Remove renal colic at home. Renal colic: how to relieve pain? Symptoms of renal colic in women and men With renal colic, it is possible

If you have renal colic, home treatment requires an accurate determination of the underlying cause, as conflicting sources may underlie an acute flare-up of pain.

The sharp development of pain in the lumbar region is called renal colic. The strongest attack of pain is often associated with an exacerbation of urolithiasis or a circulatory disorder in the kidneys. Pain in renal colic is so palpable that it causes loss of consciousness.

Since the disease is common, many sufferers seek more information about treating renal colic at home, such as how to relieve pain and relieve the condition before qualified medical help is available.

Symptoms and causes of renal colic

The main cause of the development of renal colic is urolithiasis with the movement of stones. Large stones can block the urinary tract, as a result of which the outflow of urine is disturbed and an acute pain attack develops.

• injuries and damage to the kidneys;
• omission of the kidney;
• decrease in the lumen of the ureter;
• cancers in the kidneys;
• tumor formations in the pelvic organs;
• kidney tuberculosis;
• acute inflammation of the pelvis.

The cause of pain in the kidneys are many factors. If an attack of pain appeared for the first time, then it is necessary to call a specialist to identify the source and correct treatment.

Sudden sharp pain in the lower back or hypochondrium, sometimes to the point of loss of consciousness, is the main sign of renal colic. Painful sensations do not disappear from a change in location, they persist both in a calm position and when the patient moves.

• the appearance of bloody discharge in the urine;
• frequent urination;
• problems with stools in the form of loose stools or constipation;
• painful sensations are given to the perineum, inguinal zone or side zone on the other side;
• intense pain in the form of contractions.

• increase in body temperature;
• jump in blood pressure;
• pain in the ribs;
• nausea, vomiting, or dizziness;
• bloating.

The above symptoms may indicate the presence of various diseases. After stopping the attack, you should contact a specialist and undergo a complete examination for an accurate diagnosis.

First aid for renal colic

With the primary phenomenon of renal colic, it is necessary to call an ambulance. This is especially true for babies and pregnant women. Conventional analgesics can worsen the condition and increase pain. The doctor will help to identify and eliminate the source of pain. After stopping the attack, it is necessary to undergo a medical examination and begin treatment of concomitant pathology.

If the cause of the pain is known, then the treatment of colic at home is as follows:

1. Bed rest.
2. Wrapping the patient in warm blankets.
3. Place a warm heating pad in the lumbar region. The water in the heating pad should be at a comfortable temperature. Instead of a heating pad, you can take a warm bath. Thermal procedures relieve spasms and promote the outflow of urine, so that the condition improves faster.
4. Make an intramuscular injection of Nosh-pa, or Baralgin, or Spazmalgon, or Papaverine. These drugs are acceptable without an accurate diagnosis. In the event of a repeated attack, let's take anti-inflammatory drugs previously prescribed by a doctor.
5. The amount of liquid must be increased. You can drink a decoction of rose hips, compotes, boiled water and other drinks.
6. The position of the patient should be arranged so that the bladder is placed lower than the kidneys.
7. The urge to urinate cannot be tolerated. At the slightest urge, the bladder should be emptied immediately. To do this, you can use special dishes. In the treatment of colic, it is necessary to control urination until the calculus is released and you feel better.

If the measures taken to alleviate the pain syndrome do not produce the desired effect, then hospitalization is necessary. It is important to remember that help is provided only with absolute certainty that this is really renal colic, since in other cases all home treatment will be useless.

Elderly people, patients with one kidney, pregnant women and children should be examined and treated only in a hospital under the supervision of doctors.

Treatment of renal colic at home

Since the treatment takes place in several stages, it is necessary to constantly monitor the patient's well-being.

1. When the condition improves, the patient can take a warm bath with a water temperature of up to 40 degrees and a duration of no more than 20 minutes. Warm water is able to anesthetize the attack.
2. It is forbidden to take painkillers without consulting a doctor. Even a single dose of Ketanov or Ketorol will make it difficult to make an accurate diagnosis.
3. After 6 hours, Asparkam or Panangin should be taken. These drugs perfectly strengthen the heart muscle, weakened due to an attack.
4. If the pain syndrome persists, it is necessary to reuse antispasmodics, such as Baralgin with Nosh-poy, Papaverine.

1. It is not recommended to leave the patient alone for a long time, since the treatment of renal colic at home requires constant supervision and care.
2. An increase in temperature or the presence of neoplasms is a ban on warming up.
3. Strong painkillers, highly carbonated drinks and heavy physical exertion are also prohibited.

At high temperature, nausea with vomiting, absence of urine and pain syndrome for more than two days, urgent hospitalization is necessary.

Non-drug treatment and prevention of renal colic

Many patients do not want to resort to drug treatment, so any information on how to relieve an attack of renal colic at home using folk methods is important to them.

Unconventional methods have a positive result in getting rid of an attack.

Tips on how to treat pathology with folk recipes:

1. Decoction of pumpkin seeds.
2. Flax seed for internal and external use. A decoction is taken every two hours, a compress on the lower back is recommended at bedtime.
3. One day a week eating only boiled wheat.
4. Chamomile tea with lemon balm and mint in the same amount is taken once a day, if treatment at home is preferable for renal colic.
5. An infusion of birch buds, parsley, flax seeds, strawberry leaves and rose hips is useful for colic attacks.
6. Dried lingonberry leaves have an excellent diuretic effect.

There are many other methods of traditional medicine, but it is necessary to put them into practice only after consulting a specialist and clarifying the diagnosis. It is important to remember that self-medication is unacceptable.

The main measure of prevention is timely medical examination and monitoring by ultrasound. With the help of ultrasound, you can find out about the presence of stones or sand in the kidneys and bladder.

To prevent the appearance and growth of calculi, it is necessary to follow a proper and healthy diet, drink the required amount of pure water and herbal teas with a urological effect. Refusal of pickles and smoked meats is also good for the body.

A healthy lifestyle and regular exercise will help you stay healthy for a long time.

Quite often, patients learn about such a diagnosis as urolithiasis at the onset of renal colic syndrome, with which they enter the hospital by ambulance.

As a rule, until the movement of the formed stone along the urinary tract, the pathological process is absolutely asymptomatic. Although the patient's body is already experiencing quite severe metabolic disorders, patients do not even know that they have stones and do not know what renal colic is.

Renal colic is a symptom complex that has a vivid clinical picture of what is happening, characterized by a severe attack of pain in the patient and changes in his urinary sediment (traces of blood appear in the urine, pathological impurities, etc.).

This condition is observed in people of different sexes and age groups. In children and pregnant women, renal colic is quite difficult, which requires a special approach from the doctor to relieve pain.

Renal colic, as a rule, is unbearable and begins suddenly (against the background of complete well-being). They completely deprive a person of his ability to work for a certain period of time, and if treated late, they can cause serious and dangerous complications.

Main reasons

In order for an attack of colic to develop, a violation of the outflow of urine is necessary, which leads to a reflex spasm of the smooth muscle fibers of the ureter and the appearance of a strong pain impulse in the cerebral cortex.

Stagnation of urine increases the pressure gradient in the pyelocaliceal apparatus of the affected kidney, which disrupts the processes of microcirculation and venous outflow in it. There is an increase in the parenchymal component of the organ and a stretching of the capsule, rich in nerve endings. This greatly increases the pain, and worsens the patient's well-being.

The causes of renal colic in more than 90% of cases are associated with the formation of stones at different stages of the urinary tract. It is with this disease that urological doctors most often have to deal with. The process is based on metabolic disorders, which leads to stone formation from urates, oxalates and other substances.

Among the predisposing factors, one way or another, affecting the onset of the ICD, it is necessary to highlight:

• genetic predisposition to metabolic disorders (more than half of the cases);
• work associated with heavy physical exertion, or intense sports, leading to dehydration;
• improper diet, a small amount of liquid consumed during the day;
• congenital defects of the urinary tract, leading to pathological stagnation of urine, etc.

An attack of renal colic can provoke any inflammatory process in the pyelocaliceal apparatus of the kidney, in which there is a violation of urine output due to a clot of pus that has closed the lumen of the duct (for example, against the background of acute pyelonephritis or exacerbation of its chronic form).

Destructive changes in the tissues of one or both kidneys can also cause the onset of a sudden pain syndrome. This is observed with a cancerous degeneration of an organ or a tuberculous process in it.

Against the background of oncology, normal tissues and walls of blood vessels are destroyed, which often leads to the closure of the lumen of the ureter or urethra with tumor fragments.

Severe traumatic effect on the organ (may cause a blood clot to enter the lumen of the urinary tract and clog them, for example, when falling from a height).

Compression of the ureters or urethra from the outside (growing oncological processes in the pelvis, massive hematoma, etc.).

Symptoms

As a rule, the initial manifestations of the process go unnoticed for the patient (if we are talking about the formation of stones). It is extremely rare that they pay attention to the fact that sometimes colitis or aches for no reason in the kidney area, until the disease begins to progress.

A typical and most striking symptom of the process that has begun is intense, often unbearable pain that occurs suddenly and is paroxysmal in nature (sometimes it is preceded by intense physical activity).

The pain is localized on the side of the obstruction of the ureter or excretory duct from the pyelocaliceal apparatus

The pain syndrome makes the patient toss and turn in bed in search of the most comfortable position that can reduce pain, however, these attempts are in vain. They are very excited and groan at the time of the attack.

If the calculus is localized in the lumen of the urethra, then the pain in the lower abdomen is diffuse. Dysuric disorders appear, the process of emptying the bladder is disturbed. Patients complain of pain during urination, and the desire to urinate becomes painful and constant.

A characteristic symptom of the process is the presence of blood in the urinary sediment (hematuria), the appearance of which is noted by the patient himself, because, as a rule, it is visible to the naked eye.

