How to relieve renal colic pain at home? Algorithm emergency care for renal colic First first aid for renal colic.

Renal colic is a complex symptom complex that includes the reactions of all body systems and manifests itself as pain syndrome, the causes of which may be different. It usually occurs with an acute violation of the outflow of urine due to obstruction of the upper urinary tract with calculus, a clot of blood, mucus or pus, a conglomerate of urinary salts, caseous masses, rejected necrotic papillae, as a result of a bending of the ureter or spasm of the renal pelvis, ureter. Renal colic can be observed in functional disorders of the upper urinary tract, impaired blood circulation in the kidneys and ureters, in the treatment of glucocorticoids, in allergic and other diseases.

Pre-hospital assistance:

1. Heat in the form of heating pads, heated sand, hot baths (temperature 40-50 ° C).

2. Intramuscular administration of one of the antispasmodic (atropine 0.1% solution 1 ml, platifillin 0.2% solution 1 ml, papaverine 2% solution 2 ml, no-spa 2% solution 2 ml, magnesium sulfate 25% solution 10 ml) or painkillers (analgin 50% solution 1 ml, promedol 1% solution 1 ml, omnopon 2% solution 1 ml).

3. The use of narcotic analgesics for renal colic is permissible only with the exclusion of diseases of the abdominal organs in the case when the pain is not relieved by other drugs.

4. Widely used drugs belonging to the group of spasmodic analgesics (baralgin, spazgan, trigan, maksigan). Baralgin (5 ml), which is most effective when administered intravenously, should be recognized as one of the best drugs for pain relief. The drug is contraindicated in patients with an allergic reaction to analgesics.

5. After providing emergency care, the patient is urgently hospitalized in the urological or surgical department, where the diagnosis is clarified and adequate treatment is carried out.

Help at the hospital stage:

1. For relief of renal colic used intravenously

- Platyphyllin (0.2% 1 ml) + Promedol (1% 1 ml) + Diphenhydramine (1% 1 ml).

- Papaverine (2% 2 ml) + promedol (1% 1 ml) + analgin (50% 1 ml) + pentamine (5% 0.5-1 ml).

- Halidor (2.5% 2 ml) + papaverine (2% 2 ml) + diphenhydramine (1% 1 ml) + chlorpromazine (2.5% 1 ml).

- No-spa (2% 2 ml) + pipolfen (2.5% 2 ml).

2.In order to eliminate an acute pain attack, intravenous administration of fentanyl (0.005% solution of 2 ml) in combination with droperidol (0.25% solution of 2 ml) and no-spa (2% solution of 2 ml) is also used. Usually, after insertion, the pain disappears after a few minutes.

3. An effective means of relieving renal colic is intravenous administration of prostaglandin blockers (indomethacin, voltaren, diclofenac sodium at a dose of 50 mg), which reduce urine output by 50%, which leads to the disappearance of pain.

4.For therapeutic, as well as differential diagnostic purposes, it is possible to block the spermatic cord in men or the round ligament of the uterus in women according to Lorin-Epstein:

- the skin of the groin area on the diseased side is treated with alcohol, iodine and the index finger of the left hand determine the external opening of the inguinal canal and the spermatic cord coming out of it

- the spermatic cord is fixed between the index and thumb of the left hand, and 5-8 ml of 0.5% novocaine solution is injected subcutaneously with the right;

- the needle is advanced to the spermatic cord and 50 ml of 0.25% solution of novocaine is injected into it and the surrounding tissues;

- in women, the same amount of novocaine is injected into the subcutaneous tissue at the exit from the external opening of the inguinal canal of the round ligament of the uterus

After novocaine blockade, renal colic subsides in 15-20 minutes; in acute diseases of the abdominal cavity, the pain does not decrease.

5. Sometimes paravertebral blockade with chloroethyl is used to relieve an attack of renal colic. To do this, irrigation with chloroethyl of the skin of the paravertebral region from T11 to L3 on the affected side until it is whitened. Paravertebral blockade with chloroethyl on the right allows for differential diagnosis between renal colic and acute appendicitis. With renal colic, the pains disappear completely or decrease, with acute appendicitis, they persist, their intensity does not decrease.

6. For the purpose of preventing recurrent attacks of renal colic and as additional means of eliminating acute pain syndrome, patented combined drugs are used: cystenal, urolesan, pinabin, enatin, olimetin.

Providing timely emergency care to a patient with renal colic contributes to the rapid recovery of impaired organ functions and prevents the occurrence of severe complications. Each patient after the elimination of renal colic needs a detailed urological examination.

studfiles.net

Renal colic causes

Renal colic is a sharp, paroxysmal pain that radiates to the lower back. Sometimes it is felt in the ureters (along the path of urine) or in the lower abdomen. Most often, the pain focus is localized on one side.

Pain during renal colic is caused by stretching of the renal pelvis. Such pain is considered one of the most acute and intense.

Renal spasm is a manifestation of the following pathologies in the body:

• urolithiasis disease;
• renal tuberculosis;
• exacerbation of pyelonephritis;
• the presence of diseases that cause metabolic problems (diabetes mellitus, gout).

Sometimes an attack of renal colic occurs due to trauma or the consequences of surgery. In almost half of cases, it is not possible to determine the cause of spasms.

Symptoms and first aid

Colic attacks are always sudden and very painful. In such a situation, first aid help will significantly alleviate the suffering of the patient. Before taking any action, you need to understand the symptoms that accompany the attack.

The main signs of colic

Renal colic occurs in both adults and children. This condition has no age or gender restrictions. The main symptom is acute, cramping pain.

