🏔️ 🏇🏽 🤰🏿 Renal colic: treatment, first aid at home ⛓️ 📓 👨🏼‍🏭

Renal colic is a very serious condition, which is accompanied by acute pain associated with renal ischemia or impaired urine flow. In this case, the correct diagnosis is very important. Timely treatment of renal colic will help prevent very dangerous complications.

Of course, many people are looking for more information. Why does a pain attack appear? What symptoms should I look for? How to relieve attacks of renal colic and is it possible to do this at home? What complications does the disease lead to? What code did the ICD-10 assign to renal colic? The answers to these questions are worth exploring.

General information about the disease

To begin with, it’s worthwhile to deal with basic information about renal colic. ICD-10 assigned code N 23 to this pathology. This is a complex of symptoms that occur against a background of impaired urine diversion from the kidneys (it may be impaired or absent altogether).

In the cavity of the renal pelvis, urine begins to accumulate, as a result of which the pressure inside the kidney rises. The walls of the pelvis are stretched, as a result of which a spasm (contraction) of smooth muscle fibers develops. The tissues of the kidney swell, which leads to compression of the blood vessels and a violation of normal trophism. The kidney and other organs of the excretory system do not receive enough oxygen, which only exacerbates the situation. Colic is accompanied by sharp, severe pains - they are so intense that the patient sometimes loses consciousness.

Of course, it is very important to notice disturbing symptoms in time and consult a doctor. The faster treatment for renal colic is started, the greater the chance of a full recovery without complications.

The main causes of the disease

Treatment of renal colic directly depends on the causes of the syndrome. In fact, colic is not an independent disease - it is only a symptom of other pathologies.

As already mentioned, renal colic develops as a result of impaired urination, which may be due to compression of the urinary tract or their blockage. Violation of the passage of urine is often associated with the formation of a mechanical obstruction. According to statistics, in 57-58% of cases, renal colic develops against the background of urolithiasis - the calculus blocks the lumen of the ureter.
It is impossible not to mention pyelonephritis, since against the background of the inflammatory process, mucous clots and pus can accumulate in the ureter.
Renal colic may indicate kidney tuberculosis - in this case, the ureter becomes clogged with rejected anesthetized tissues and caseous masses.
Torsion or kink of the ureter can also lead to renal colic. This is often observed, for example, against the background of kidney dystopia, as well as with nephroptosis.
The list of causes includes kidney tumors, adenoma or prostate cancer, post-traumatic hematomas. The appearance and growth of such formations often leads to compression of the urinary tract.
An attack of renal colic can be associated with congestion and an active inflammatory process. The cause of symptoms may be prostatitis, urethritis, hydronephrosis, phlebostasis of the veins of the small pelvis.
The reason for the violation of the passage of urine is sometimes associated with a disease of the vessels that nourish the organs of the excretory system. For example, colic is observed with kidney infarction, embolism, and renal vein thrombosis.
Such symptoms are sometimes associated with certain congenital disorders of urodynamics (dyskinesia, spongiform kidney, achalasia, urinary tract dyskinesia).

Are there any risk factors?

Of course, there are some factors, their presence increases the likelihood of developing renal colic (in the presence of other conditions, of course). Their list is as follows:

proven that there is a hereditary predisposition;
increased physical activity;
prolonged, systematic overheating;
increased fluid loss;
the presence in a person of diseases that predispose to the development of calculi (sarcoidosis, polycystic kidney disease, tubular renal acidosis);
taking medications that are poorly soluble (especially when it comes to unauthorized use of the drug, improper dosage, etc.).

Potentially dangerous is the presence in the patient's history of urolithiasis. According to statistics, the likelihood of a recurring episode is 60%.

What symptoms should I look for?

How does renal colic manifest? Signs largely depend on the severity of the pathology and the stage of its development. It is customary to distinguish three phases, each of which is accompanied by certain violations.

The acute phase is the initial phase of renal colic. Suddenly there is a sharp pain. If at this time a person is awake, then he can name the exact time of the onset of symptoms. If soreness appears at night, then the patient suddenly wakes up. According to research results, physical activity does not affect the onset of symptoms. Nevertheless, stress, abundant food or drinking the day before, shaking while riding can intensify and accelerate the appearance of pain. The intensity of discomfort is constantly increasing. Unpleasant sensations are localized in the lower back, side, sometimes under the ribs.
After a few hours, a constant phase sets in. The pain reaches its climax and becomes almost unbearable. The patient can not eat, talk, find a comfortable position for the body. From such an unpleasant sensation, a person can lose consciousness. As a rule, it is at this time that patients enter the hospital. This period lasts from 4 to 12 hours.
The decay phase follows. Unpleasant sensations disappear as instantly as they appeared. As a rule, it is at this time that the bladder is emptied (urine is excreted in large quantities and often contains blood impurities).
Of course, there are other symptoms. For example, some patients complain of increased urge to urinate, with little urine output. Cutting pain in the urethra and in the bladder is possible.
Other symptoms include nausea, dry mouth, and vomiting, which, alas, does not bring relief to the patient.
Gases accumulate in the intestines of the person, resulting in bloating and constant urge to empty (although the bowel movement itself may not occur).
Sometimes a slight increase in body temperature, the appearance of chills, increased heart rate, and hypertension are possible.

If untreated, renal colic can lead to pain shock - the frequency of heart beats decreases, blood pressure drops, the patient's skin turns pale and cold sweat appears on it.

