones, Ibuprofen) should be taken with extreme caution: it is permissible to take it for left-sided pain, since pain on the right side can be a sign of most other diseases.

Prophylaxis

If urolithiasis has become the cause of muscle spasm, the main preventive measure is diet, with the exception of some foods, depending on the type of stones.

Prevention of renal colic: reduce the negative effects of stress, avoid hypothermia, dehydration, injury and an inactive lifestyle.

Treatment

Urgent care for renal colic is carried out after the presumptive diagnosis has been made. To this end, renal colic help involves the intramuscular administration of antispasmodic, anti-inflammatory drugs (Metamizole, Ketorolac, Drotaverin).

Further, medical personnel, referring to how renal colic manifests itself, decide on hospitalization, which is necessary if the pain syndrome affects both organs or one in the absence of the second. Also, observation in the hospital is necessary for elderly people and patients whose pain has not disappeared after taking antispasmodics. A particular danger is spasm, accompanied by signs of intoxication, disruption of other systems.

Operation

Surgical emergency care for urolithiasis and other serious complications (hydronephrosis, wrinkling, lack of effect from drug treatment) is performed.

In case of renal colic, first aid is promptly carried out for large stones by means of remote wave crushing of stones, endoscopic and open kidney surgery.

Also, surgical intervention is necessary when there are complications of renal colic:

pyelonephritis and hydronephrosis against the background of urine retention, which leads to the development of infection;
uremic intoxication;
intoxication of the body with harmful compounds that have been accumulated during urolithiasis.

A spasm in the kidney is accompanied by a feeling of pain, which can migrate to the navel, lower back, groin. As a rule, this is one of the symptoms of kidney pathologies, therefore it does not develop on its own and is accompanied by other symptoms of the underlying disease. If pain occurs, you need to take a hot bath or apply a warm compress, take No-shpa before the ambulance arrives. In a hospital setting, pathology is treated using conservative therapy or promptly.

Pain caused by obstructed urine flow is excruciating and indicates a serious health hazard.

If the acute painful sensations in the kidney area do not go away, no matter how you change the position of the body, it is quite possible that this has begun. Symptoms in women differ in that with this disease the pain "gives" not only to the lower back, but much lower - even to the vaginal area.

Those who have given birth compare the signs of renal colic in women with prenatal contractions. The pain occurs suddenly, without any visible prerequisites and can last for a very long time.

Striking signs that indicate colic are:

localization of pain on only one side;
its paroxysmal nature;
increased painful sensations when urinating;
blood clots and pus, sometimes appearing in the urine;
high body temperature and surges in blood pressure.

Changes in urine flow are especially noticeable with this kidney problem. The fluid leaving the body becomes noticeably less, sometimes it is excreted along with it, which provoked the disease.

The characteristic manifestations of renal colic, characteristic of women, will be that the attack responds with pain in the hip, groin and genitals, leading to the inability to sit, stand and walk.

What is the reason?

The main factor that stimulates the onset of renal colic in the fairer sex is the appearance of stones in the organ, and only ten percent of the total number of cases is caused by gynecological and other problems.

The reasons for fluid retention in the kidneys can be:

swelling due to inflammation or allergies;
reflex spasms;
pathology caused by vasoconstriction and thrombosis;
tumors of various nature, etc.

The prolapse of this organ (the so-called "") can be very painful, as well as the consequences of various injuries associated with internal hematomas.

The list of diseases that can be "confused" with renal colic is quite extensive.

A very similar clinical picture is observed with appendicitis, diseases of the spine and acute pancreatitis, gastric ulcer, hepatic colic and intestinal obstruction.

The gynecological factor also plays a role. Many people know that often "women's problems" make themselves felt with pain in the kidney area.

A common, although not the most dangerous, neoplasm - uterine fibroids - can form adhesions near the urinary tract during growth, which will block the outflow of fluid. This is one of the options for the occurrence of renal colic.

Feels like colic gynecological diseases of a different nature:

torsion of the ovarian cyst;
inflammation of the appendages;
ectopic pregnancy;
rupture of the fallopian tube.

Any of the gynecological diseases is not only dangerous to health, but also fraught with a threat to life. Therefore, the diagnosis must be made immediately.

Activity causing stones to shift

It often seems that acute kidney pains come out of nowhere.

However, the factors provoking them still exist - these are processes that lead to the movement of stones and their blocking of the pathways for urine outflow.

Active sports or hard physical labor can set in motion the stones formed inside.