Usually the pain is localized in the lumbar region or on the side of the kidney. When colic is caused by urolithiasis, the discomfort can be felt in different places. It is caused by the movement of the stone through the ureter. Men often have painful sensations in the groin, testicles and penis, while in women, pain is felt in the perineum and labia. Children usually complain of pain at the navel.

The pain is accompanied by the following symptoms:

• the patient is restless, trying to take the most comfortable position of the body;
• intense thirst;
• pallor of the skin;
• high fever, chills;
• false urge to urinate;
• cutting pain when urine passes;
• obstruction of the outflow of urine.

If the intensity of pain is very high, the patient may experience a state of shock up to loss of consciousness. The skin becomes covered with cold, clammy sweat, the pressure rises sharply.

Attention! If the patient has an attack of pain in the kidneys, you should immediately call a doctor. Renal colic can last from several hours to a day.

How to stop pain at home

The attack overtakes a person without choosing a place and time. If this happens, first aid is needed for renal colic.

In order not to harm the patient and not to provoke an increase in pain, it is necessary to follow the algorithm of emergency care for renal colic.

1. Call the ambulance team urgently.
2. Try to calm the patient down, find out the symptoms of his condition.
3. Measure your body temperature.
4. Apply a heating pad filled with hot water to the lower back (pre-wrap with a cloth).
5. Place the patient in a warm bath.

It is allowed to enter antispasmodics only with the ability to do intramuscular injections (No-shpa, Baralgin). If it is not possible to inject the drug intramuscularly, the listed drugs can be used in the form of tablets.

Heat exposure can provoke uterine bleeding and even miscarriage, therefore, pregnant women in the event of a kidney attack, it is better to refuse a heating pad and a bath. It is allowed to take a No-shpy pill and wait for the arrival of a doctor.

Attention! If the patient cannot urinate, in no case should he be given diuretics. They will only increase the speed of movement of the stones and worsen the patient's condition.

Alternative treatments

Medicinal herbs can also help with renal colic. The following plants can be used to achieve a positive effect:

• celandine;
• flax-seed;
• carrot seeds;
• rosehip.

Celandine: 2 tbsp. tablespoons of crushed raw materials are poured with a glass of boiling water. After cooling, the broth is decanted and taken twice a day before meals.

Flaxseed: 1 teaspoon of seeds should be boiled in 1 glass of water, take half a glass a day every 2 hours. The broth is allowed to be diluted with water. Take the remedy for two days.

Carrot seeds: 1 tbsp. the spoon is diluted with a glass of boiling water. The broth is infused, wrapped in a cloth, for about 12 hours, after which it is decanted. Should take 1/2 cup of warm broth before meals for 2 days.

Rosehip: chopped roots in the amount of 2 tablespoons are boiled in two glasses of water for about 15 minutes. The resulting liquid is wrapped in a cloth and insisted until completely cooled, decanted. Apply the resulting product up to four times a day, drinking 1/2 cup at a time. The course lasts seven days.

Important! Self-medication can be hazardous to health.

It is worth taking folk remedies with caution, being sure of the good tolerance of the drug components.

Inpatient specialized medical care

A urologist or surgeon can state renal colic, they also prescribe the optimal treatment. Because seizures often start suddenly, emergency doctors provide emergency assistance. After examining the patient, doctors decide whether a referral to the urological or therapeutic department is needed.

Immediate hospitalization is required in the following cases:

• home medical care does not give the expected results (severe pain persists);
• temperature above 39 degrees;
• the only kidney in the patient;
• pregnancy of any period or suspicion of it.

After the patient is admitted to the hospital, a set of measures is taken to confirm the diagnosis:

• Ultrasound (helps to see the stone);
• radiography;
• laboratory and clinical research.

When the diagnosis is confirmed, the patient is assigned to inpatient treatment. At this stage, the following methods of therapy are used:

• further use of antispasmodics;
• prescribing stronger pain medications;
• blood pressure and cardiac activity are monitored;
• the use of antibiotics (in case of inflammatory processes);
• the appointment of a course of vitamins.

The patient should understand that relief of pain syndromes and even removal of stones does not guarantee recovery. After a certain period of time, a new calculus may form. To prevent new attacks, the patient must follow all the doctor's prescriptions: a strict diet, the correct choice of physical activity and taking the necessary medications are important.

Limitations and possible contraindications

It is necessary to provide first aid in case of attacks of renal colic, taking into account the following characteristics of the patient:

• the reasons that caused the attack;
• the age group the patient belongs to;
• the presence or absence of concomitant diseases.

If the patient is taking any medications, antispasmodics should be excluded - such remedies do not always work well with other medications. It is also necessary to take into account the age of the patient. It is not recommended to put the elderly in a warm bath - this is a great burden on the body. Also, the bath is prohibited for people who have had a heart attack or stroke. It is enough to limit yourself to a heating pad or mustard plasters.

An attack of renal colic is not only painful, but also extremely dangerous. Fortunately, you can beat an attack at home as well.

The main thing in this situation is not to get lost and know a clear algorithm for first aid. It must be remembered that the temporary elimination of colic symptoms does not exclude a mandatory visit to a specialist in the future.

Immediate help in these situations is to call the ambulance team - doctors will take the necessary measures to eliminate the attack.

nefrologinfo.ru

Symptoms, diagnosis and factors provoking the disease

Renal colic is an attack of severe pain, which is associated with a violation of the outflow of urine from the renal pelvis, but can also occur for other reasons. The attack can last for a long time and occur both during physical activity and during a period of calm.

The pain spreads to the abdomen, thigh, shoulder, perineum, genitals. Dizziness, high blood pressure, nausea and vomiting may occur.

If there is an inflammatory process, then the temperature may rise. But such symptoms do not always appear, sometimes they can be worn out.

