Renal colic should be considered in the event of sudden, unbearable pain in the flank area. The symptoms are caused by a blockage of the ureter by a urinary stone. The doctor can prescribe effective painkillers, monitor the course of the renal colic and, if necessary, intervene surgically.
What is renal colic?
Renal colic describes an acute pain condition that is usually unbearable for those affected and occurs in phases. The pain begins in one of the flanks and extends to the lateral abdomen and genitals. See etaizhou for What does Tall Stature Mean.
In addition, the pain can cause vomiting and profuse sweating. The trigger for renal colic is a larger urinary stone from the renal pelvis, which suddenly blocks the ureter on its way to the bladder.
As a result, the muscles surrounding it constantly contract in order to loosen the stone and transport it to the bladder. The increasing cramping of the muscles leads to the typical wave-like pain of renal colic.
Causes
Renal colic is caused by a blockage of the ureter by a urinary stone. The person affected often has several stones in the renal pelvis, which cause dull pain in the flank independently of the spontaneously occurring colic.
Smaller stones can usually pass through the ureter without problems. Urinary stones are more common in patients with frequent urinary tract infections. Sufficient fluid intake is therefore important on the one hand to avoid infections and also to counteract the formation of urinary stones.
Urinary stones can also develop after weight loss and the associated change in diet. In the case of narrowing and malformations of the ureter, there is also a higher probability of urinary retention and the subsequent formation of urinary stones. Renal colic may therefore occur more frequently in these patients.
Symptoms, Ailments & Signs
One-sided, severe to unbearable pain is characteristic of renal colic. It begins acutely in the affected kidney, i.e. in the back at the height of the short ribs. The severity depends on the shape and size of the kidney stone that caused it and the condition of the ureter. The pain can radiate down the back or into the chest and abdomen.
If a kidney stone is stuck in the ureter, the pain stays in one place and can increase and decrease in episodes. As the stone moves through the ureter toward the bladder, the point from which the pain radiates slowly moves down into the back of the abdomen and finally obliquely toward the center of the body. Bloody urine is possible, but does not occur in all those affected.
The pain can end suddenly if the kidney stone enters the bladder. When urinating, the stone can now get into the urethra. This causes the pain to return, this time in the center of the pelvis. Acute pain travels down the urethra until the stone comes out. Some patients report hearing the passed kidney stone fall down the toilet.
Diagnosis & History
The diagnosis of renal colic is usually suspected by the doctor based on the typical pain along the patient’s flank. They are often so unbearable for the patient that he immediately goes to the doctor or the emergency services are called. A laboratory examination of the urine serves to exclude infections of the urinary bladder or kidneys.
If the patient has chills or a fever, an additional inflammation of the renal pelvis must also be considered. The urinary stones as a trigger of the renal colic can be shown by an ultrasound examination or an X-ray examination with contrast medium. Computed tomography (CT) is rarely necessary.
When should you go to the doctor?
If sharp pains, nausea and vomiting or signs of intestinal blockage are noticed, a doctor’s visit is recommended. If the symptoms do not go away on their own, they must be examined by a doctor, as there may be a serious cause such as renal colic. A reduced amount of urine and swelling in the kidney area also indicate a medical emergency. Affected persons should be taken to the hospital or, in the case of severe symptoms, the emergency services must be called. If there is already a concrete suspicion that the symptoms could be due to renal colic, the family doctor must be consulted immediately.
Corresponding complaints must be clarified if they occur in connection with a urinary stone or an acute urinary drainage disorder. The same applies if renal colic occurs in connection with a diagnosed tumor disease in the area of the ureter or kidneys, previous blood clots or diseases of the connective tissue. Renal colic is treated by a nephrologist or a gastroenterologist. In the event of a medical emergency, the patient must be treated as an inpatient in the hospital. During drug treatment, any side effects from the prescribed medication must be carefully monitored and these must be reported to the doctor in order to rule out further complications.
Treatment & Therapy
The treatment of renal colic is initially intended to relieve the patient’s severe pain with painkillers. These are usually taken every two to three hours. Stones up to five millimeters in size should dislodge themselves from the ureter and travel further into the bladder.
The patient has to drink a lot and move around enough to additionally stimulate the further transport of the stone. Up to 80 percent of urinary stones disappear in this way without surgical treatment. However, if renal colic recurs or if the urinary stone is larger, shock wave lithotripsy (ESWL) can be performed under local anesthesia.
The stones are destroyed by shock waves generated outside the body and the resulting fragments can then easily pass through the ureter. Large urinary stones and especially those that fill the renal pelvis can also be removed endoscopically from the renal pelvis through the abdominal skin using what is known as percutaneous nephrolithoplaxia (PNL).