Diagnostic measures

Diagnosis in this case is extremely important, because it is necessary to determine the cause of colic, as well as the presence of concomitant complications. The patient requires a complete examination.

An important is a blood test. Against the background of renal colic, the level of urea rises sharply (this often indicates blockage of the upper urinary tract).
A lot of useful information can be obtained by studying the analysis of urine. With renal colic, an increase in the amount of salt, proteins, red blood cells and white blood cells can be observed. Sometimes blood clots are present in the urine.
Be sure to x-ray the abdominal cavity and pelvic area. During the procedure, you can determine the presence of edema of the kidneys, see large calculi, check the condition of the intestine.
Intravenous urography allows you to evaluate the degree of kidney function. The patient is injected with a contrast agent, and then a series of x-rays are taken - this is how the doctor can track the movement of the contract.
Chromocystoscopy is a procedure that allows the doctor to examine the inner surface of the urinary tract, mucous membranes of the bladder and ureters. During the inspection, a special contrast solution is used.
Computed tomography is performed if ultrasound diagnostics have not made it possible to find out the cause of the appearance of colic. Such a procedure is mandatory if the patient has surgery.

Based on the data obtained, the doctor can assess the patient's condition, select medications and draw up a scheme for further treatment.

Renal Colic: Emergency Algorithm

At the first symptoms, an ambulance crew should be called. Only a doctor knows what treatment requires renal colic. First aid at home is reduced to the following recommendations:

put the patient to bed (the patient should remain at rest until the arrival of specialists);
thermal procedures help to cope with pains, for example, you can put a warm heating pad on your stomach (it should be understood that if colic is associated with inflammation, heat is contraindicated, since it can only aggravate the patient's condition);
if the patient is thirsty, then he can be given warm water (coffee, tea, carbonated drinks are contraindicated);
severe pain can be relieved with antispasmodics.

The standard treatment for renal colic in a hospital

Treatment for such a disease should be carried out in a hospital setting - the patient should always be supervised. How to anesthetize renal colic? What should be the therapy? It depends on the intensity of the symptoms and the root cause of their appearance.

If during the diagnosis it was revealed that the appearance of colic was not associated with the inflammatory process, then a warm heating pad is placed on the patient's abdomen or perineal region. This helps alleviate the condition of the patient.
Antispasmodics for renal colic also help. The pain does not completely disappear.
As a rule, analgesics and non-steroidal anti-inflammatory drugs are used. Opiates are used only in extreme cases, although sometimes pain can only be relieved with their help. Pain medication for renal colic is selected by the doctor. In the event that the patient is not able to take the pill, painkillers are administered intravenously or intramuscularly.
The relief of renal colic in the event that the above drugs do not help is carried out by introducing novocaine directly into the region of the round ligament of the uterus or spermatic cord. The introduction of an anesthetic into the perinephric tissue is not recommended - this can only further injure the kidney.
If the pain could not be removed with the help of medications, then the doctor decides to install a catheter in the ureter. This procedure helps to remove urine, which, as a rule, instantly eases the patient's condition.

Eliminate the cause: primary disease therapy

It is worth immediately explaining that the above measures can only relieve colic and alleviate the condition of the patient, but do not guarantee that the symptoms do not appear again. It is very important to determine the nature of the primary disease, therapy should be aimed precisely at its elimination.

If the obstruction of the ureter with a stone became the cause of colic, then the obstacle must be removed. The method in this case is selected individually. Sometimes calculus can be dissolved with medication. But in most cases, lithotripsy is performed remotely (stones are destroyed by treating them with ultrasonic waves) or contact (stones are removed using an endoscope).
If there is an initial stage of kidney prolapse, then special exercises are selected for patients to strengthen the muscles of the pelvic floor. Helping and wearing a special bandage, which prevents further displacement of the kidney.
With severe nephroptosis or an excess of the ureter, the situation can be corrected surgically.
An indication for surgical intervention is the presence of stricture (narrowing) of the ureter. If the stricture is small, then it is eliminated through an endoscopic procedure.
In the event that the twisting or bending of the ureter is caused by the growth of the tumor, surgical excision is performed. If the neoplasm is benign, then the operation is enough. In the presence of a malignant tumor, surgical procedures are combined with radiation or chemotherapy.

Proper diet for renal colic

A very important part of the treatment is proper nutrition. Diet not only helps speed up the healing process, but also prevents the development of complications in the future. The principles of nutrition are simple:

First of all, it is worth giving up spices and salt;
sweets, pastries and other simple carbohydrates that are quickly absorbed should be excluded from the diet;
fats, smoked meats, canned foods, processed foods are contraindicated;
lactic acid products will be useful (whole milk can be added to tea);
should include vegetables in the diet, but it is better to boil or bake;
low-fat varieties of fish and meat will be useful (you can’t fry them);
It is very important to increase the daily amount of fluid to 3 liters.

Possible complications due to the disease

You already know how and why renal colic develops. The emergency algorithm, effective therapeutic measures, the main symptoms are, of course, important information. But it is worth considering that in the absence of proper treatment, this pathology can result in dangerous complications. These include acute obstructive pyelonephritis, as well as the formation of strictures in the ureter. Violation of urine diversion can result in renal failure, sepsis, or bacteremic shock. That is why it is so important to seek help on time.

Renal colic: treatment, first aid at home