Dehydration of the body is fraught with the same consequences to a large extent. Sometimes frequent stagnation of urine is a hereditary problem caused by the individual characteristics of the anatomy of a particular person.

Although both a child and an elderly person can get renal colic, among women the largest number of cases belongs to the age category of 30-50 years - the most active and able-bodied.

The fact that colic in women is diagnosed less often than is not related to sexual characteristics: it is just that the representatives of the stronger sex do not particularly monitor their health and often bring their diseases to the extreme.

Peace and no water

The diagnosis of renal colic cannot be postponed until later, and you will not succeed: the pains in such a condition are so strong that women develop tachycardia, and sometimes they even lose consciousness.

It is best to use the services of an "ambulance" in such a situation.

But just in case, remember the rules of self-provision of first aid for this disease. The patient will need complete rest, she cannot make even the slightest movements - this will only increase the pain.

Therefore, put the woman who has an attack in a comfortable place, try to give her an anesthetic (analgesic) or antispasmodic, and try not to disturb her before the arrival of the doctors. If you are sure that there are no inflammations, you can try to relieve the pain by warming the lower back with a heating pad, but it is better not to risk it - after all, you do not know the real reasons for the attack.

In no case should the patient be given a drink - this will worsen her condition. If she has been taking any medication, be sure to tell the medical team that arrived.

Features of symptoms and signs during pregnancy

If a woman in a position previously had urolithiasis, during this difficult period of restructuring of the whole body, it can worsen and cause acute pain in the kidneys during pregnancy. Other kidney diseases can be another cause of this condition.

Symptoms accompanying kidney colic during pregnancy:

as a rule, during pregnancy, the right kidney hurts, the pain radiates to the groin, labia and thighs;
painful sensations along the ureters;
fever and chills;
sometimes nausea or vomiting.

Sometimes women at a later date with these symptoms are brought directly to the maternity ward, mistaking them for the onset of labor. The appearance of blood in the urine caused by the passage of stones can seriously scare the expectant mother.

How to help a pregnant woman?

Any stress and acute pain in women in position can provoke premature birth or serious intrauterine fetal pathology. Therefore, if there are kidney problems during pregnancy, help to representatives of this category should be professional and very quick.

If the kidney aches during pregnancy, at the first symptoms, immediately call a doctor. And while awaiting his arrival, you should:

give the patient an effective antispasmodic - Papaverine or;
try to find a body position in which the pain will be slightly less
try to calm down the woman who is having a seizure.

A remedy that could be used in other cases - a warm heating pad - is prohibited for pregnant women, as well as a bath with hot water, narcotic pain relievers.

Treatment of pregnant patients is carried out only in a medical hospital.

To avoid excruciating pain ...

Renal colic is not at all the sensations that anyone would like to experience in their life.

Serious illness can be prevented if you constantly take care of your health and follow proper nutrition, which plays a significant role in its prevention. It is important to always adhere to the optimal drinking regime and avoid dehydration.

Two liters of water a day - pure or with the addition of lemon, herbal decoctions - is the average intake of this liquid for a person. If your body has a tendency to form stones, consult your doctor about an individual diet.

In contact with

Renal colic is one that is 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. Such factors can be mechanical obstruction of the duct, as well as a genetic factor.

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:

- more than ninety percent of attacks of renal colic develop as a result of diseases 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 kidney injury, 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 whose diet lacks 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, there is a familial nature of the pathology;
Malabsorption syndrome - a condition accompanied by a chronic lack of water in the body;
Parathyroidism or - multiple.

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 a 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, the 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 \u200b\u200bthe affected kidney, gives to the groin and external genitals.
Pain accompanied by nausea and vomiting is characteristic. 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 in laboratory diagnostics, if the blood enters 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.

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

The symptoms of gynecological diseases and renal colic in women are very similar, when located or in their lower part.

If the stones are located in the lowest part of the ureters, there is a frequent urge to urinate, 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. The 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 a fetal 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;
Ruptured fallopian tubes;
Ovarian apoplexy;
Torsion of the cyst legs;
Ectopic pregnancy.

To diagnose colic will help to interview the patient about the date of the last menstruation, the activity of physical activity. The pulse and blood pressure are measured - with gynecological acute pathologies, there is a decrease in blood pressure, dizziness, and increased heart rate.

Urgent Care

First aid is indicated only if the diagnosis is established accurately and is beyond 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 administered 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 for high-intensity pain syndrome. 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 renal failure.
Drotaverin is an antispasmodic drug administered 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;
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 curative 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.