Characterized by irradiation of pain in the genitals, different parts of the abdomen, rectum, which is accompanied by painful urge to empty the intestines. Intestinal distention may occur, simulating the clinical picture of an acute abdomen.

At the peak of pain, attacks of nausea and vomiting appear, which do not relieve symptoms and do not bring relief to the patient. If the temperature rises to febrile values ​​\u200b\u200band higher, then this is direct evidence of the addition of bacterial flora, which can threaten the patient with a number of serious complications.

With spontaneous discharge of the calculus, the pain syndrome ends as suddenly as it began, which indicates the restoration of the outflow of urine.

Renal colic in children and pregnant women

Treatment of pathology in this category of patients is carried out only in a specialized hospital.

In children, stone formation is usually due to malnutrition and genetic predisposition. During pregnancy, those processes that previously proceeded latently are often activated, including urolithiasis.

Renal colic during pregnancy is often mistaken for the onset of preterm labor, especially if it occurs in the last stages, as a result of which the woman is mistakenly hospitalized in the maternity hospital. If urinary outflow disorders are observed in young children, then making a diagnosis can also be difficult, since babies cannot always explain what exactly worries them.

When choosing an anesthetic for renal colic in children and pregnant women, preference is given to the safest antispasmodics that are administered subcutaneously or intramuscularly (for example, No-shpa).

Complication

An unfavorable outcome is observed if the treatment of renal colic is late for one reason or another (for example, it hurts for a long time to stop pain attacks by taking large doses of painkillers and did not consult a doctor).

The complications of the process include:

• inflammation of one or both kidneys (obstructive pyelonephritis);
• cicatricial deformities of the affected ureter (development of strictures in it);
• septic condition of the patient (urosepsis) and others.

Cicatricial narrowing of the lumen of the ureter can be restored only by surgical intervention

Diagnostic principles

When a patient is admitted to a hospital, the doctor must very carefully collect an anamnesis of the disease from him. To do this, a question is asked about the presence of similar symptoms earlier, both in the patient himself and in his relatives (family history).

Subjective complaints are evaluated, because already on their basis a number of other pathological processes can be excluded. The characteristics of pain sensations, their exact localization and irradiation, what provokes them, and what, on the contrary, helps to stop renal colic, are asked in detail.

When examining a patient, the doctor performs palpation of the abdomen and pelvic organs. There is a sharp pain on the side of the lesion, that is, in the place where the blockage of the lumen of the ureter or urethra occurred. The abdomen is usually tense. When tapping on the lumbar region, a sharp pain occurs.

The main importance in differential diagnosis is given to methods of laboratory and instrumental research.

All patients are prescribed:

• blood test (general and biochemical);
• urinalysis and Nechiporenko test;
• overview x-ray and excretory (intravenous) urography;
• Ultrasound of the pelvic organs and urinary tract;
• CT or MRI of the urinary tract;
• other studies according to indications (diagnostic laparoscopy, etc.).

Diagnosis of the presence of kidney stones can be done using X-ray and ultrasound methods.

Principles of differential diagnosis

Unfortunately, there are no pathognomonic symptoms characteristic only for an attack of acute colic, so the process must be differentiated from a number of other diseases.

Below is a list of the main diseases that occur with symptoms resembling the clinic of renal colic:

• acute processes in the abdominal organs (inflammation of the appendix, acute cholecystitis or pancreatitis, peptic ulcer of the stomach or duodenum with perforation, intestinal obstruction);
• acute processes in the pelvic organs in women (inflammation of the fallopian tubes or ovaries, ectopic pregnancy and rupture of the tube, torsion of the cystic formation and necrosis of its legs, and others);
• inflammation of the urinary system (cystitis, urethritis, prostatitis and others);
• pathological processes of the organs of the cardiovascular system (attack of myocardial infarction, exfoliating aortic aneurysm);
• pain syndrome associated with diseases of the musculoskeletal system (intercostal neuralgia, osteochondrosis of the thoracic or lumbar spine, prolapsed hernia, and others).

Each of these conditions requires a thorough laboratory and instrumental examination of the patient.

If sudden pain occurs, it is necessary to call an ambulance as soon as possible, which will refer the patient to a hospital for further examination and specialized treatment.

It is worth saying about what you can not do with renal colic:

• for a long time to try to anesthetize discomfort on their own, taking huge doses of analgesic drugs from different pharmacological groups;
• heat the site of greatest pain if there is no certainty that the cause of the symptoms is related to the movement of the stone. Before the arrival of the medical team, you should do the following:
• it is necessary to calm down as much as possible and try to breathe deeply with each attack of pain;
• find a first-aid kit at home (for a while, analgesics and antispasmodics, or a combination of them, for example, Baralgin, will help relieve an unbearable attack of renal colic).

You can also take 2 tablets of No-shpy or Drotoverin. If there is a person with a medical education in the family, then their intramuscular administration is recommended.

When none of the above drugs is in the first-aid kit, then a Nitroglycerin tablet is used as an anesthetic, which is taken under the tongue until it is completely dissolved (cannot be chewed or washed down with water).

Specialized Emergency Therapy

In order to reduce the severity of pain as soon as possible, all drugs are administered intravenously, if this is not possible, intramuscularly.

Among the most common and effective painkillers, it is worth highlighting Ketorol, Diclofenac, Tramadol, Baralgin M and others.

Before the doctor begins to stop the attack of colic, it is necessary to tell him in detail about all the drugs and their dosages that were previously taken.

Antispasmodics in renal colic help fight the spastic component of the pathological condition, so their appointment is mandatory (No-shpa, Platifillin, Papaverine and others).

Relief of renal colic in a hospital

When a patient enters a specialized department, the basis of the patient's treatment is painkillers and antispasmodics. This continues until the stone passes or until the patient feels better.

If a patient has complications of an infectious nature against the background of the addition of bacterial agents, adequate antibiotic therapy is mandatory. Antibiotics are prescribed taking into account the microflora, which is sown in urine tests (protected penicillins, cephalosporins, macrolides, and others).

All patients are prescribed a salt-free diet, and they completely exclude from their diet all foods that can, in one way or another, influence the formation of stones (fatty meats and fish, confectionery, etc.). The choice of a specific type of diet depends on the type of stones (urate, oxalate and others).

Surgery

Further management of the patient directly depends on the size of the calculi, their number, location, age of the patient, etc.

If an attack of colic is easily controlled, and the stone is small (up to 1 cm in diameter), and there is a possibility of natural discharge, then it is usually not touched. This is not an indication for surgery, so the patient continues to be treated with conservative methods (they prescribe the necessary diet, prescribe drugs that help dissolve stones, etc.).

In the event that the severity of pain is unbearable, and there are signs of a violation of the kidney, immediately proceed to the operation.

The choice of surgical access is determined by the patient's condition and the specifics of the process (abdominal surgery, endoscopic intervention, etc.)

Conclusion

Every patient who has suffered an attack of renal colic associated with urolithiasis at least once in his life must continue to adhere to a number of rules and principles of nutrition. Even surgical removal of the stone does not guarantee the patient the complete absence of a recurrence of the disease.

Renal colic

is a common clinical syndrome that can occur due to a variety of factors that cause a violation of the outflow of urine or a spasm of the smooth muscles of the ureter, which is accompanied by severe pain.

In the vast majority of cases, this disease develops on the basis of previously existing

pathologies of the kidneys or urinary tract

and without proper treatment and prevention, it often manifests itself in several recurring episodes. Most often, renal colic occurs due to blockage of the urinary tract by stones at the level of the renal pelvis or ureters, or due to any other obstruction.

According to statistics, the frequency of kidney stones is about 12% for men and about 7% for women. share

urolithiasis

among all urological diseases (

kidney and urinary tract diseases

) is 30 - 40% depending on the region. The ratio of affected men to women is 3 to 1. At the same time, the likelihood of developing post-infectious stones is higher among the female population, which results in approximately equal chances of developing renal colic. If someone in the family suffers from this disease, the risk of its occurrence doubles. Most often, this pathology affects people aged 20 to 50 years, with the highest frequency between 35 and 45 years. For the first time, renal colic after 50 years of age is a rare occurrence, as well as colic that has developed in children. Only in 9-17% of cases is urolithiasis affecting both kidneys, that is, in the vast majority of cases, this pathology develops in one of the kidneys (

more often right

). It is with this that the renal colic occurs only on one side.

Interesting Facts:

the oldest stone in the urinary tract that could cause renal colic was found in a mummy that is over 7,000 years old; renal colic caused by stones in the urinary tract, as well as methods of its treatment, is described in the book of the Roman physician Galen, who lived in the second century AD; the right kidney is affected much more often than the left; it is believed that the risk of kidney stones and, accordingly, renal colic is higher, the higher the level of socio-economic well-being; relapses (repeated exacerbations) of urolithiasis and renal colic are observed in almost a third of cases.

Causes of renal colic

Renal colic is a disease that can occur for a variety of reasons. The basis of this pathology is a violation of the outflow of urine from the kidney, which leads to a sudden increase in pressure in the urinary tract. The cause of renal colic may be any obstruction at the level of the upper urinary tract, which blocks the lumen of the ureter, causing its occlusion, thereby provoking the development of a number of pathophysiological mechanisms that cause the main symptoms of this disease.

The cause of renal colic can be:

kidney and upper urinary tract stones; kink and narrowing of the ureter; blood clots; accumulations of pus; swelling of the ureter due to an allergic reaction.

Kidney and upper urinary tract stones

The formation of stones in the kidneys and upper urinary tract is associated with various metabolic disorders, which can be caused by a variety of external, internal and congenital factors. In the vast majority of cases, this pathology is associated with a violation of salt metabolism, which leads to a violation of the ratio between substances that maintain urine in a liquid state and contribute to the formation of stones.