It is necessary to differentiate spasm associated with impaired renal function and acute appendicitis when symptoms of irritated peritoneum are present. Diagnosis of the cause of an attack most often does not present any particular difficulties, because in patients the urine changes, there is frequent urination and the hypochondrium hurts on palpation.

Factors that can provoke an attack of renal colic:

• violation of the diet;
• excess or lack of fluid;
• alcohol intake;
• driving on a bad road;
• physical or mental stress;
• infections.

First aid in case of an attack

The key to a favorable and successful treatment is properly provided first aid and urgent hospitalization. Medical measures are permissible if the diagnosis was established earlier and you do not doubt its correctness.

To provide first aid for renal colic, you need to have an idea of \u200b\u200bthe methods of arresting an attack. To urgently relieve acute pain is the main task of first aid, which can be solved with the help of thermal procedures and the use of antispasmodic and analgesic drugs.

First aid algorithm:

• call a doctor;
• provide peace;
• determine the side and place where the pain is intense;
• control the temperature;
• collect urine for visual examination;
• put a heating pad on the lumbar region or fill the bath with water;
• give injections of one of the listed antispasmodic and analgesic drugs: noshpa, baralgin, ketan, cystenal, papaverine.

If the procedures have not brought the desired effect, medications can be used. The best drug for relieving pain is baralgin. You cannot use diuretics, because their use can provoke the movement of a stone in the ureter or other undesirable effects.

The attack should be stopped within 2-3 hours. In the absence of a positive effect, emergency hospitalization in the urology department is required.

If an attack of renal colic is complicated by acute pyelonephritis and there is a high temperature, then it is impossible to carry out thermal procedures, an urgent need to call a doctor.

In most cases, increased heating of the sore spot either reduces pain, or relieves it completely.

Correct and timely assistance will restore the functions of the organ and prevent serious complications.

Then it is necessary to be examined by a doctor, who will prescribe a more detailed examination and further treatment, depending on the severity of the disease.

Taking antibiotics, installing a stent for urine outflow, novocaine blockade, surgical intervention - there are many treatment options.

Limitations and contraindications for first aid

Renal colic causes severe pain that must be urgently eliminated. It is not difficult to provide it if you know the list of necessary actions.

Urgent care for renal colic should be provided taking into account:

• the patient's age;
• the presence of concomitant diseases;
• the causes of the attack.

An elderly person with a list of diseases should be helped with great care, because a hot bath is a burden on the body. If he suffered a stroke or heart attack, then the bath is strictly prohibited. It is necessary to put mustard plasters, a heating pad, warm sand on the sore spot.

Do not give pain relieving injections without knowing how they will interact with other medications that the patient was taking before the attack.

First aid in such cases should be to call a specialist who will take urgent measures to eliminate the discomfort. He clearly knows the algorithm for providing ambulance, which consists in establishing a preliminary diagnosis and providing assistance according to the indications corresponding to it.

popochkam.ru

What causes renal colic?

The main factors in the mechanism of disorders that cause renal colic are all diseases of the urinary system, which contribute to obstruction (violation of the lumen) of the outflow tract and the growth of salt deposition. It can be:

• chronic inflammation (pyelonephritis, cystitis, kidney tuberculosis);
• suffered injuries and operations;
• developmental anomalies, nephroptosis;
• diseases that affect the general metabolism (gout, diabetes mellitus).

In 70% of patients, pathology leads to urolithiasis.

Salt crystals gradually form a rock formation. The size, shape and structure depend on the chemical structure. The most traumatic effects are oxalate stones from oxalic acid salts. They are distinguished by sharp edges, needle-like ends.

The place of formation of the stone is often the pelvis and calyxes of the kidneys. Crystalline compounds are deposited here, which are not excreted in the urine. If the stone is stationary, it may not cause any symptoms or present with dull, intermittent lower back pain.

Signs of renal colic appear when a stone moves into the ureter and are caused by:

• spasm of the muscles of the urinary tract in response to irritation of the nerve receptors located in the submucosa;
• the addition of reflex vasospasm of the kidney vessels, which affects the special zones of baroreceptors that respond to pressure drop;
• a simultaneous sharp increase in pressure inside the pelvis and cups;
• overstretching of the fibrous capsule by the accumulation of urine, the occurrence of edema and an increase in the size of the kidney.

We figured out what renal colic is, from the point of view of pathogenetic disorders of the urinary tract. Now let's consider the leading symptoms and diagnostic problems.

Clinical manifestations of pain syndrome

The clinic can be roughly divided into:

• period of pain;
• post-pain symptoms.

Most often, an attack of renal colic is the first manifestation of urolithiasis and forces the patient to seek emergency care at any time of the day or night. Usually, patients associate the manifestation of the disease with previous long walking, shaking in transport, physical activity, and alcohol intake.

The classic signs are:

• cramping pains in the lower back on one side, which appeared suddenly;
• irradiation (spread) goes to the groin, along the inner surface of the thigh.

The movement of the stone through the ureter causes a change in irradiation. Men complain of pain in the testicle and penis. Symptoms of renal colic in women are accompanied by pain in the labia.

Irritation of the solar plexus contributes to:

• nausea and vomiting at the height of pain;
• intestinal paresis with stool retention;
• bloating;
• identification of unilateral tension of the abdominal and lumbar muscles.

Pains are accompanied by:

• expressed anxiety of the patient, attempts to take a comfortable body position;
• feeling of thirst;
• blanching of the skin;
• reduction in urine output until complete cessation (oliguria, anuria);
• chills with fever;
• decrease in heart rate;
• increased blood pressure;
• false desires and cuts during urination.

Very intense pain and a low threshold of patient sensitivity contribute to the onset of shock with:

• a drop in blood pressure;
• the release of sticky cold sweat.

Characteristics of post-pain symptoms

Help with renal colic relieves or reduces pain, but in the clinic there are signs of the post-pain period.