The human body is an intelligent and fairly balanced mechanism.

Among all infectious diseases known to science, infectious mononucleosis has a special place ...

The world has known about the disease, which official medicine calls "angina pectoris" for a long time.

Mumps (scientific name - mumps) is an infectious disease ...

Hepatic colic is a typical manifestation of gallstone disease.

Cerebral edema is a consequence of excessive stress on the body.

There are no people in the world who have never had ARVI (acute respiratory viral diseases) ...

A healthy human body is able to assimilate so many salts obtained with water and food ...

Knee bursitis is a common condition among athletes ...

Renal colic symptoms in women treatment

Renal colic symptoms in women on the right: treatment, symptoms

When renal colic occurs, the symptoms in women can be varied, depending on what kind of disease they are due to.

The intensity of renal colic can be quite high, so a woman needs emergency medical attention.

The doctor's intervention should be immediate also for the reason that kidney spasms are often accompanied by a serious impairment of urodynamics.

Failure of the urinary process favors the occurrence of dangerous kidney pathologies, among which hydronephrosis, pyelonephritis, and renal failure stand out.

Renal colic is accompanied by pain in the abdomen, then radiating to the groin.

In most cases, pain is caused by excessive squeezing or stretching of the ureter. This happens when a large stone penetrates it.

In addition to kidney stones, clots of blood, pus, or mucus can act as an obstacle.

Blood clots occur when a stone that has been set in motion has sharp protrusions. Moving along the urinary tract, it damages the mucous membrane of the ureter and kidneys, causing bleeding.

Clots of pus and mucus are the result of inflammation. More often this situation is provoked by the acute stage of pyelonephritis.

Painful symptoms of renal colic in a woman arise against the background of an increase in the pressure of the fluid concentrated in the renal pelvis. Due to the fact that the outflow of urine is seriously impaired, the renal parenchyma swells, and the renal capsule is excessively stretched.

Such an unusual condition for her provokes an attack of colic, which brings excessive suffering to the patient.

The outflow of urine, and with it the occurrence of colic, provokes an inflection of the ureter, characteristic of the pathological activity of the kidneys against the background of nephroptosis and their abnormal prolapse.

Kink of the ureter

Compression of the ureter causes organ injuries, hematomas, as well as pathologies such as renal vein thrombosis, renal infarction.

A malignant tumor, accompanied by rapid growth, can narrow the urinary lumens to the minimum.

External factors, which include the patient's lifestyle, his place of work, and genetic predisposition, can affect the frequent occurrence of colic attacks.

In particular, working in hot workshops, living in places accompanied by a hot climate, provokes dehydration of the body, an increase in the concentration of salt deposits, and the rapid onset of urolithiasis.

The kidney needs a daily intake of sufficient water. If the patient does not comply with the drinking regimen, the risk of ICD increases several times.

The kidneys negatively perceive hypothermia, reacting to this with inflammatory and infectious processes. For this reason, doctors recommend giving preference to clothing that prevents hypothermia.

Clinical manifestations

The symptoms of renal colic in women are the most striking and intense among the rest of the symptoms of kidney pathologies. Colic occurs suddenly, the patient cannot predict the moment of their manifestation.

However, some external factors can still affect the appearance of colic, which include driving on a bumpy road, performing heavy work associated with lifting weights, or hitting the lumbar region with a strong blow.

Colic zones

Spasms during colic are accompanied by high intensity, but the patient's situation worsens by the fact that their duration can be both short-term and reach several hours.

It is not difficult to distinguish colic from other symptoms, since they are cramping and persistent. They can radiate not only to the groin area, but also to the perineum, rectum, and thigh.

The general condition of the patient is rapidly deteriorating, along with this, additional symptoms arise that cause serious concern about the woman's health.

Against the background of a general deterioration, women begin to experience bouts of nausea and vomiting. You may experience severe bloating.

There are false urges to defecate, urinate. When the bladder is emptied, a small amount of urine is released.

In women, a symptom, characteristic of many renal problems, is also observed in the form of an increase in blood pressure, which is difficult to lower with medication.

Hematuria

If the problem has arisen due to urolithiasis, symptoms of hematuria (blood in the urine) are observed, indicating that the stone is moving along the urinary tract, damaging their mucous membranes.

When the situation worsens, a symptom appears - a harbinger of a dangerous situation in the form of a short-term loss of consciousness. The patient may not lose consciousness, but at the same time be in a semi-faint state.