The following substances keep urine liquid:

urea; creatinine; hippuric acid; sodium chloride; magnesium; salts of citric acid.

Stone-forming substances are:

calcium salts; oxalates; uric acid; cysteine;

The formation of kidney stones depends on two processes. The first is based on the oversaturation of urine with stone-forming substances that form the core of crystallization (

a sufficiently large cluster of atoms forming a stable microscopic crystal

) on the surface of which other atoms are deposited, thereby causing its gradual growth. This process underlies the formation of uric acid and cysteine ​​stones.

The second mechanism of stone formation, which is considered responsible for the formation of oxalate and oxalate-calcium stones, is the deposition of salts on the crystallization nucleus, which is the subepithelial accumulation of calcium phosphate around the renal papillae. These accumulations are formed due to the penetration of calcium phosphate salts through the wall of the renal tubules during the filtration of primary urine with further accumulation at the subepithelial level (

under the layer of cells that form the wall of the urinary tubules

). These formations injure the endothelium (

mucous membrane

) of the urinary tract and thus become exposed and become an anchor for calcium salts and calcium oxalate. This model of stone formation was proposed recently, but, despite this, a fairly large amount of experimental data confirming it has already been accumulated.

In addition to the listed mechanisms of stone formation, we should separately mention struvite stones, which are formed during an infectious lesion of the upper urinary tract. They include salts of various minerals, as well as urea breakdown products. associated with enzymatic activity.

bacteria

Which, through the production of urease (

enzyme that breaks down urea

) increase the concentration of ammonia and carbon dioxide, which combine with other ions to form ammonium phosphate and calcium carbonate, and also significantly alkalinize urine. All this leads to the formation of so-called staghorn stones, which are characterized by a fairly rapid growth rate, and which can completely fill the pelvicalyceal system of the kidney. It should be noted that, despite the use of antibacterial drugs, these stones are quite common.

Nevertheless, it is necessary to understand that the process of formation of stones in the kidneys and upper urinary tract is based on various systemic disorders, metabolic pathologies, as well as on a number of exogenous (

external influences

) factors.

The following factors increase the risk of developing kidney stones:

Climate. It is believed that the risk of kidney stones is higher in warm southern regions and lower in the north. Composition and properties of water and soil. The composition of the water consumed determines the concentration of salts and minerals entering the body and thus affects the filtration processes in the kidneys and, accordingly, the process of stone formation. The qualitative composition of the soil is a factor that affects the concentration of various substances in the composition of directly consumed plant foods, as well as the composition of animal products (since animals eat plant foods and get the appropriate substances from it). Diet. Deficiency or excess of any substances, minerals or vitamins in foods can cause a violation of the normal function of the kidneys and provoke the process of stone formation. Excessive consumption of chocolate, parsley, sorrel, sweet foods, pickles, smoked meats can create a predisposing background for the development of this disease. Vitamin A deficiency. A lack of vitamin A leads to excessive sloughing of the epithelial cells of the renal pelvis, which act as crystallization nuclei. Vitamin D deficiency. Vitamin D is essential for normal calcium metabolism. With its deficiency, calcium is not able to bind oxalic acid in the intestines, and when it enters the body, it accumulates in the kidneys, where, settling in the form of salts, it forms oxalate stones. Too much vitamin D. Excessive intake of vitamin D has the opposite effect, increasing the likelihood of stones. The recommended daily dose of vitamin D is about 600 IU (1 IU of vitamin D is 0.025 micrograms of cholecalciferol or ergocalciferol). Dehydration of the body. Dehydration of the body, which can occur against the background of intense evaporation of moisture through the skin, vomiting, diarrhea, or insufficient fluid intake into the body, leads to an increase in urine density (since the process of reverse absorption of water in the tubules of the kidneys to compensate for lost fluid volumes is enhanced), which significantly stimulates the process of crystallization of calcium salts.

The following internal factors of the body contribute to the development of urolithiasis:

Congenital or acquired anomalies of the urinary tract. The presence of constrictions, bends, changes in the structural and functional state of the kidneys (spongy kidney, horseshoe kidney) leads to a violation of the outflow of urine, which contributes to stagnant processes and increases the risk of stone formation. In addition, in the presence of narrowing of the ureters, the risk of urinary stones getting stuck with the development of renal colic increases significantly. Vesicoureteral reflux. Vesicoureteral reflux is a phenomenon in which urine from the bladder is thrown back into the ureters, leading to increased intrapelvic pressure and urinary stasis. All this contributes to stone formation. Urinary tract infections. Infectious agents change the properties of urine, alkalizing it, and also produce a number of enzymes and waste products that, by acting on various substances, contribute to their transformation with further crystallization in the form of stones. In addition, some bacteria can cause local tissue damage, which creates a crystallization nucleus. Deficiency or impaired production of enzymes. The absence or defect of enzymes that serve for the normal metabolism or transport of a number of stone-forming substances (for example, cysteine) leads to their accumulation and, accordingly, to the formation of stones in the urinary tract. In the vast majority of cases, this condition is congenital, but it can be corrected with the right treatment. Gout. Gout is a metabolic disease in which uric acid is not metabolized, which accumulates in excess in the blood and urine and forms crystals (which usually form in the joints, causing considerable pain during movement, and in the kidneys, forming urate stones). The main part of uric acid is formed in the human body as a result of the breakdown of purine bases that enter the body along with meat and fish food, as well as tea and coffee. Prolonged immobilization. Prolonged immobilization leads to dysfunction of most human organs and systems. The kidneys are no exception, in which the risk of stone formation increases. This is due to partial bone resorption and an increase in the concentration of phosphates and calcium salts, with a decrease in the number of protective substances, with insufficient synthesis of vitamin D (which is necessary for normal calcium metabolism, and which is formed in the skin under the influence of sunlight). Other factors. Excessive intake of vitamin C, sulfa drugs, bone cancer, sarcoidosis, leukemia, Crohn's disease, Paget's disease, gastrointestinal disorders, and many other factors can create conditions for the formation of kidney stones.

It must be understood that urolithiasis most of the time (

outside of renal colic

) is asymptomatic. Symptoms of the disease occur at the moment when occlusion develops (

blockage

) urinary tract stone moving from the pelvis to the bladder. This can occur spontaneously, during a change in body position, after physical exertion, after exposure to any traumatic factors or vibration, or gradually, with a significant size of the stone that closes the mouth of the ureter. Since the stone from the renal pelvis enters the ureter, which is a rather narrow channel, a blockage occurs, and the larger the stone, the more pronounced urinary excretion disorders and pain syndrome. In addition, large stones can cause traumatic rupture of the ureter or kidney failure. The resulting spasm of the smooth muscles of the ureter over the site of occlusion, which serves to move the stone, significantly aggravates the situation, as it further increases the pressure over the obstacle and provokes an aggravation of both the pain syndrome and urinary excretion disorders. Small stones can pass into the bladder on their own, resulting in relief of symptoms.

Kinking and narrowing of the ureter

Kinks or narrowing of the ureter can cause a serious violation of the outflow of urine from the kidney, which will lead to an increase in intrapelvic pressure, which will manifest itself as renal colic. This pathology can be caused by many different factors, among which changes in the position of the kidneys, traumatic effects, and congenital anomalies play a special role.

Kinking and narrowing of the ureter can occur for the following reasons:

Omission of the kidney. Omission of the kidney (nephroptosis) is a pathology in which abnormal mobility of the kidney occurs due to the weakening of the apparatus supporting its normal position (ligaments and blood vessels). Most often, there is a displacement of the kidney from top to bottom with a vertical position of the body. Due to excessive mobility, vasodilation occurs, which leads to an even greater aggravation of the pathology, as well as to impaired blood circulation in this organ. In some cases, with nephroptosis, a kink or compression of the ureter occurs with the development of acute renal dropsy (hydronephrosis). tumor processes. Tumor processes can cause displacement of the ureter or kidney, which is fraught with a change in the direction of the ureter, and which can cause a critical bend with stopping the outflow of urine. In addition, the tumor process can cause narrowing of the lumen of the ureter (with a tumor of the ureter - by closing the lumen, with a tumor outside the ureter - by compressing it.). Injuries. The site of a traumatic injury to the kidney or ureter can become a substrate for the development of scar tissue, which, due to less elasticity and greater volume, causes a significant decrease in the lumen of the ureter. Damage to the ureter can be observed after stab and gunshot wounds of the lumbar region, after operations on the ureters, and also after the passage of stones formed in the renal pelvis through the ureter. Growth of scar tissue in the retroperitoneal space (retroperitoneal fibrosis or Ormond's disease). In some cases, the narrowing of the ureter is associated with the growth of fibrous tissue that compresses the ureters in the retroperitoneal space. This pathological condition is called Ormond's disease and is presumably the result of chronic inflammatory and infectious processes, malignant tumors, and autoimmune diseases. Additional vessel. The presence of an additional vessel passing near the ureter can cause a gradual narrowing of its lumen. Congenital anomalies of the ureters. Some anomalies in the development of the fetus may be accompanied by a violation of the formation of the ureters and kidneys with the development of narrowing (up to the complete absence of the lumen), and may also be the cause of their non-physiological position.

blood clots

Blood clots can cause obstruction (

blockage

) urinary tract with the development of renal colic. Blood clots require a relatively large volume of whole blood to enter the urinary tract.

Blood clots in the pyelocaliceal system of the kidney can form in the following situations:

Injury. A traumatic effect on the kidney and urinary tract can cause a violation of the integrity of blood vessels with the development of bleeding of varying severity. Blood that enters the urinary tract can clot and form a clot that can cause ureteral obstruction. Tumors of the pelvis and ureter. Tumor processes are accompanied by active growth of blood vessels, but also by some tissue destruction. As a result, bleeding can occur, which can cause a blood clot to form. Urolithiasis disease. Urolithiasis is a pathology that can not only directly cause renal colic, but also indirectly, since the sharp edges of some stones can injure the mucous membrane of the pelvis with the release of blood and the formation of a clot.