A combination of both methods is also possible. Ureterorenoscopy can also be performed in patients with large urinary stones that lead to repeated renal colic with unbearable pain if all other measures fail to provide relief. In this surgical procedure, the stones, and thus the trigger of the renal colic, are removed endoscopically via the urethra.
Complications
Renal colic is always an emergency and should be treated as soon as possible. The kidney stone that caused it often dissolves on its own with the help of fluid intake, exercise and drug treatment. However, it can happen that the stone gets stuck and leads to a dangerous urinary retention. If this urinary retention is not treated, severe kidney damage will occur, which can lead to complete destruction of the kidneys.
After an acute urinary stasis, however, the functionality of the kidneys can be fully restored with immediate treatment. However, if the symptoms of renal colic are ignored, chronic urinary retention can occur, in which the urine drainage is only partially guaranteed. As a result, a sac-shaped expansion of the renal cavity often develops.
This leads to the destruction of functional kidney tissue with the development of a so-called atrophic kidney. If there is a problem with the outflow of urine, an infection of the urinary tract can also occur. Under certain circumstances, this then leads to a septic urinary stasis kidney, which is associated with severe fever, chills, severe pain and pyelitis. If left untreated, congestion can lead to death. This is especially the case when the bacteria are washed into the bloodstream and cause blood poisoning there.
Outlook & Forecast
Renal colic is an acute health condition that requires immediate action. Without the fastest possible medical care, the person affected is at risk of irreversible organ damage and life-threatening conditions. The sooner the medical emergency is treated professionally, the better the further course of the disease and thus the prognosis.
Under optimal conditions, in addition to the supply of liquids, drug treatment is initiated and special movement therapy is carried out. These measures can already lead to a significant alleviation of the symptoms and, in the further course, lead to freedom from symptoms. If there are no complications or permanent tissue damage to the kidneys, the patient can be discharged from treatment after a few weeks as recovered.
In most cases, despite all efforts, the kidneys cannot function properly. Long-term therapy may be necessary. In addition to drug treatment, dialysis is another possible health measure to improve the overall situation.
This poses a particular challenge for those affected to cope with everyday life. The emotional stress is often so severe that psychological complications occur. This must be taken into account when making the forecast. For some patients, the last line of treatment is a transplant. Otherwise, the average life expectancy is significantly reduced because there is a risk of organ failure.
Prevention
Renal colic can be prevented with adequate fluid intake. This is particularly important in summer temperatures and the associated increased sweating. Frequent urinary tract infections, which also promote the formation of urinary stones, can also be prevented. The rapid loss of body weight without drinking enough also promotes the formation of urinary stones and thus the occurrence of renal colic.
Aftercare
After treatment of renal colic, follow-up care is indicated to provide targeted relief of any symptoms and to monitor disease progression beyond recovery. The risk of complications varies depending on the type and severity of the colic. Metaphylaxis is necessary in any case, since otherwise kidney damage can go unnoticed or renal colic can occur again and further damage the organ.
The first follow-up examination primarily includes checking the affected kidney. For this purpose, the doctor uses imaging methods and a physical examination. The anamnesis serves to answer open questions and to clarify any complaints. If no abnormalities are found, the aftercare can be completed. Renal colic should not cause any further symptoms once it has subsided.
It is sufficient if the patient makes use of the normal check-ups. In addition, one must continue to pay attention to signs of renewed kidney problems. Drug treatment of pain or persistent inflammation can be monitored by the general practitioner. Finding the cause of the renal colic can also be part of the follow-up care, insofar as the trigger has not already been determined during the actual treatment.
You can do that yourself
To support a natural passage of the urinary stone, the affected person should move sufficiently. Regular sporting activities and targeted movements of the pelvis can lead to spontaneous detachment of the foreign body. This avoids a surgical intervention and reduces the necessary medical treatments. At the same time, it is important to warn against overexerting or overloading the organism, otherwise the general condition will deteriorate.
As soon as the urinary stone has been completely removed, spontaneous healing occurs and the patient is normally symptom-free. Various measures can also be taken to minimize the risk of renal colic in the long term. Changing your diet can counteract the formation of new urinary stones. The consumption of meat and offal should be reduced or avoided. The intake of the stimulant coffee should also be restricted in order to improve health. In addition, drinking black tea and consuming dairy products should be avoided.
A healthy and balanced diet as well as regular physical activity promotes long-term health maintenance. The intake of two liters of liquid per day is recommended for adults. In the case of existing renal colic, the amount of fluid intake should be increased. This stimulates the activity of the kidneys and increases the likelihood of the foreign body being transported away naturally.