In these cases, additional symptoms arise in the form of pallor of the skin, the appearance of perspiration, followed by a rapid drop in blood pressure.

Quite often, as soon as the symptoms of renal colic disappear, the patient experiences relief, followed by the urge to urinate. The volume of fluid released will be large enough.

The patient may detect a sign of hematuria or a stone exit in the excreted urine.

Due to the fact that the symptoms of renal colic in women can indicate various diseases, doctors immediately refer the patient for differential diagnosis.

The symptoms of renal colic may be similar to those of appendicitis as well as hepatic colic. Vascular pathologies, intestinal obstruction in women, as well as certain gynecological problems can also be misleading.

Analysis of urine

Radiculitis, intervertebral hernias, intercostal neuralgia in women have similar symptoms.

At the same time, the doctor clarifies with the woman all the symptoms that she noticed, and certainly listens to complaints.

At this point, a general urine test is carried out in the laboratory, according to the results of which it is possible to recognize which pathology provoked the failure.

Doctors are not limited only to laboratory tests of urinary fluid, since an incorrect diagnosis creates the basis for prescribing the wrong treatment, which can provoke a fatal outcome.

It depends on the diagnosis what kind of treatment the doctor will carry out. If the diagnosis is incorrect, only the outward symptoms will be muted, but the cause will remain and continue to worsen.

Based on the patient's condition, doctors refer her to an X-ray of the abdominal cavity. Also, to demonstrate the level of performance of the ureter and kidneys, urography with the introduction of a contrast agent will help.

Ultrasound examination is carried out, accompanied by high information content. During an ultrasound scan, doctors are able to visually observe the shape of the kidneys, their size, and the presence of calculi.

Shown and such a kind of endoscopic examination, as chromocystoscopy, which allows you to determine the nature and speed of the urinary process.

To be able to reliably determine the causes of renal colic, doctors can guide a woman to undergo computed or magnetic resonance imaging.

Treatment

When symptoms of renal colic are detected, doctors should refer the woman for diagnosis, and after receiving the results, develop an effective treatment plan.

The primary measures should be actions aimed at eliminating pain symptoms.

Electropuncture

For this purpose, physicians use antispasmodic drugs, analgesics, herbal medicines, acting as alternative medicines.

To eliminate the symptoms of intense renal colic, a woman is recommended to take a warm bath or apply a warm heating pad to the area of \u200b\u200brelief of pain symptoms.

If an attack of renal colic continues for a long period, doctors decide to carry out a novocaine blockade.

Acupuncture is also indicated in these cases. Such a procedure as electropuncture is also accompanied by high efficiency.

Therapeutic measures are aimed not only at eliminating pain symptoms, but also at eliminating the identified causes that provoked pathological changes in the body.

In particular, antibiotics and antiseptics can be prescribed for inflammatory processes.

If calculi are the culprits of the symptoms of intense pain, doctors prescribe drugs that absorb such uroliths.

With a large size of stones, or with a significant deterioration in a woman's condition, doctors resort to surgical intervention, during which the calculi are fragmented.

Modern medicine has equipment that uses gentle methods to crush stones with a laser, shock wave, and ultrasound.

Of course, in order for the treatment process to be accompanied by high efficiency, doctors orient a woman to adjust her diet and lifestyle.

It is very important in the course of treatment to follow a strict diet, excluding certain foods that the doctor indicates.

Also, doctors always focus on maintaining a drinking regimen. If there are no contraindications regarding pathological edema, a woman is recommended to take up to three liters of fluid.

Complications and prevention

Renal colic provokes the appearance of the most dangerous pathologies arising from violations of the outflow of urine.

In particular, from the accumulation of a large amount of urine, the kidneys increase in size, along with them, the pelvis also increase in size, provoking hydronephrosis.

Hydronephrosis

Against the background of renal colic, pathology such as pyelonephritis, pyonephrosis can also occur.

Unfortunately, inaction, failure to carry out medical measures is fraught with the loss of the functionality of the organ, and subsequently can lead to its complete loss.

In order to never experience symptoms of renal colic throughout her life, a woman must take care not only of observing the correct drinking regime, but also of the quality of water.

The use of tap water is not allowed, since it may contain a large amount of salts and minerals, which are the main provocateurs of urolithiasis.

It is useful to fortify the body, saturating it with vitamins in strictly defined dosages. In particular, an excess of vitamin C can, on the contrary, negatively affect a woman's health, contributing to the occurrence of stones.