Collections of pus

The accumulation of pus, which can cause blockage of the lumen of the urinary tract, can occur with an infectious lesion of the pyelocaliceal system of the kidneys with

pyelonephritis

This disease is one of the most common kidney diseases and can affect people at any age. It occurs due to the penetration of infectious agents (

bacteria from the environment, mycoplasmas, viruses, fungi

) in the pyelocaliceal system of the kidneys with frequent lesions and parenchyma (

basic substance

The most common causative agents of pyelonephritis are:

Staphylococcus. Staphylococci are usually introduced into the kidneys by the hematogenous or lymphogenous route (with blood or lymph flow) from other pyoinflammatory foci (furuncle, mastitis, otitis media, purulent tonsillitis). Escherichia coli. E. coli is characterized by an ascending route of penetration from the lower urinary tract. Most often, E. coli is introduced into the bladder, from which it enters the renal pelvis, if personal hygiene is not observed or against the background of disorders of the gastrointestinal tract (dysbacteriosis). It should be noted that there is a high probability of developing pyelonephritis caused by Escherichia coli during hypothermia and a change in the normal acidity of urine. Pseudomonas aeruginosa, protea. In the vast majority of cases, pyelonephritis caused by Pseudomonas aeruginosa and Proteus occurs after any instrumental or surgical interventions on the bladder and urinary tract (catheterization, various operations, cystoscopy).

Pyelonephritis develops against the background of a violation of the general and local

immunity

Which may occur due to prolonged hypothermia, incorrect treatment with antibacterial or steroid drugs, with

diabetes

In the presence of untreated infectious and inflammatory foci.

In the presence of bacteria in the urinary tract, the body activates a number of pathophysiological mechanisms that are aimed at destroying infectious agents. As a result, pro-inflammatory substances are released into the focus of inflammation,

leukocytes

Fibrin. Dead bacteria, exfoliated epithelial cells, leukocytes loaded with absorbed pathogenic agents, and a number of protein components form pus, which in some cases can cause ureteral occlusion with the development of renal colic.

Swelling of the ureter due to an allergic reaction

The occurrence of allergic edema of the ureters is quite rare. However, the use of certain drugs

codeine, iodine preparations and some other drugs

) can cause an allergic reaction in which, due to the release of pro-inflammatory substances, vasodilation occurs and plasma exits the bloodstream, which leads to significant tissue edema. If the ureter is affected, the edema can be so severe that it can completely block the lumen and cause renal colic.

Symptoms of renal colic

Renal colic is a combination of several fairly stable symptoms that are similar in most cases. The main symptom of this disease is a pronounced pain syndrome and changes in the urine. All other signs arise either against the background of these, or constitute one of the pathogenetic links in their development, or are a reflex or compensatory reaction of the body.

The main symptoms of renal colic are:

sharp pain; quantitative and qualitative changes in urine; nausea and vomiting, delayed passage of intestinal gases; increased blood pressure; change in heart rate; awesome chill.

acute pain

Pain is the leading symptom of renal colic. There is a pain sensation due to an increase in urine pressure on the renal pelvis and the fibrous membrane of the kidney (due to some increase in the size of the kidney), which causes irritation of the nerve endings, impulses from which are transmitted along the sympathetic nerve fibers through the celiac ganglion to the spinal cord to the level of the lower thoracic and upper lumbar segments. The pain usually occurs suddenly, does not depend on the time of day and body position, and is described as a sharp sharp pain in the lumbar region radiating along the ureter to the external genital organs (irradiation along an oblique line connecting the twelfth rib to the genitals). However, the distribution of pain may be slightly different depending on the level of ureteral obstruction.

The following options for the spread of pain syndrome are possible:

In the navel and the corresponding side. Irradiation of pain in the umbilical region and in the corresponding side develops with occlusion at the level of the ureteropelvic segment (the place where the pelvis passes into the ureter, which is a physiological narrowing). Groin area and outer thighs. The spread of pain in the groin area and on the outer surface of the thigh is typical for occlusion that occurred near the intersection of the ureter with the iliac vessels. In the head of the penis or in the area of ​​the clitoris and the vestibule of the vagina. Irradiation of pain to the external genital organs is characteristic of prevesical occlusion of the ureter.

Pain in renal colic is constant, which is how it differs from

intestinal colic

hepatic colic

In which undulating bouts of pain are noted. Since the increase in pressure inside the pelvis and ureter is constant and progressive (

the pressure drops when the stone passes into the bladder or when the organ is severely damaged

), a change in body position does not bring relief (

in some pathologies that may have a similar clinical picture, the patient can take a specific position in which the pain sensation is significantly reduced

). Due to the lack of an alleviating position, the person is restless and tossing about in bed.

The duration of the pain syndrome can be different and depends on the speed of stone advancement or removal of obstruction. In children, renal colic can last 10-15 minutes, in adults - from several hours to several days. It should be noted that a violation of the discharge of urine from the kidney for 24 hours leads to its reversible damage, and with a duration of 5 or more days, irreversible functional and structural damage to the organ occurs.

Quantitative and qualitative changes in urine

Since the occurrence of renal colic is associated with a violation of the discharge of urine from one of the kidneys, this ailment is always accompanied by any changes in the urine. However, it must be understood that qualitative changes in urine (

change in its composition, the appearance in it of salts, blood, pus from the affected kidney

) can be detected only after the obstruction is removed, since during renal colic, urine enters the bladder only from the other kidney. But quantitative changes in urination can be observed during an attack.

For renal colic, the following changes in urine are characteristic:

Painful urination. Painful urination may be due to reflex spasm of the urinary tract. After an attack of renal colic, pain can be caused by a stone in the bladder. Frequent urination. Frequent urge to urinate is characteristic of a low location of the obstacle (pre-bladder level), which leads to irritation of nerve receptors and reflex contraction of the bladder. Absence or decrease in the amount of urine. In most cases, with renal colic, the total amount of urine excreted changes very little or does not change at all. This is due to a compensatory increase in the volume of filtered blood through the unaffected kidney. However, with structural or functional damage to this kidney, as well as in its absence (congenital or after surgical removal), there may be a lack of urine flow into the bladder with a significant decrease in daily diuresis (urine output).

Nausea and vomiting, delayed passage of intestinal gases

The disorder of the gastrointestinal tract is a reflex and is associated with the anatomical proximity of the perirenal and solar (

innervates the digestive tract

) nerve plexus. As a result of partial irritation of the solar plexus, constant nausea and vomiting occurs, which is not associated with eating and does not bring relief. Intestinal motility is impaired and

flatulence

In other words, there is a delay in the passage of intestinal gases.

Increase in blood pressure

The kidneys are an organ that is directly involved in the regulation of blood pressure (

this is necessary to ensure adequate circulation to the kidneys to filter and remove toxic substances from the blood

). Functional changes that occur with renal colic, in which blood filtration through one of the kidneys decreases and increases through the other, causes a slight increase in blood pressure. In addition, an increase in blood pressure occurs due to neurovegetative reactions that occur against the background of pain stimulation.

Pulse change

A change in the pulse can occur against the background of an increase in blood pressure, as well as due to pain, which activates a number of neurovegetative reactions in the brain. This can be observed as a decrease in heart rate (

most often

) and increase (

less common, usually with fever

awesome chills

Chills occur in the case of a sharp increase in pressure in the renal pelvis, which leads to the development of pyelovenous reflux (

reverse flow of blood and urine from the pelvis and calyces of the kidney into the venous network

). The entry of decay products into the blood leads to an increase in body temperature to 37 - 37.5 degrees, which is accompanied by a tremendous chill.

Separately, it is necessary to mention that after an attack of renal colic, when the ureter occlusion is eliminated, the pain syndrome becomes less pronounced (

the pain becomes aching

) and a relatively large amount of urine is excreted (

accumulation of which occurred in the pelvis of the affected kidney

). Impurities or clots of blood, pus, and also sand can be seen in the urine. Occasionally, individual small stones may be passed out with the urine, a process sometimes referred to as "stone birth". In this case, the passage of a stone through the urethra can be accompanied by significant pain.

Diagnosis of renal colic

In most cases, for a competent specialist, the diagnosis of renal colic is not difficult. This ailment is assumed even during a conversation with a doctor (which in some cases is enough to diagnose and start treatment), and is confirmed by an examination and a series of instrumental and laboratory tests.

It must be understood that the process of diagnosing renal colic has two main goals - establishing the cause of the pathology and differential diagnosis. To establish the cause, it is necessary to undergo a series of tests and examinations, as this will allow more rational treatment and prevent (

or delay

) repeated exacerbations. Differential diagnosis is necessary in order not to confuse this pathology with others with a similar clinical picture (

acute appendicitis, hepatic or intestinal colic, perforated ulcer, thrombosis of mesenteric vessels, adnexitis, pancreatitis

), and prevent improper and untimely treatment.

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

Be that as it may, the most competent specialist in the treatment, diagnosis and prevention of renal colic and its causes is a urologist. It is this specialist who should be contacted first of all if renal colic is suspected.

If renal colic occurs, it makes sense to call an ambulance, as this will allow earlier treatment to eliminate pain and spasm, as well as speed up the process of transportation to the hospital. In addition, the emergency doctor makes a preliminary diagnosis and sends the patient to the department where he will be provided with the most qualified assistance.

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

interview; clinical examination; ultrasound procedure; X-ray methods of research; laboratory study of urine.