Hematuria

Excretion of blood in the urine (hematuria) - occurs in 90% of cases. Called by:

• damage to the mucous membrane of the renal pelvis, cups, ureter by an advancing stone;
• rupture of small arterioles of the renal parenchyma due to a sharp increase in intralocal pressure from accumulated urine;
• a similar rupture is possible after the stone has come off with rapid pressure normalization.

Hematuria serves as a differential diagnostic sign with pain in tumors. It occurs only in the post-pain period, and in patients with a tumor and in the pre-pain period.

Signs of hematuria are found after tapping on the lower back (definition of Pasternatsky's symptom).

Hematuria is not found if urinalysis is taken during an attack with one ureteral block remaining. The other (intact) ureter will supply normal urine.

Violation of urination

If the stone has been in the lower parts of the ureters for a long time, adjacent to the bladder, then there are:

• nocturia (increased urine output at night);
• pollakiuria (frequent urination);
• dysuric disorders (cramps, pain, false desires).

Signs of secondary cystitis occur when the infection quickly joins. At the same time, many leukocytes and bacteria (leukocyturia, bacteriuria) are found in the urine. Perhaps the beginning of the formation of calculous pyelonephritis.

Stone exit

The most reliable sign and outcome of renal colic is the passage of stones in the urine. In 1/5 of patients, the process is painless.

Usually this symptom is observed soon after a painful attack. Stone washing out is influenced by:

• shape (oxalates dig with sharp edges deep into the wall);
• the condition of the urinary tract (congenital narrowing, concomitant inflammation are possible).

What contributes to a colic attack?

The factors that trigger the symptoms of renal colic include:

• violation of the diet (overeating meat dishes, fried and spicy foods);
• too much or, conversely, insufficient fluid intake;
• alcohol, a significant amount of beer;
• shaking when driving on a bad road;
• overstrain of physical forces;
• infectious diseases.

These reasons can disrupt the compensatory mechanisms of the kidneys, disrupt metabolism, accelerate the damage to the urinary tract in the latent course of urolithiasis.

Features of renal colic in women and children

Pregnancy and gynecological diseases can cause renal colic in women:

• pathological conditions of the uterus (disturbed location, bend);
• inflammatory diseases of the appendages (adnexitis);
• damage from tubal pregnancy;
• torsion of the "legs" with cystic changes in the ovary;
• hemorrhage and rupture (apoplexy) of the ovary;
• spontaneous miscarriage.

Therefore, any woman brought to the hospital by an ambulance with a diagnosis of renal colic should be examined by a gynecologist.

Some women with a long term of pregnancy perceive pain as the onset of labor, and go into labor. house. When finding out the absence of signs of labor, the patient is transferred to the pathology department, where they are fully examined and possible treatment is carried out before delivery.

In children, stone formation often depends on the presence of inflammatory kidney disease. Stones consist of mucus, fibrin, desquamated epithelium, leukocytes, bacteria. In the onset of renal colic, pediatricians attach importance to family predisposition. This is due to the genetically determined course of metabolism.

Risk factors for early childhood include:

• increased fluid loss (with frequent diarrhea, vomiting, development of malabsorption syndrome);
• treatment with drugs with a toxic effect on the kidneys.

In early childhood, the localization of pain does not correspond to the classical signs. It occurs in the navel and is accompanied by bloating and vomiting. The child is in an agitated state, scared, crying. Slight temperature rise possible.

How to make a correct diagnosis?

When talking with a patient or parents of a sick baby, you need to find out everything about the cause and nature of the disease.

Therefore, you will have to remember and answer the questions:

• how the pain began suddenly or gradually;
• where to give and how much they have changed over time;
• whether there was chills, nausea, or vomiting;
• are there any difficulties, cramps when urinating;
• is the attack the first or there have been similar manifestations before;
• whether the diagnosis of urolithiasis was made to the patient himself and his relatives.

During the examination, the doctor pays attention to:

• type of patient;
• painful palpation of the kidney on the affected side;
• positive symptom of Pasternatsky;
• bloating and muscle tension in the abdominal wall and lower back.

Violation of the filtration function of the kidneys with the accumulation of nitrogenous substances is suspected when the electrolyte content changes. Anemia is detected with the formation of renal failure. In the analysis of urine, a significant number of erythrocytes, mucus, salt in the form of cylinders, moderate leukocyturia, epithelial cells are detected.

Renal colic must be distinguished from other conditions with similar symptoms. These include all conditions called by one term "acute abdomen":

• acute appendicitis;
• dyskinesia of the biliary tract, cholecystitis and pancreatitis with hepatic colic;
• perforation of gastric and duodenal ulcers;
• an attack of intestinal obstruction;
• vascular diseases such as aortic dissection, thromboembolism of the mesenteric arteries.

In women, it is imperative to exclude:

• adnexitis (inflammation of the appendages);
• ectopic pregnancy;
• possible torsion of the leg of the ovarian cyst.

Lower back pain radiating to the groin is associated with:

• intercostal neuralgia;
• herniated intervertebral disc with radicular pain syndrome;
• shingles caused by a herpes infection.

For each disease, it is necessary to take into account the history, age of the patient, characteristics of pain and accompanying symptoms. The choice of measures necessary for targeted therapy in order to make them most effective depends on the correct diagnosis.

The doctor can obtain the maximum information when conducting:

• ultrasound examination of the kidneys and bladder, if it is completely full;
• x-ray examination (excretory urography);
• chromocystoscopy - an endoscopic method for detecting obstruction of the ureters with the introduction of indigo carmine.

What first aid should be provided for an attack?