Vitamins

Deficiency of vitamin A favors the death of the epithelium, which precipitates and provokes the appearance of stones.

It is also beneficial to take vitamin D within normal limits, which neutralizes oxalic acid, thereby preventing ICD.

Unfortunately, its excess favors an increase in the concentration of urine, respectively, the occurrence of stones.

Due to the fact that the kidneys are afraid of hypothermia, urologists orient women to maintain the correct temperature regime.

So, renal colic entails grave consequences, therefore it must be prevented, rather than subsequently carried out medical measures. Of course, preventive measures are not always accompanied by effectiveness, but nevertheless, their implementation significantly reduces the risk of dangerous complications.

mkb03.ru

Renal colic in women: causes, symptoms and treatment

Renal colic in a woman occurs in the form of an acute painful attack, which occurs suddenly with a violation of the urinary passage, as well as with an increase in intralochanical pressure. With renal colic, a woman experiences cramping pain in the lumbar region, which radiates downward. In addition, urination becomes more frequent, the woman is nauseous, and there may be vomiting. What to do with colic in the kidneys? How dangerous is the disease? Is it possible to cure it?

Causes of female renal colic

Pathology develops with disorders of the urinary system. Renal colic is caused by internal blockage, compression of the urinary tract. First, the musculature of the ureter reflexively contracts, then the hydrostatic pressure rises inside the pelvis, renal ischemia is observed, the parenchyma swells, the fibrous renal capsule is overstretched. When a woman's sensory receptors are irritated, pain begins to develop, which is characteristic of renal colic.

As medical practice shows, about 60% of cases in which renal colic is provoked by urolithiasis. In some situations, pain occurs as a result of pyelonephritis, in which pus and mucus accumulate.

Sometimes renal colic is triggered by:

Torsion or kink of the ureter.
Renal dystopia.
Ureteral stricture.

Externally, the urinary tract can be squeezed by a tumor of the ureter, kidneys, prostate gland, as well as retroperitoneal hematoma. Colic in the kidneys occurs with vascular diseases in the urinary tract, less often with embolism, with renal infarction.

With congenital pathology - dyskinesia, achalasia, megacalycosis, urodynamics in the upper urinary tract is disturbed, and then renal colic develops in women.

Symptoms of colic in the kidneys in women

With the disease, intense, cramping pain in the lumbar region may suddenly occur. Most often she bothers at night in a dream. Sometimes renal colic appears after physical exertion, shaking in transport, walking for a long time, or after taking diuretics.

In women, pain can radiate to the thigh, labia and perineum. An attack of pain can last for several hours or a whole day. The patient is restless, begins to rush, cannot find a position in which it will be easier for him.

Renal colic is accompanied by frequent urination, anuria and oliguria. Some women complain about:

Increased dry mouth.
Cut in the urethra.
Vomiting.
Flatulence.

Sometimes blood pressure may increase, a woman is worried about chills, tachycardia. Severe pain can result in a woman's shock state, which is accompanied by hypotension, pallor of the skin, cold sweat, and bradycardia.

It is important to distinguish renal colic in a timely manner from diseases such as:

Acute appendicitis.
Cholecystitis.
Acute pancreatitis.
Vascular thrombosis.
Aortic aneurysm.
Ectopic pregnancy.
Torsion of the legs of the ovarian cyst.
Gastric ulcer.
Herniated disc.
Intercostal neuralgia.

Diagnostics of the female renal colic

During the illness, it is impossible to touch the diseased kidney. After an attack, a urine test is taken. It usually contains blood clots, erythrocytes, salts, protein, epithelium, leukocytes.

To exclude abdominal pathology, an overview X-ray of the abdominal cavity is performed. An x-ray, urogram is also additionally performed. With the help of intravenous urography, you can learn about changes in the pelvis, renal displacement, and the nature of the bending of the ureter.

During renal colic, chromocystoscopy is necessary. With its help, timely learn about hemorrhage and edema. In order to study in detail the condition of the urinary tract, it is necessary to conduct an ultrasound of the kidneys and bladder to exclude an acute abdomen.

The cause of renal colic in a woman can be established after a tomographic examination - MRI or CT.

Renal colic treatment methods

Thermal procedures will help to stop the attack - applying a heating pad to the lumbar region, abdomen. Hip baths are also very helpful. Keep in mind that the water temperature should be no more than 39 degrees.