Interview

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

During the survey, the following facts are revealed:

Characteristics of pain. Pain is a subjective indicator that cannot be quantified, and the assessment of which is based only on the verbal description of the patient. For the diagnosis of renal colic, the time of onset of pain, its nature (acute, dull, aching, constant, paroxysmal), the place of its distribution, the change in its intensity when changing the position of the body and when taking painkillers are important. Nausea, vomiting. Nausea is also a subjective sensation, which the doctor can learn about only from the patient's words. The doctor needs to be informed when nausea appeared, whether it is associated with food intake, whether it is aggravated in some situations. It is also necessary to report episodes of vomiting, if any, their relationship with food intake, changes in the general condition after vomiting. Chills, fever. It is necessary to inform the doctor about the development of chills and elevated body temperature (unless, of course, it was measured). Changes in urination. During the interview, the doctor finds out if there are any changes in the act of urination, if there is an increased urge to urinate, if there was a discharge of blood or pus along with urine. The presence of attacks of renal colic in the past. The doctor should find out whether this attack is a new one or if there have been episodes of renal colic before. The presence of a diagnosed urolithiasis. It is necessary to inform the doctor about the fact of the presence of urolithiasis (if any now, or was in the past). Diseases of the kidneys and urinary tract. The fact of having any pathologies of the kidneys or urinary tract increases the likelihood of renal colic. Operations or injuries of the organs of the urinary system or the lumbar region. It is necessary to inform the doctor about the surgeries and injuries of the lumbar region. In some cases, also about other surgical interventions, as this allows us to suggest possible risk factors, as well as speed up differential diagnosis (removal of the appendix in the past excludes acute appendicitis in the present). Allergic reactions. Be sure to tell your doctor if you have any allergic reactions.

The following data may be required to determine risk factors:

diet; infectious diseases (both systemic and urinary tract organs); bowel disease; bone diseases; place of residence (to determine climatic conditions); place of work (to determine working conditions and the presence of harmful factors); the use of any medicinal or herbal preparations.

In addition, depending on the specific clinical situation, other data may be required, such as, for example, the date of the last

menstruation to rule out ectopic pregnancy

), chair characteristic (

to rule out intestinal obstruction

), social conditions, bad habits and much more.

Clinical examination

The clinical examination for renal colic provides little information, but when combined with a well-conducted interview, it may suggest renal colic or its cause.

During a clinical examination, it is necessary to undress in order for the doctor to be able to assess the general and local condition of the patient. To assess the condition of the kidneys, their percussion can be performed - a light tapping of the hand on the back in the region of the twelfth rib. Pain experienced during this procedure

symptom of Pasternatsky

) indicates damage to the kidney on the corresponding side.

To assess the position of the kidneys, they are palpated through the anterior abdominal wall (

which during an attack can be tense

). The kidneys are rarely palpable during this procedure (

sometimes only their lower pole

), however, if it was possible to palpate them completely, then this indicates either their omission or a significant increase in their size.

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

Ultrasound procedure

Ultrasound procedure (

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

Since many factors affect the quality of an ultrasound image (

intestinal gases, subcutaneous fat, bladder fluid

) it is recommended to pre-prepare for this procedure. To do this, a few days before the examination, exclude milk, potatoes, cabbage, raw vegetables and fruits from the diet, and also take activated charcoal or other drugs that reduce gas formation. Drinking regimen can not be limited.

Ultrasound without prior preparation may be less sensitive, but in emergency cases where urgent diagnosis is needed, the information obtained is sufficient.

Ultrasound is indicated in all cases of renal colic, as it allows you to directly or indirectly visualize changes in the kidneys, and also allows you to see stones that are not visible on the x-ray.

With renal colic, ultrasound allows you to visualize the following changes:

expansion of the pelvicalyceal system; an increase in the size of the kidney by more than 20 mm compared to the other kidney; dense formations in the pelvis, ureters (stones); changes in the structure of the kidney itself (previous pathologies); swelling of the kidney tissue; purulent foci in the kidney; changes in hemodynamics in the renal vessels.

X-ray methods of research

Radiation diagnosis of renal colic is represented by three main research methods based on the use of x-rays.

Radiation diagnosis of renal colic includes:

Plain x-ray of the abdomen. An overview picture of the abdomen allows you to visualize the area of ​​​​the kidneys, ureters, bladder, as well as the condition of the intestines. However, using this research method, only radio-positive stones (oxalate and calcium) can be detected. excretory urography. The method of excretory urography is based on the introduction into the body of a contrast X-ray positive substance, which is excreted by the kidneys. This allows you to monitor the circulation in the kidneys, evaluate the function of filtration and concentration of urine, as well as monitor the excretion of urine through the pelvicalyceal system and ureters. The presence of an obstacle leads to a delay of this substance at the level of occlusion, which can be seen in the picture. This method allows diagnosing blockage at any level of the ureter, regardless of the composition of the stone. CT scan. Computed tomography creates images that help assess the density of stones and the condition of the urinary tract. This is necessary for a more thorough diagnosis before surgery.

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

Computed tomography is indicated for suspected urolithiasis caused by urate (

uric acid

) and coral-like (

more often - post-infectious nature

) stones. In addition, tomography allows you to diagnose stones that could not be detected by other methods. However, due to the higher cost, CT scans are only used when absolutely necessary.

Excretory urography is carried out only after complete relief of renal colic, since at the height of the attack, not only does the outflow of urine stop, but the blood supply to the kidney is also disturbed, which, accordingly, leads to the fact that the contrast agent is not excreted by the affected organ. This study is indicated in all cases of pain arising in the urinary tract, with urolithiasis, with the detection of blood impurities in the urine, with injuries. Due to the use of a contrast agent, this method has a number of contraindications:

Excretory urography is contraindicated in the following patients:

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

Laboratory study of urine

A laboratory study of urine is an extremely important research method for renal colic, since changes in urine always occur with this disease (

which, however, may not be present during an attack, but which appear after its relief

General urine analysis

allows you to determine the amount and type of impurities in the urine, identify some salts and fragments of stones, evaluate the excretory function of the kidneys.

In a laboratory study, analysis of morning urine is carried out (

which accumulated in the bladder during the night, and the analysis of which allows one to objectively judge the composition of impurities

) and daily urine (

which is collected during the day, and the analysis of which allows you to evaluate the functional ability of the kidneys

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

the amount of urine; the presence of salt impurities; urine reaction (acidic or alkaline); the presence of whole erythrocytes or their fragments; the presence and quantity of bacteria; the level of cysteine, calcium salts, oxalates, citrates, urates (stone-forming substances); creatinine concentration (an indicator of kidney function).

With renal colic and urolithiasis, a high content of calcium salts, oxalates and other stone-forming substances, blood and pus impurities, and a change in the reaction of urine can be detected.

It is extremely important to analyze the chemical composition of the calculus (

), since further therapeutic tactics depend on its composition.

Treatment of renal colic

The goal of treating renal colic is to eliminate pain and spasm of the urinary tract, restore urine flow, and eliminate the root cause of the disease.

First aid for renal colic

Before the arrival of doctors, you can perform a number of procedures and take some medicines that will help reduce pain and improve your general condition. In this case, one should be guided by the principle of least harm, that is, it is necessary to use only those means that will not aggravate or cause complications for the course of the disease. Preference should be given to non-drug methods, as they have the fewest side effects.

In order to alleviate the suffering of renal colic before the arrival of an ambulance, the following measures can be used:

Hot bath. A hot bath taken before the arrival of the ambulance can reduce spasm of the smooth muscles of the ureter, which helps to reduce pain and the degree of blockage of the urinary tract. local heat. If the bath is contraindicated or cannot be used, you can apply a hot heating pad or a bottle of water to the lumbar region or to the abdomen on the side of the lesion. Drugs that relax smooth muscles (antispasmodics). Taking drugs that help relax smooth muscles can significantly reduce pain and, in some cases, even cause the stone to pass on its own. For this purpose, the drug No-shpa (drotaverine) is used in a total dose of 160 mg (4 tablets of 40 mg or 2 tablets of 80 mg). Painkillers. Painkillers can only be taken with left-sided renal colic, since pain on the right side can be caused not only by this disease, but also by acute appendicitis, cholecystitis, ulcers and other pathologies in which self-administration of painkillers is contraindicated, as it can lubricate the clinical picture and make diagnosis difficult. To relieve pain at home, you can use ibuprofen, paracetamol, baralgin, ketanov.

Medical treatment

The main treatment for renal colic should be done in a hospital. At the same time, in some cases, there is no need for hospitalization, since the passage of the stone and the restoration of the outflow of urine allow us to talk about positive dynamics. However, within one to three days, monitoring and monitoring of the patient's condition is carried out, especially if there is a possibility of re-development of renal colic or if there are signs of kidney damage.

The following categories of patients are subject to mandatory hospitalization:

who do not have a positive effect from taking painkillers; who have a blockage of the urinary tract of the only functioning or transplanted kidney; blockage of the urinary tract is combined with signs of infection of the urinary system, a temperature of more than 38 degrees.

Drug treatment involves the introduction into the body of drugs that can alleviate symptoms and eliminate the pathogenic factor. In this case, preference is given to intramuscular or intravenous injections, as they provide a faster onset of action of the drug and do not depend on the work of the gastrointestinal tract (

vomiting can significantly reduce the absorption of the drug in the stomach

). After stopping an acute attack, it is possible to switch to tablets or rectal suppositories.

For the treatment of renal colic, drugs with the following effects are used:

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

Painkillers

Antispasmodics

Antiemetics

Drugs that reduce urine production

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

in some cases more

In addition to the listed drugs, drugs from the group of calcium channel blockers (

nifedipine

), nitrates (

isosorbide dinitrate

), alpha-blockers and methylxanthines, which can reduce spasm of smooth muscles and eliminate pain, but whose effectiveness in renal colic has not yet been studied enough.

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

Drugs used to dissolve uric acid stones

In parallel with this, the treatment of the pathology that caused the stone formation is provided. For this, various vitamins and minerals, nutritional supplements, drugs that reduce the concentration of uric acid, diuretics can be used.