First aid for renal colic can be provided before calling an ambulance at home. It is only important to be sure of urolithiasis as the cause of pain. This is possible if the patient has previously suffered similar seizures and is diagnosed during examination.

In such cases, it is permissible to use such methods of first aid as:

• applying a hot heating pad to the lower back;
• placing the patient in a warm water bath;
• intramuscular injection of an antispasmodic drug (No-shpy, Platifillin, Baralgin);
• ingestion of Cistenal.

It must be remembered that thermal procedures are categorically contraindicated in inflammatory diseases, tumors, lesions of the pelvic vessels, and during pregnancy. The expectant mother can be allowed to take the No-shpy pill. Warming up contributes to abortion, uterine bleeding.

The algorithm of actions in assisting a patient consists of pre-medical measures and the use of special medications by medical workers. With a painful attack, it is necessary:

• call an ambulance;
• reassure the patient, find out the symptoms and the previous course of the disease;
• put a thermometer to measure temperature;
• determine, together with the patient, the maximum localization of pain, irradiation;
• pour hot water into a heating pad, wrap with a towel and apply to the lower back on the affected side;
• give Cistenal for oral administration, if skills allow, inject one of the antispasmodics.

If the ambulance is delayed for a long time, it is permissible to place the patient in a hot bath with water. Timely emergency treatment for renal colic helps preserve the kidneys and improves the outcome of further treatment.

When is the patient admitted to the hospital?

The attack is usually stopped at home by measures provided by loved ones and the ambulance. In the future, a person should consult a doctor at a polyclinic for a complete examination and treatment.

Hospitalization is considered mandatory for:

• unsuccessful actions of the ambulance personnel and unresolved pain in the patient;
• a single kidney or a severe attack with pain in the transplanted donor organ;
• high body temperature, suspected infection;
• pregnancy.

In the hospital:

• continue to use antispasmodic drugs;
• use stronger painkillers;
• if pain persists, perirenal novocaine blockade is performed;
• prescribe symptomatic anti-vomiting agents;
• control blood pressure and the state of cardiac activity;
• when signs of inflammation appear, a course of antibiotic therapy is carried out;
• prescribe vitamins.

To determine the further tactics of patient management, the results of the examination are taken into account, the issue of planned surgical treatment for the purpose of installing a stent and removing a stone, and indications for the use of ultrasound therapy are decided.

Patients should understand that removing the stone after an attack does not mean complete recovery. Changes in salt metabolism in the body remain. This means that after a while another stone will form and the attack will recur. Therefore, you should be attentive to the recommendations for diet, exercise, medication.

Renal colic is called an acute painful attack, which is caused by a sudden violation of the process of passing urine through the urethra, an increase in pressure inside the pelvis and, as a consequence, renal ischemia. Colic is characterized by severe cramping lower back pain, painful and frequent urination, psychomotor agitation, nausea and vomiting.

In urology, renal colic is regarded as a condition requiring immediate assistance, in which it is necessary to quickly relieve acute pain and normalize the functioning of the kidney. It is important to understand that colic is not just an attack of pain, it is a signal from the body that the kidney is in danger.

The causes of renal colic

The development of renal colic is always due to a sharp violation of urine drainage from the kidney, which occurs due to external compression or internal blockage of the urinary tract. This condition is accompanied by venous stasis of the kidney, increased hydrostatic intralocal pressure, reflex spastic contraction of the ureteral muscles, parenchymal edema, overstretching of the fibrous capsule, and renal ischemia. As a result, a sudden pain syndrome develops, called renal colic.

The immediate cause of such a violation can be mechanical obstructions that prevent the passage of urine from the ureter or renal pelvis. In more than 50% of all cases, colic occurs with urolithiasis due to infringement of calculus in any part of the urinary tract. Sometimes the condition provokes torsion or kink of the ureter with its strictures, renal dystopia or nephroptosis.

Also, the cause of blockage of the urinary tract can be clots of pus or mucus with pyelonephritis, rejected necrotic papillae or caseous masses with kidney tuberculosis.

External ureteral compression can cause tumors of the prostate gland (cancer or prostate adenoma), kidney (eg, papillary adenocarcinoma), urinary duct, and post-traumatic hematomas in the retroperitoneal region.

Another group of reasons for the development of renal colic is due to congestive, inflammatory or vascular diseases of the urinary tract: hydronephrosis, prostatitis, urethritis, periurethritis, phlebostasis, renal vein thrombosis, renal infarction, embolism, etc.

Urodynamics in the upper urinary tract can be impaired in congenital anomalies, for example, in spongy kidney, dyskinesia, achalasia, and megacalycosis.

Renal colic symptoms

Sudden cramping and very intense pain in the costal-vertebral angle or in the lumbar region is a classic symptom of renal colic. Most often, a painful attack develops during sleep at night, but sometimes this condition is preceded by heavy physical exertion, long walking, shaking riding, taking large amounts of fluids or diuretics. From the lower back, pain can spread to the rectum, thigh, ileum or mesogastric region, in women - to the perineum and labia, in men - to the scrotum and penis.

The duration of an attack of renal colic can be from 3 to 18 hours or more, while the localization of pain, its intensity and irradiation can vary. During this period, a person has a frequent urge to urinate, later developing flatulence, vomiting, dry mouth, cramps in the urethra, tenesmus, anuria or oliguria. Against the background of colic, tachycardia, chills, moderate hypertension, subfebrile condition occur. Severe pain can cause shock, manifested by bradycardia, pallor of the skin, cold sweat and hypotension.

After the seizure is over, a significant volume of urine is usually released, in which the patient can detect blood.