It is possible to relieve pain, spasm from the urinary tract and restore urination with the help of antispasmodics and pain relievers. Baralgin, Promedol, Atropine, No-shpa are administered intravenously. An injection of Platiphyllin is given intramuscularly.

If the attack of renal colic is delayed, novocaine blockade is prescribed. In case of an acute attack, acupuncture and electropuncture are additionally used. When small stones are diagnosed in a woman's ureter, physiotherapeutic procedures can be prescribed - ultrasound therapy, diadynamic therapy, as well as vibration therapy.

If renal colic is accompanied by acute pyelonephritis, a high temperature rises with it, in this case all thermal procedures are prohibited. In this situation, it is best to call an ambulance to prevent a serious complication.

Prevention of renal colic in women

To prevent renal colic from recurring, it is necessary to stop and eliminate the cause of its development in a timely manner. In the case of long-term obstruction of the urinary tract, it can result in renal failure. It is dangerous when an infection joins the renal colic, then everything ends with secondary pyelonephritis, bacteremic shock, urosepsis.

To prevent renal colic, all risks must be eliminated, especially urolithiasis. For preventive purposes, do not forget to visit a urologist at least once a year, undergo an ultrasound scan, and take urine and blood tests. The sooner the pathology is detected, the better.

Thus, renal colic brings a lot of trouble to a woman. It is especially dangerous during pregnancy, therefore, during the planning of the baby, it is necessary to undergo a preliminary examination of the kidneys and timely identify all diseases.

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Renal colic - causes, symptoms in men and women, diagnosis, treatment and prevention

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. The 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.

Kidney dysfunction syndrome can be accompanied by the following symptoms:

an acute painful attack in the lumbar region 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.

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 the pain subsides, but weak painful sensations persist.

Renal colic in children

In babies who still cannot speak themselves, colic can be recognized by increased anxiety, tearful 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, lumbar regions, and inguinal zones are indicated. Since cramping pain can indicate serious pathologies, fraught with serious complications, the child should be immediately shown to the 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 make a history of the disease, carry out differential diagnostics, ask the patient about the nature of the pain, the time of its occurrence, localization, 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 a computed tomography scan of the urinary tract is done 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 alkalize 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. If the cause of colic was kidney 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 for colic with renal dysfunctions, you can take other, no less serious, formidable diseases - 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. The heat causes the ureter and urethra to expand, 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 correct salt balance in 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 drug 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 spasm of the urinary tract. 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. With 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.

Treatment with 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.

What is renal colic?

What is the mechanism of pain during an attack of renal colic? (pathogenesis of renal colic)

Symptoms of an attack of renal colic

Differential diagnosis

General rules

Differential diagnosis of right-sided renal colic

Renal colic and acute intestinal obstruction

Differential diagnosis of atypical renal colic and abdominal catastrophes (acute pancreatitis, gastric ulcer perforation, acute cholecystitis)

What examinations and tests can a doctor prescribe for renal colic?

Forecast

Complications

Which doctor should i contact for renal colic?

Renal colic treatment

First aid

Emergency medical care

Diet

Urolithiasis disease

Uremia

Accumulation of pus

Allergy

Symptoms of the disease

Diagnostics

Questioning and inspection

Laboratory diagnostics

Instrumental research

Distinctive diagnostics

First aid

Prophylaxis

Treatment

Operation

What is the reason?

Activity causing stones to shift

Peace and no water

Features of symptoms and signs during pregnancy

How to help a pregnant woman?

To avoid excruciating pain ...

Description of the disease

Colic etiology

Risk factors for urolithiasis

Pathogenesis

Symptoms

Differential diagnosis

Right-sided colic

Abdominal disasters

Urgent Care

Drugs

Hospitalization

Renal colic symptoms in women treatment

Renal colic symptoms in women on the right: treatment, symptoms

Clinical manifestations

Treatment

Complications and prevention

Renal colic in women: causes, symptoms and treatment

Causes of female renal colic

Symptoms of colic in the kidneys in women

Diagnostics of the female renal colic

Renal colic treatment methods

Prevention of renal colic in women

Renal colic - causes, symptoms in men and women, diagnosis, treatment and prevention

What is renal colic

Renal colic in children

Causes

Diagnostics

Treatment

First aid for renal colic

Renal colic medications

Pain reliever

Antispasmodics

No-shpa

Surgery

Treatment with folk remedies

Prophylaxis

What is the mechanism of pain during an attack of renal colic?
(pathogenesis of renal colic)