Surgery

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

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

complicated urolithiasis; hydronephrosis of the kidney (dropsy of the kidney); wrinkling of the kidney; ineffectiveness of medical treatment; stones larger than 1 cm in diameter that cannot pass on their own. Since the main cause of renal colic is urolithiasis, in most cases there is a need for surgical removal of stones from the urinary tract. To date, several effective methods have been developed that allow breaking and extracting stones with the least injury.

Stones can be removed in the following ways:

remote lithotripsy; contact lithotripsy; percutaneous nephrolithotomy; endoscopic stone removal; stenting of the ureter; open kidney surgery.

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

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

Remote lithotripsy is contraindicated in the following situations:

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

contact lithotripsy Contact lithotripsy involves the direct impact of a high-energy physical factor (ultrasound, compressed air, laser) on the stone (this is achieved by inserting a special tube through the urinary canal into the ureter or by piercing the skin at the level of the stone). This method allows you to more accurately and efficiently affect the stones, and also provides a parallel extraction of the destroyed fragments.

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

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

Ureteral stenting Ureteral stenting involves the introduction of a special cylindrical frame by endoscopic means, which is installed at the site of narrowing of the ureter or its incision, to prevent stones from getting stuck in the future.

open kidney surgery Open kidney surgery is the most traumatic method of stone removal, which is practically not used at the moment. This surgical intervention can be used with significant damage to the kidney, with its purulent-necrotic change, as well as with massive stones that are not amenable to lithotripsy.

Preparation for surgical removal of stones involves the following activities:

Delivery of analyses. Before surgery, it is necessary to pass a general urine test and a general blood test, do a fluorography, and conduct an ultrasound and x-ray examination of the kidneys. Therapist's consultation. To exclude possible contraindications and systemic pathologies, it is necessary to consult a therapist. Diet. Proper diet allows you to avoid excess gas and accumulation of feces in the intestines, which greatly simplifies the intervention. To do this, a few days before the operation, it is necessary to abandon sour-milk products, fresh vegetables, and legumes. No food is allowed on the day of the procedure.

The recovery time after surgery depends on the extent of the operation. For non-invasive and minimally invasive procedures (

lithotripsy, endoscopic and percutaneous stone removal

) return to normal activity is possible after 2 - 3 days.

Treatment with folk remedies

Alternative methods of treating renal colic should be resorted to only when it is not possible to obtain qualified medical care.

The following remedies can be used to treat renal colic:

Hot tub. As mentioned above, hot water helps to relax the smooth muscles of the ureter. In water, you can add 10 g (2 tablespoons) of cudweed grass, sage leaves, birch leaves, chamomile and linden flowers. Medicinal infusion. Six tablespoons of a mixture of birch leaves, harrow root, juniper fruits and mint leaves must be poured with 1 liter of boiling water and infused for half an hour. The resulting decoction should be consumed warm within an hour. Decoction of birch leaves. Eight tablespoons of birch leaves, twigs or buds must be poured with 5 glasses of water and boiled for 20 minutes in a water bath. Consume hot for 1-2 hours.

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

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

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

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

Urate stones can be treated with the following decoctions:

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

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

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

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

Prevention of renal colic

What do we have to do?

For the prevention of renal colic, it is necessary:

consume enough vitamins A, D; sunbathing (stimulates the synthesis of vitamin D); consume enough calcium; consume at least 2 liters of water per day; treat pathologies and infections of the urinary system; correct congenital metabolic pathologies; go for a walk or other physical exercise.

What should be avoided?

With renal colic and urolithiasis, it is necessary to avoid factors that contribute to the growth of stones and spasm of the ureters. To this end, it is recommended to follow a diet with a reduced content of stone-forming substances.

It is necessary to follow a diet for the following types of stones;

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

Must be avoided:

hypothermia; drafts; systemic and urological infections; dehydration; injuries of the lumbar region; sedentary lifestyle.

There are contraindications to the drugs mentioned in the text. It is necessary to read the instructions or consult with a specialist.

Specialty: Practicing therapist of the 1st category

Renal colic: causes, symptoms, diagnosis, treatment Causes of renal colic Renal colic is an emergency condition, the main manifestation of which is acute pain in the lumbar region. With renal colic, the pain is sharp, cutting, and more often one-sided. The main cause of renal colic is a violation of the outflow of urine from the kidney. Violation of the outflow of urine occurs as a result of blockage by a stone or compression from the outside (for example, by a tumor) of the outflow of urine from the kidney. Renal colic is usually caused by the following diseases:

urolithiasis pyelonephritis kidney tumors; kidney tuberculosis; kidney injury; diseases of the retroperitoneal space (paranephritis - inflammation of the perirenal tissue); gynecological diseases (adnexitis, oophoritis, salpingitis).

Symptoms and signs of renal colic The main symptoms of renal colic are pain, frequent urination with blood in the urine, nausea, single vomiting, fever, etc. With renal colic, pain is felt in the lumbar region. Typically, pain in renal colic occurs after walking, running, riding a motorcycle, lifting weights, or for no particular reason. With renal colic, pain occurs sharply and increases rapidly. During renal colic, pain occupies the upper abdomen, and also spreads along the ureter to the bladder, scrotum and penis in men, to the vagina and labia in women, to the thigh. In each individual case, the pain of renal colic may be accompanied by one or more of the following symptoms:

frequent urge to urinate, which ends with a cutting pain in the urethra (urethra); the appearance of blood clots in the urine (hematuria); nausea, vomiting, dizziness, which serve as a manifestation of the general reaction of the body to pain; urge to defecate; an increase in temperature to 39 C (if renal colic is caused by pyelonephritis) an increase in blood pressure.

An attack of renal colic, as a rule, lasts an average of 10-12 hours. Often an attack of renal colic lasts several days with short breaks. What can be confused with renal colic? Renal colic can be confused with manifestations of acute appendicitis, acute cholecystitis, intestinal obstruction and pancreatitis due to similar abdominal pain, as well as nausea and vomiting that accompany all these diseases. However, the appearance of blood in the urine with greater accuracy indicates the presence of renal colic in a patient.

In addition, there are other differences between the above diseases and renal colic. For example, with appendicitis, pain, as a rule, appears first in the epigastrium (under the pit of the stomach), then moves to the navel and, finally, reaches the right iliac region. Pain in acute appendicitis is accompanied by nausea, single vomiting and bloating. In case of acute inflammation of the uterine appendages (adnexitis, oophoritis, salpingitis), there is pain radiating to the lower back, as well as a violation of urination (due to inflammation of the organs adjacent to the bladder). With these gynecological diseases, the onset of pain is gradual, and not sharp, as with renal colic, the pain is constant or intensifies, spreads to the entire abdomen, and radiates to the sacrum. Characterized by an increase in temperature to high numbers (38-39 C). Pain in a perforated ulcer of the stomach and duodenum is sharp (like a stab with a dagger), is located in the left hypochondrium, often occurs after eating. When the ulcer is perforated, the patient becomes sharply pale, covered with cold sweat, takes the least painless position and is afraid to move, so as not to increase the pain that is already there. With renal colic, on the contrary, the patient cannot find a place for himself, rushes about. With intestinal obstruction, the pain is cramping; the abdomen is swollen due to the retention of gases and the absence of stools. A distinctive characteristic of pain in acute pancreatitis is that these pains are strong and persistent, located in the epigastrium (in the epigastric region), the left hypochondrium and in the umbilical region, are often girdle in nature. Thrombosis of the mesenteric vessels, in other words, intestinal infarction, is characterized by a strong pain throughout the abdomen, which is not relieved by analgesics. The face of patients with thrombosis of the mesenteric vessels turns pale, facial features are sharpened, the bowels are slow (there are no gases and stools).

Features of renal colic in children Children have some features of renal colic: the pain is located mainly in the navel, vomiting often occurs. The child is restless, crying. Attacks of acute pain last up to 20 minutes. It is possible that the temperature rises to 37.2-37.3 C. Features of renal colic during pregnancy In pregnant women, an exacerbation of chronic pyelonephritis or urolithiasis often becomes the cause of renal colic. More often, pain in renal colic in pregnant women is located on the right, and gives to the labia, thighs. An attack of renal colic can cause premature birth, so if symptoms of renal colic appear, you should immediately consult a doctor. Treatment of renal colic. Emergency care for renal colic. Medications for renal colic First of all, a patient with renal colic is advised to lie down and call an ambulance. Before the arrival of the ambulance, you can take a warm bath or put a heating pad on the lumbar region. Drug treatment for renal colic is carried out with the help of antispasmodics (No-shpa, Papaverine) and painkillers (Baralgin, Revalgin). No-shpu and Baralgin recommend taking 1 tablet up to 3 times a day.

Hospitalization of patients with renal colic is mandatory in the following cases:

renal colic that does not go away after taking medication; the presence of complications (repeated vomiting, lack of urine (anuria), high fever, etc.); bilateral renal colic; renal colic in patients with a single kidney.

If hospitalization is not indicated for the patient and the attack of renal colic was stopped (stopped), he is recommended to rest, diet, thermal procedures (heating pads, baths), emptying the bladder immediately when the urge appears, as well as personal hygiene. It is advisable to collect urine in a vessel to monitor the sediment or the presence of stones. Diet for renal colic Patients with renal colic should be excluded from the diet of all salty foods, as well as broths, liver, sausages, smoked meats, legumes, chocolate, cocoa, strong tea. It is recommended to eat boiled vegetables, vegetarian soups, cereals, vegetable and fruit salads. If the condition of a patient who has undergone renal colic gradually worsens, the attack resumes, fever, nausea, vomiting are noted, an ambulance should be called. Seeing a Doctor After Colic All patients who have had renal colic are advised to contact a urologist at the clinic for examination and to establish the exact cause that led to the appearance of renal colic.