Urgent care for renal colic

Help with renal colic should be provided by a doctor, therefore, if severe pain in the abdomen and lower back appears, an ambulance should be called urgently. The fact is that by clinical signs, colic is similar to many other diseases and pathologies, which are also accompanied by lumbar and abdominal pain: with acute appendicitis, aortic aneurysm, ovarian torsion, ectopic pregnancy, intercostal neuralgia, acute pancreatitis, thrombosis of mesenteric vessels and dr.

In the event that a person has renal colic not for the first time, and he is sure of this diagnosis, then before the arrival of the ambulance team, the patient's condition can be alleviated.

Urgent care for renal colic consists of:

• Applying a heating pad to the lower back or putting the patient in a warm bath in order to reduce spasm of the ureter and blood vessels, which will improve the blood supply to the kidney, and a blood clot or stone can slip into the bladder;
• Taking any antispasmodic and analgesic drug, best of all Papaverine, Baralgin or No-shpy, as a last resort, if these drugs are not in the first-aid kit, you can take Nitroglycerin.

It is necessary to understand: the described procedures will help, provided that it is really renal colic. Otherwise, thermal procedures and pain medications can only harm, for example, with acute appendicitis, a person's condition after taking a bath and No-shpy deteriorates sharply.

Upon arrival, the ambulance doctor also uses analgesics and antispasmodics to relieve an attack, but in the form of injections - so they are more effective.

Renal colic treatment

After the attack is relieved, treatment of renal colic involves the elimination of the factor that led to the obstruction of the urinary tract, i.e. therapy of the underlying disease. For this, the patient is recommended to undergo the following examinations:

• Plain X-ray of the abdominal cavity;
• Urine examination;
• Urography;
• Chromocystoscopy;
• Ultrasound of the kidneys, bladder, pelvic organs and abdominal cavity;
• Computer and magnetic resonance imaging of the kidneys.

Renal colic is understood as a sudden attack. Often this condition is associated with, but in fact, doctors consider renal colic one of the symptoms of many pathologies of the urinary system of the body.

The causes of renal colic

Doctors say that the pain syndrome in question is manifested against the background of blockage of the ureter and impaired urine movement. But the following reasons can lead to this condition:

• , moreover, only if the stone has closed the ureter and does not allow urine to come out;
• tumors (benign or) of the kidney - the ureter may be blocked by a blood clot or pus;
• necrotizing papillitis;
• , flowing in a purulent form;
• kidney injury;
• benign and / or malignant tumor of the ureter or bladder.

It is extremely rare that the cause of renal colic is compression of the ureter, which can occur during surgery on the pelvic organs, against the background of an increase in nearby lymph nodes or a tumor of the retroperitoneal space.

In order for renal colic to occur, provoking factors are needed, since the above pathologies themselves are not characterized by pain. The provoking factors in this case are:

• a long journey in a car or train (shake-up);
• medicines for the treatment of urolithiasis;
• a sharp limitation of the amount of fluid consumed, or, conversely, a sharp increase in this amount;
• strong blow in the back.

If there is a blockage of the ureter with a stone, then the result will be a violation of the outflow of urine. At the same time, new portions of urine continue to be produced in the renal tubules, there is no exit of this fluid from the body, and the renal calyceal system expands. The longer the ureter is blocked, the faster the renal vessels are compressed and the blood supply to it is disturbed.

Note: the size of the stone / clot has absolutely no effect on the presence or absence of renal colic. There are cases when even a small stone / clot size (1-1.5 mm) provokes a powerful attack of pain.

Renal colic symptoms

The main symptom of the condition under consideration is intense, sharp pain in the lumbar region. It can be joined by:

• blood in the urine - not always observed, but if the stone in the ureter has sharp edges or is too large, then hematuria is inevitable;
• increased urination - occurs only if there is an obstruction to the outflow of urine in the lower parts of the ureter;
• bloating;
• complete absence of urine excretion - occurs with bilateral renal colic or in the presence of only one kidney.

Doctors emphasize that there are many pathologies that can mimic renal colic. For example, these include torsion of the ovarian cyst in a woman, radiculitis, kidney infarction, acute pleurisy ,. Therefore, in no case can self-treatment be carried out - only a specialist can make an accurate diagnosis and provide qualified medical care.

Diagnostic measures for renal colic

To find out the true causes of the pain syndrome and confirm renal colic, the patient is prescribed a number of examinations.

Physical examination

The doctor reveals soreness in the area of \u200b\u200bthe anatomical location of the kidneys along the ureteral points. At the same time, differential diagnosis is carried out with a number of acute surgical diseases - for example, a specialist during the initial examination will distinguish an attack of acute appendicitis from renal colic.

Ultrasound procedure

With this type of examination, the doctor will see the expansion of the collecting space in the kidney, stones in the ureters and kidneys and their exact location. with renal colic, it is considered quite informative, but in some cases it will not give results - for example, with an abnormal structure of the organs of the genitourinary system, or with obesity in a patient.

Excretory urography

This examination method is considered the most informative, it consists in carrying out radiography. First, a snapshot of the renal system is taken, then the patient is injected with a contrast agent into the vein, which enters the urine quickly enough. After a certain period of time, another X-ray is taken to the patient - the doctor can assess the level of filling with urine with contrast of the renal pelvis, ureter, the size of the stone and the level at which it is located in the urinary system.

Excretory urography also has contraindications - an allergy to iodine (it is contained in the contrast agent used) and thyrotoxicosis.

First aid for renal colic

If the pain syndrome in question happened at home, then you need to immediately call the ambulance team. Before the arrival of specialists, it is permissible to take a warm bath or shower - this will reduce the intensity of renal colic.

Note: if there is a history of pregnancy (even the smallest period), then the bath is contraindicated! Most likely, such an intense painful attack will indicate an ectopic pregnancy, and exposure to heat can lead to rupture of the fallopian tube and the release of the ovum.

If the pain is unbearable, then before the arrival of specialists, you can take an anesthetic - for example, Baralgin or No-shpu. But this is an extremely undesirable act - such drugs "lubricate" the clinical picture and it will be difficult for a doctor to make a diagnosis.

Renal colic treatment

If the patient is diagnosed with renal colic, the treatment will be selected. based on the etiology of the syndrome. For example, if the cause of the condition in question is urolithiasis, then it is possible to conduct it. The essence of such treatment is to prescribe specific medications that accelerate the process of stone exit from the ureter. But the doctor can make such appointments only after the examination confirms the presence of a small stone. Within the framework of lithokinetic therapy, the following drugs can be prescribed:

• antispasmodic - they not only reduce the intensity of pain, but also contribute to the expansion of the ureter;
• alpha blockers - relax the smooth muscles of the walls of the ureter;
• non-steroidal anti-inflammatory - reduce the edema of the ureter and have a good analgesic effect.

Usually, when carrying out this type of therapy, the stone leaves the ureter within 2-3 days, but if this does not happen, then the doctors conduct an additional examination of the patient and decide to change the tactics of therapy - they are prescribed. This method is considered the "gold standard" for urolithiasis - a directed beam of mechanical waves acts exactly on the stone and destroys it. This procedure is carried out necessarily under the control of ultrasound or X-ray, the effectiveness of such treatment is 95%.

Note: if the stone stands in one place for a long time, then this may result in the development of ureteral fibrosis just in the place of its localization. Therefore, even knowing about urolithiasis, the patient should not relieve renal colic at home - taking strong medications will not change the position of the stone.

Preventive measures

To prevent the development of renal colic, you should follow the recommendations of specialists:

• drink at least 2.5 liters of water daily;
• eating a balanced diet
• limit (the best option would be to completely abandon it);
• avoid overheating;
• regularly use cranberry and lingonberry, special urological collections of medicinal herbs, but only after consulting a urologist.

Renal colic is not just pain, but a “signal” from the body that there are problems in the kidneys and ureters. Even if the pain was relieved, it is necessary to undergo a medical examination and understand the cause of the condition in question, which will prevent the appearance of renal colic in the future.

ㅡ one of the strongest pain attacks, radiating to the lower back. It is provoked by stones leaving the kidneys into the ureter. The attack is progressive or manifests itself suddenly in the form of cramps. The pain is felt not only from the side of the affected organ, but also moves to the groin, pubic region, or the inner thighs.

The main cause of renal colic is a violation of urine discharge due to compression or blockage of the urinary tract. In the excretory system, a reflex muscle spasm occurs, an increase in pressure in the renal pelvis and tissue edema.

The most dangerous causes are pathologies:

1. Mechanical obstruction associated with the release of calculus through the ureter in urolithiasis (the incidence is about 58%).
2. Blockage of the ureter with clots of mucus or purulent discharge with complicated pyelonephritis.
3. The appearance of necrotic and caseous masses in kidney tuberculosis.
4. Twisting or bending of the ureter due to nephroptosis, malposition of the kidney, or narrowing of the ureter.
5. Impact of tumors (renal adenocarcinoma, adenoma and prostate cancer, hematomas after injury).
6. (progressive expansion of the renal pelvis).
7. Severe swelling of the mucous membrane with urethritis of various types, prostatitis and stagnation of blood in the peripheral veins.

Symptoms

Paroxysmal pain can be easily confused with the manifestation of other pathologies, but in the aggregate of specific symptoms indicate renal colic:

1. With increased urge to urinate becomes difficult. Toilet trips can be made every 20 minutes.
2. The patient has general disorders such as nausea, vomiting, gas and diarrhea (loose stools).
3. A pain attack usually occurs during activity while running, walking, jogging, and playing sports. But even in a calm state, the patient often feels discomfort.
4. In a short period, the pain becomes unbearable, the person moves quickly, cannot resist in one position and find a relief position.
5. An attack is characterized by the formation of pain in the lumbar region, then it moves from the ureters to the lower abdomen.
6. In complicated cases, renal colic is long lasting, receding only for a while.
7. During urination, severe pain occurs if small stones and salt come out. Urine becomes reddish due to injury to the walls of the urinary or urethra.

Other pathologies similar in symptoms to renal colic:

• ectopic pregnancy;
• appendicitis;
• acute attack of pancreatitis or cholecystitis.

The above pathologies are a threat to human health, they must be distinguished from colic. Attempts to self-relieve a painful attack should be with full confidence that it is caused by urolithiasis, and not another serious disease.

First aid algorithm

To provide first aid you need:

1. The patient must be provided with complete rest. With pain syndrome, there is a desire to move the position of the body in search of relief, but any physical activity only worsens the condition.
2. Renal colic resolves quickly with a thermal procedure. The best option is dry heating of the lumbar region. It is necessary to pour hot water into a heating pad and apply it through a dry cotton cloth in the area of \u200b\u200bthe lower back or abdomen.
3. A hot bath perfectly replaces dry heat. It relaxes smooth muscles, which helps relieve spasms.
4. Heat alone is not enough to stop an attack. Pain medications can help relieve colic. But some of them are poorly effective for this pain syndrome.

Pain relief drugs

Funds in this group are intended to stop an attack and improve the outflow of urine. Some analgesics and antispasmodics work within 15 minutes after administration. Usually, for colic use:

• Combined drugs

They have a high effect on sharp sudden toothache, headache and muscle pain. They contain antispasmodic, anti-inflammatory and analgesic components. They are taken orally or injected intramuscularly. A single dose is 1 tablet, but for shock pains, it is allowed to take two.

Spazmalgon, Revalgin, Spazgan, Baralgetas.