Renal colic - an attack of acute pain in the lumbar region, caused by acute blockage of the upper urinary tract, impaired hemodynamics in the kidney. The incidence of renal colic in the population is 1 - 12%, more than half of the cases occur in the male half of the population. In 13% of cases of the total number of patients with renal colic, there are other diseases of the kidneys and ureter (stones, tumors, tuberculosis, hydronephrosis, urovasal conflict, retroperitoneal fibrosis), as well as the appearance of blood clots, pus, mucus, covering the lumen of the urinary tract. As a result, the renal pelvis and fibrous capsule of the kidney are stretched. Colic that occurs with renal pathology is one of the most severe types of pain that requires urgent diagnosis and treatment.

Possible causes of renal colic.

Renal colic can occur at any age and in a patient of any gender. The most common cause of renal colic is urolithiasis, which can be localized both in the kidney itself and its departments, and in departments below the renal level (ureter, bladder, urethra). Such a diverse arrangement of stones is due to the fact that, formed in one of the sections of the kidney, stones can migrate down with the urine stream and even go out on their own. In almost 95% of cases, renal colic is the result of irritation of the fibrous capsule formed as a result of blockage of the upper or lower urinary tract.

In addition to stones, epithelium, leukocytes, fibrin and mucus as a result of an inflammatory reaction in acute or chronic pyelonephritis, blood clots and necrotic tissue can also cause urinary retention in case of tumor and tuberculosis processes in the kidney.

Also, occlusion can occur not only as a result of urolithiasis, but also with tumor processes and other inflammatory diseases that are not localized in the urinary system, such as gynecological diseases (adnexitis, uterine fibroids), and their consequences in the form of an adhesive process (proliferation of connective tissue after inflammatory diseases). Diagnosis of gynecological diseases is most often possible after a vaginal examination. All of the above processes lead to a sharp increase in pressure in the cavitary system of the kidney, which leads to edema due to overstretching of the fibrous capsule, in which pain receptors are located - renal colic occurs.

Risk factors that may affect the incidence of kidney stones:

The presence of urolithiasis in relatives. Previously occurring pain in the lumbar region, paroxysmal in nature (the probability of recurrence of urolithiasis is 75% over the next 10 years). Increased physical activity. Prolonged increase in body temperature, within 2-3 months. The presence of diseases that have a risk of provoking the formation of kidney stones (systemic connective tissue diseases, urinary tract infections). Low fluid intake.

The main symptoms of renal colic

Renal colic in the adult population is characterized by sudden onset of pain, cramping, of a permanent nature, usually in the lumbar region from one, in rare cases, from both sides at once. The pain may radiate to the groin, genitals (scrotum, penis, vagina and labia). Pain may increase with urination.

Area of ​​irradiation of pain in renal colic

Of the general symptoms, the symptoms of intoxication come to the fore: nausea, vomiting, which may not bring relief; due to paresis of the intestine, there is a difficulty in the discharge of gases.

For renal colic in children, localization of pain in the navel with vomiting is characteristic. Children are usually restless and whiny.

The pains are so severe that patients rush around the room, constantly changing location and posture, which usually does not bring relief to them. Depending on the location of the obstruction, false urges to defecate and urinate may occur. The body temperature may rise to subfebrile numbers (37.1 - 37.5 ° C), the heartbeat slows down and blood pressure slightly rises. Urine may become pink or red when a stone damages the wall of the ureter or the cavity of the kidney.

Examination for renal colic.

Diagnostic measures for renal colic are a set of measures that help to accurately compare some data with others and make a correct diagnosis. The doctor will begin the examination with a general examination and collection of data on your diseases (possible earlier manifestations of urolithiasis, discoloration of urine without pain, fever, possible swelling of the lower extremities, etc.). Then he will check a number of symptoms that are characteristic for the suspected pathology.

Of the laboratory indicators, a general urine test will be of great importance, in which the content of blood cells and salt will be increased. With an increase in the protein content in the urine and leukocytes, it is necessary to think about the presence of glomerulonephritis or pyelonephritis (these diseases are characterized by a number of additional diagnostic characteristics that only a doctor can establish), in favor of urolithiasis, a sign of the appearance of blood after an attack of renal colic will testify.

Often, pain in the lumbar region, very reminiscent of renal colic, may be a symptom of another disease. So with appendicitis, cholecystitis, pancreatitis, duodenal ulcer and stomach ulcer, thrombosis of mesenteric vessels, adnexitis, signs of an acute abdomen may appear, in combination with renal colic. Some neurological diseases have a similar pain syndrome, but differ in the nature of the pain. A distinctive feature of intercostal neuralgia is a rather constant nature of pain, and not cramping, as in renal colic, and the pain syndrome also depends on the position of the patient's body.

Ultrasound is the primary method for detecting urolithiasis, using this method it is possible to observe patients with renal colic in dynamics. The method is quite informative and non-invasive.

From radiological methods, it is possible to use excretory urography of cystography, these methods are limited in use in pregnant women and children, due to ionizing radiation and invasiveness.

Treatment of renal colic.

Therapeutic measures for renal colic have two main tasks: to stop the pain syndrome that occurs as a result of capsule overstrain and to eliminate urinary tract obstruction. At the first stage of treatment, it is necessary to use antispasmodics and painkillers (diclofenac, indomethacin, drotoverin, atropine, platifilin). The cause and level of urinary obstruction must then be determined.

In urolithiasis, treatment methods depend on the size of the calculus, perhaps surgical treatment, crushing with ultrasound, or prescribing drugs that can partially dissolve stones and facilitate their independent discharge. From folk remedies, it is possible to use infusions and teas based on rose hips, they have a slight diuretic and anti-inflammatory property, and facilitate the passage of stones. Lingonberry leaves have antiseptic properties and prevent infection. Chamomile flowers have anti-inflammatory and analgesic effects. Caution should be taken with other herbal preparations, as they can significantly worsen the course of the disease. Comprehensive treatment with both herbal and medicinal methods will contribute to a quick recovery.

Drinking plenty of water 2.5-3 liters a day of pure water helps prevent the formation of kidney stones. Abundant consumption of meat, chocolate, dairy and vegetable products should be excluded from nutrition in patients with urolithiasis, a large amount of salty and smoked foods also contributes to the deposition of salts in the kidneys. Physical exercise can help the stones pass.

Possible complications of renal colic.

Renal colic is only a symptom of the underlying disease, so determining the cause of this symptom is the most important task. The main complication is acute urinary retention, which leads to renal failure, uremic intoxication. The formation of pyonephrosis or hydronephrosis is possible, in these conditions the kidneys increase in size and gradually lose their functional activity. With prolonged untreated urolithiasis, obstructive pyelonephritis occurs, which will soon lead to urosepsis or bacterial shock.

Therapist Zhumagaziev E. N

How does renal colic occur, how to relieve pain? develops due to malnutrition - frequent consumption of meat products containing purine bases, as well as insufficient or excessive fluid intake.

Heavy physical labor and physical inactivity often provoke an attack. The disease of urolithiasis is often inherited. The presence of endocrine and other chronic diseases has a negative impact on the state of the urinary system.

Scientists have proven that patients with a negative Rh factor of blood are diagnosed more often. from 20–30 years are more susceptible to morbidity.

Renal colic can provoke the following pathological conditions:

• oncological diseases of the urinary system;
• tuberculosis of the kidneys;
• narrow lumen of the ureters;
• kink of the ureter when the kidney is lowered.

Symptoms of the disease

Renal colic has a vivid clinical picture. The main symptom in this complication is pain. The pain during the exacerbation is very strong.

In some cases, it can provoke fainting in the patient. The pain is located in the area of ​​​​the projection of the kidneys and, it radiates to the following places:

• crotch;
• lower limbs;
• to a healthy kidney.

Other symptoms:

• frequent urge to urinate if the lower ureters are affected;
• lack of urine (the patient has one kidney);
• stool retention or diarrhea;
• hematuria;
• hypertension;
• false urge to defecate;
• hyperthermia up to 38–39 degrees;
• pain in the urethra;
• dyspeptic symptoms (nausea, vomiting);
• dizziness.

Therapeutic measures for renal colic

The goal of treating the disease is to reduce the intensity of pain and relieve spasms of the ureters. They also prescribe drugs that accelerate the passage of the stone through the urinary tract and destroy the structure of the calculus.

With the ineffectiveness of conservative therapy, the patient undergoes surgery, the purpose of which is to remove the stone from the urinary system. This avoids complications caused by blockage of the ureters and renal pelvis.

Conservative treatments

Conservative measures in the treatment of renal colic include: diet therapy, drug therapy, ultrasonic lithotripsy. Drug therapy includes: antispasmodics and painkillers, as well as agents that destroy the stone.

Features of the provision of first aid

If symptoms of renal colic appear, the patient must be reassured and put to bed. Several pillows are placed under the back of the patient so that the patient is in an elevated position.

This will facilitate and speed up the process of movement. After that, relatives (or the patient himself) should definitely call an ambulance.

What to do before the arrival of the doctor? To relax the smooth muscles of the ureters, a heating pad should be applied to the area of ​​the diseased kidney. It shouldn't be very hot. It is better to wrap the heating pad in a towel to prevent overheating of the tissues.

With the appearance of renal colic, home treatment is actively used warm baths. They help to calm the patient and expand the lumen of the ureters, which alleviates the patient's condition. Heat is an anesthetic for renal colic.

If the patient has a high temperature, warming up can not be used. In this case, it is better to inject an antispasmodic intramuscularly or into a vein.

With the appearance of renal colic, how to relieve pain? The following antispasmodics will help relieve pain:

• No-shpa (Drotaverine);
• Analgin with Dimedrol;
• Papaverine;
• Baralgin;

If there is no possibility of intravenous or intramuscular excretion of painkillers, tablets should be used.

You can not use a large number of drugs, as they smooth out the symptoms of the disease, this will make it difficult for the emergency doctor to make a diagnosis.

After the doctor confirms the diagnosis, doctors can give an intravenous injection to reduce the intensity of the pain syndrome. If the patient's condition allows outpatient management, the doctor will give a referral to a general practitioner, and also tell you how to relieve renal colic.

In a severe course of the pathological condition, the patient is hospitalized in the urological, therapeutic or surgical department.

Indications for hospitalization

The patient must be hospitalized if the pain syndrome could not be stopped.

Hospitalization is indicated for patients in the following cases:

• the patient has one kidney;
• 2 kidneys are affected;
• the stone did not come out on its own within 3 days;
• the disease is found in a child;
• pathology was diagnosed in a pregnant woman;
• the patient is elderly.

Hospitalization is necessary to rule out:

• tubal pregnancy;
• acute appendicitis;
• intestinal obstruction;
• hydronephrosis of the kidney;
• neoplasms of the prostate.

These disorders can cause symptoms of renal colic.

diet therapy

In therapeutic measures, the nutrition of the patient plays an important role. Doctors prescribe 10 treatment tables for people with kidney pathology. The patient should consume the required amount of proteins, fats, carbohydrates and fluids: up to 2 liters per day.

It will depend on the type of kidney stones.

Prohibited Products:

With phosphate formations, urine is acidified with Ascorbic acid and Methionine.

They require alkalization, for which mineral waters rich in alkalis are prescribed.

Medical therapy

Antispasmodics and analgesics act as painkillers for hepatic colic. A good medicine is Metamizole sodium (Baralgin), which belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

It is prescribed to adolescents from 15 years of age and adults intravenously slowly. Before injection, the ampoule should be warmed by holding it in a fist. While taking this medicine, the urine becomes pink.

An anesthetic is not prescribed for patients with chronic renal failure, kidney pathology, aspirin asthma. The drug should not be combined with alcoholic beverages.

Antispasmodics are actively used in renal colic. The most popular is Drotaverin (No-shpa).

It relaxes the smooth muscles of the internal organs, including the ureters. The antispasmodic is injected into a vein slowly. No-shpa is not prescribed for glaucoma, enlarged prostate, low blood pressure, atherosclerosis of cerebral vessels.

If Drotaverine does not relieve pain, Ketorolac is used. It is an NSAID that has a strong analgesic effect. The drug is administered intravenously slowly. This drug is prohibited for use in bronchial asthma, peptic ulcer, as well as in children under 16 years of age.

How can you relieve pain in renal colic when painkillers do not help? In this case, the doctor prescribes a pararenal blockade.

Treatment is complex. It also includes antibacterial drugs, drugs that destroy the structure of stones.

Preparations that dissolve stones

Medicines designed to destroy stones are prescribed depending on the type of calculus.

Formed from salts of uric acid. Dissolving them is not difficult. To do this, it is necessary to make the urine more alkaline. With urates, the doctor uses citrate drugs.

These include drugs:

• Allopurinol (Hypoxanthin);
• Potassium citrate (appointed only with normal calcium levels);
• Magnesium citrate (used for violation of the absorption of the intestinal wall and after surgery);
• Prolit super septo (based on herbs).

With phosphate calculi, urine should be acidified with fruit drinks from wild rose, barberry.

Medicines used for this type of stones:

• Aluminum hydroxide gel (toxic, increases the risk of calcium oxalate formations);
• Madder tint extract (almost no side effects, effective for urate calculi);
• Cyston (contains moraine extract).

The next type of stones are oxalates. When they appear, the urine is alkalized. These dense formations are difficult to treat, so long courses are used to dissolve them.

Drugs for renal colic caused include:

• Asparkam;
• Cholestyramine (inhibits intestinal absorption of oxalates).

Lithotripsy using ultrasound

Ultrasonic lithotripsy is used quite often. It is prescribed for the ineffectiveness of conservative treatment and the appearance of contraindications to the surgical removal of stones.

This treatment technique is non-invasive, suitable for the destruction of stones in children. It is indicated when dense formations appear, the diameter of which does not exceed 1 cm. The technique cannot be used in obese patients, since the destructive power of ultrasound, reaching the calculi, is too weak.

Surgical treatment of the disease

Surgical treatment is carried out when other methods have not helped. If the stones are large and cannot come out on their own, the following operational methods for removing stones are used:

• endoscopic method (extraction of dense formations from the bladder and lower ureter);
• operative lithotripsy (mechanical, laser, electrohydraulic);
• extended operation followed by resection or removal;
• laparoscopic surgery on the kidneys or ureter.

Forecasts

Urolithiasis is common throughout the world. Its frequency depends on the quality of water and food. There are many ways to deal with this disease, but it is better to try to prevent it.

To do this, you need to monitor the chemical composition of water. You can not drink water from wells, as it has a high hardness. If it is not possible to refuse to use it, the water must be filtered, settled and boiled.

It is also worth reducing the amount of salt and pickles, meat and dairy products. With a hereditary predisposition to urolithiasis, the patient must annually take a general urine test. All these activities help prevent the appearance of stones and renal colic.

The occurrence of pain in the lumbar region can be associated with various diseases, including kidney damage. The body's signal about a malfunction in its work cannot be ignored and a timely visit to a doctor is the best solution in such a situation.

The desire to alleviate the condition leads to the question of whether it is possible to heat the kidneys in case of pain, in which cases the thermal effect will be effective, and also what methods can be used at home.

When heat is good for the kidneys

With back pain, you must first find out its cause. To do this, you should consult a doctor who will conduct an examination and make an accurate diagnosis, as well as give advice on treatment and the possibility of using heat therapy. In the event that the cause of pain is not associated with acute or chronic inflammatory processes, there is no risk of provoking the development of complications, then warming up will help alleviate the condition and reduce the manifestations of the disease.

Warming up the kidney area will be effective and safe in the following cases:

• Urolithiasis, which is accompanied by severe pain during an attack of renal colic. Obstruction of the urinary tract causes the smooth muscles of the bladder and ureters into a state of increased tone. A strong spasm irritates the nerve receptors, and the person feels severe pain. Exposure to heat will help relieve muscle spasm and facilitate the passage of stones.
• Neoplasms can be located in one kidney, when it hurts, you can use a heating pad directly in the area of ​​colic localization.
• The menstrual cycle or hypothermia can provoke soreness in the lumbar region in women. The use of heat in this case reduces the manifestation of unpleasant symptoms, but it is better to reduce the impact on the kidney area and place the heating device closer to the spine.

Is it possible to warm the kidneys in other cases, the doctor decides, since there are conditions in which thermal exposure can be very harmful.

When warming up can hurt

You should refrain from warming up if the reasons why the kidneys may hurt are unknown or have arisen for the first time. Thermal procedures are prohibited in most cases with renal pathology, colic, in which warming relieves pain, is often complicated by the development of inflammation and infection. Using a heating pad in this case will only bring harm.

The main signs by which the development of the inflammatory process can be suspected:

• an increase in temperature indicates the presence of a focus of infection in a diseased kidney, the spread of which is provoked by exposure to heat;
• violation of urination, indicates that other organs of the urinary system are involved in the comb;
• vomiting, headache, loss of consciousness are evidence of severe intoxication of the body and require urgent medical attention.

The presence of any of these signs, and even more so from the combination, is a reason for calling a doctor at home.

Diseases in which heat therapy is prohibited

Most of the disease of the urinary system is accompanied by inflammatory processes. Absolute contraindications for thermal procedures are:

• Acute and chronic pyelonephritis, the cause of which is pathogenic microflora, and the entire renal tissue is involved in the process. Thermal exposure will create favorable conditions for the development of a focus of infection, and a close relationship with the bloodstream will allow the inflammatory process to spread. Dangerous complications of pyelonephritis are sepsis, acute renal failure and toxic coma.
• Malignant neoplasms are among the diseases in which most physiotherapy procedures are contraindicated. Thermal exposure can accelerate the development of a cancerous tumor and provoke metastases to other organs. Benign neoplasms can cause increased pain under the influence of heat due to pressure on nearby nerves and vessels.

The exact answer to the question of what to do if the kidneys hurt, whether it is possible to warm them up will only be given by the doctor after the necessary diagnostic measures have been taken.

How to warm the lower back

Often a person does not know how to use thermal procedures to their advantage, whether it is possible to heat the entire back or whether it is worth focusing only on the kidney area, what effective methods of warming are available at home.

The simplest methods of warming the lower back:

• A rubber heating pad is the simplest device for thermal procedures. Hot water is poured inside, wrapped in a towel and applied to the painful area. It is recommended to continue exposure for 15-20 minutes.
• An electric heating pad is convenient in that the temperature can be adjusted, it cools down longer, but without access to an outlet, its use is impossible.
• Salt heater is a more modern device that does not require preparation. When pressed, crystals are activated, due to a chemical reaction, heat is released.
• Bags of salt or sand provide a dry heat effect. The filler is preheated in a hot oven or in a frying pan, and then poured into the fabric.
• Warming creams, ointments and gels contain natural or synthetic components that have a local irritating effect, increase blood flow and cause a feeling of warmth.
• Belts made of natural wool are comfortable to use and also do not require the use of water.
• It is more effective to use them in combination with warming ointments and gels.
• Baths help to evenly warm the painful area, and the use of herbal decoctions has a calming effect due to the aromatic effect.
• The bath and sauna are suitable for people with a healthy heart, and after exposure to heat, cooling procedures should not be performed to relieve kidney pain.

Any methods of pain relief, especially those associated with diseases of the vital organs, must be agreed with the doctor in advance. The absence of contraindications makes it possible to use thermal procedures, but you need to act in accordance with the recommendations and carefully monitor your health.