• Pure analgesics

Antipyretics... The simplest group of analgesics. Their effectiveness depends on several factors - the level of the body's pain threshold, susceptibility to active components and the intensity of the pain attack. Simple analgesics in combination with paracetamol do not always help with renal colic, but if there are no more such stronger remedies in the home medicine cabinet, then such drugs can be taken for relief. If the patient has a fever, then they will quickly reduce it.

Analgin, Tempalgin, Renalgan.

• Non-steroidal anti-inflammatory drugs (NSAIDs)

They have not only an analgesic effect, but also significantly inhibit inflammation, quickly reduce the temperature. NSAIDs are considered more effective drugs than simple analgesics, but they are extremely harmful to abuse. Treatment with most of the drugs in this group cannot last more than three days. If the instructions are violated, the patient has side effects.

Citramon, Diclofenac, Ortofen, Citramon, Acetylsalicylic acid.

• Narcotic analgesics

This is a special group of medicines sold only by prescription. These include all drugs based on codeine or opium. Sometimes they are prescribed to eliminate unbearable pain and alleviate the patient's serious condition before surgery.

Fentanyl, Promedol and Codeine.

• Pure antispasmodics

Provides relaxation of smooth muscles, which simplifies the passage of calculus into the bladder. After taking an antispasmodic, the patency of the lumen of the ureter is restored. This helps relieve tension in the lower back. But to enhance the effect, an analgesic must be taken along with one of the remedies.

Papaverine, No-shpa, Platyphyllin.

You can also learn about help with renal colic from this video.

Renal colic in itself is not a disease, representing a symptom indicating rather pronounced manifestations that something is wrong in the body. Pain acts as the main manifestation accompanying this condition. Renal colic, first aid in which is focused specifically on the elimination of this pain, in terms of the frequency of its own occurrence takes the "honorable" second place, following the manifestations of acute appendicitis.

Renal colic causes

The following conditions are distinguished as the reasons for the appearance of renal colic:

• urolithiasis disease;
• disorders in mineral metabolism;
• pyelonephritis;
• nephroptosis;
• hydronephrosis;
• tumor formations in the kidney area;
• diseases associated with the functions of the prostate gland, etc.

In general, about 38% of the total number of cases of this condition, the causes of renal colic cannot be determined. Meanwhile, the most common reason is the relevance of urolithiasis for a patient, in which there is a blockage of the lumen of the ureter with a stone.

Renal colic, the first aid for the appearance of which we will consider a little below, requires contacting a doctor after it appears, and it is important to do this in any case, even if the pain has passed by itself and quickly enough. The fact is that this condition may indicate the presence of one or another, often extremely dangerous disease, the treatment of which should be started immediately. Such diseases include, for example, tumors (whether it is a benign tumor formation or a cancerous formation).

In the case of the formation of stones in the kidney and the appearance of renal colic against the background of kidney stone disease, this condition is accompanied first by pain, and then by the appearance of an admixture of blood in the urine during urination.

Renal colic, provoked by a blood clot of dense consistency, as a result of the formation of which there was a blockage of the ureter, initially determines the presence of blood impurities in the urine, and only after that, in fact, the renal colic itself develops.

Renal colic symptoms

Renal colic can appear quite suddenly, even against the background of a person's normal well-being. In addition, its peculiarity lies in the severity of the manifestations accompanying the state as a whole. So, the patient develops a sharp pain, concentrated in the lumbar region, this pain has a pulsating character, and only by changing the position of the body in this situation, it will not be possible to reduce its intensity. When accepting any position of the body, the pain does not subside, the patient is in a restless state, almost reaching a state of pain shock.

Often, renal colic is accompanied by symptoms indicating intoxication, which manifests itself in severe tremors (tremors) of the extremities, nausea and vomiting, general weakness and impaired consciousness. In addition, there is a urge to urinate, which are also very painful.

In almost all situations, renal colic is accompanied by intestinal paresis, which occurs at the reflex level as a reaction to severe pain in the area under consideration. This manifests itself in the form of difficulty in passing gas, constipation, and bloating.

Renal colic: first aid

As we have already noted, renal colic, when it occurs, requires a mandatory visit to a doctor, it is necessary to cause it, regardless of how intense the pain sensations relevant to this condition are and how long the attack lasts. Signs of renal colic can often imply completely different diseases, in which it is simply impossible to do without emergency specialized care. It can be appendicitis or ectopic pregnancy, an attack of cholecystitis or pancreatitis, as well as any other pathology.

Often, renal colic is mistakenly diagnosed as intestinal obstruction, and this is quite justified - the clinical picture in both cases is almost identical.

Providing first aid for renal colic requires, first of all, the conviction that the point here is really in this condition, and not in something else. If this is any acute disease, heat is completely contraindicated in it, which cannot be said about renal colic, in which, on the contrary, it is necessary. Accordingly, to determine a specific condition, an assessment of the signs of renal colic is carried out, which is described somewhat above, in particular, you need to pay particular attention to the manifestations of pain, which, in the state of interest to us, is cramping. A factor such as frequent urination is also taken into account.

In particular, first aid for renal colic is to provide the victim with warmth. Nevertheless, if he has a high fever and impaired consciousness, this item is skipped as a measure of implementation.

If the patient has a normal temperature and really renal colic, then the most effective first aid measure is a hot bath, which must be taken in a sitting position. You need to fill it with water as hot as a person can tolerate its heating to the maximum.

Again, there is a contraindication in this regard. So, if the victim of renal colic is an elderly person or a person who has one or another serious disease associated with the functions of the cardiovascular system, as well as a person who has had a previous heart attack or stroke, then a hot bath in these options is unacceptable. In such cases, first aid for renal colic is to restrict heat before using a heating pad on the lumbar region. In addition, mustard plasters can also be applied, they must also be placed in the kidney area.