Renal colic: how to relieve pain at home and when you can’t do without an “ambulance”? Symptoms of an attack of urolithiasis.

Attack urolithiasis characterized by severe pain caused by a violation of the outflow of urine through the ureter due to blockage by a stone.

What happens during an attack of urolithiasis

As a result of stretching and spasm of the walls of the ureter and the capsule of the kidney, caused by acute blockage of the ureter, the patient experiences severe pain.

When a stone "gets stuck" in the ureter, the area of ​​the urinary system above the blockage begins to generate active contractile waves to move the stone. Muscle spasm, increased contraction of the proximal ureter, local inflammation and irritation of the wall of the ureter with its subsequent swelling lead to pain.

The often used term "renal colic" misrepresents real essence Problems. With an attack of urolithiasis, pain persists long time, while intestinal or biliary colic is characterized by undulating, periodically increasing pains.

A stone moving down the ureter causing only partial blockage may cause much more pain than an immovable stone.

A long-term blockage leads to the development of kidney edema, accompanied by stretching of the kidney capsule, which contains many receptors, the stimulation of which enhances pain. Distension of the renal pelvis with accumulated urine stimulates an increase in ureteral motility, but after 24 hours, peristalsis begins to fade, as does renal blood flow.

If at the beginning of the blockage the renal blood flow decreases and the pressure inside the urethra increases, then after five hours both the blood flow and the pressure inside the ureter begin to decrease.

72 hours after the onset of an attack of urolithiasis renal blood flow decreases by 50%, after a week to 30%, by the second week to 20% of the initial level, and by the eighth week to 12%.

Experimental animal studies suggest that kidney damage can begin as early as 24 hours after complete ureteral occlusion, while irreversible changes start in 5-14 days.

Manifestations of an attack of urolithiasis

An attack of urolithiasis, as a rule, is unilateral, sometimes renal colic can develop on both sides. The pain comes on suddenly or builds up gradually. Pain may occur in the area "from waist to groin". Colicky pain, characteristic of an attack of urolithiasis, is localized in the region of the costovertebral angle or even the hypochondrium. The pain radiates (radiates) down and forward towards the groin.

The severity of the pain syndrome depends on the level of blockage, and not on the size of the stone. In most cases, a patient with an attack of urolithiasis can indicate the place of maximum pain, this area, as a rule, corresponds to the blockage.

Since the kidneys and genitals have a single supply of nerves, pain can occur in the testicles in men or the labia in women. The pain is so severe that it does not allow the patient to sit in one place. The person becomes restless. In addition, the following symptoms are characteristic of an attack of urolithiasis:

• nausea and vomiting;
• frequent urge to urinate;
• decreased frequency of urination, or acute urinary retention. Or vice versa, frequent urination.
• temperature;
• blood in the urine (hematuria).

Sometimes the stone go out on your own with urine. If possible, the stone should be preserved for chemical analysis, which will help determine the cause of its formation.

• pancreatitis;
• pyelonephritis;
• appendicitis;
• aneurysm of the abdominal aorta;
• intestinal tumor;
• ectopic pregnancy;
• rupture of an ovarian cyst;
• pleurisy - inflammation of the pleural membrane of the lung, for example, with pneumonia.

How is an attack of urolithiasis detected?

Renal colic is recognized based on the symptoms of the disease, the history of the development of an attack, and a physical examination of the patient. Besides great importance in the diagnosis of an attack of urolithiasis play the following tests and instrumental studies:

Blood analysis. A blood test helps to detect infection, inflammation, or signs of kidney dysfunction, etc.

Urinalysis is one of the most important analyzes performed during an attack of urolithiasis. In 85% of cases of renal colic, the presence of blood is determined in the urine. Although the absence of blood in the urine may indicate other causes of pain, this cannot completely rule out renal colic. The presence of nitrites and / or leukocytes in the urine indicates possible infection genitourinary system. The normal acidity of urine is 5.5. Determining the pH of urine suggests the type of urinary stone. For example, urine acidity above 7 may indicate an infection with struvite stone formation.

Beam and other research methods. These include:

Survey X-ray or (X-ray with contrast (intravenous urography). Plain radiography of the kidneys, ureters, and bladder can easily identify calcium stones. However, some types of stones are X-ray negative (see article "Types of stones in urolithiasis") and cannot be detected by conventional X-ray examination. At intravenous urography A radiopaque dye is injected into a vein and a series of images are taken to determine the level of blockage in the ureter.

CT scan. Computed tomography is a type of X-ray examination with a higher diagnostic accuracy.

Ultrasound is one of the first research methods for an attack of urolithiasis. Allows you to identify both the position and size of stones, and the presence of dilation of the ureter above the blockage caused by the accumulation of urine.

Treatment of an attack of urolithiasis

If a patient has a small stone, it may not need treatment. One has only to wait and the stone will come out on its own during the next urination. It is believed that a stone up to 6 mm in size in the smallest dimension can "come out" on its own. However, these dimensions are conditional and also depend on individual anatomical features, namely the width of the lumen of the ureter.

Treatment of an attack of urolithiasis can be carried out by surgical and medical methods.

Medicines used to treat an attack of urolithiasis:

In the absence of indications for hospitalization you can treat yourself at home, in 80% of cases, the stone leaves the urinary tract on its own. To facilitate the release of the calculus, the doctor will prescribe the necessary therapy for you. In this case, the pain siptom should quickly pass quickly after taking painkillers, i.e. you can control the disease at home. It relieves an attack of urolithiasis well by taking a hot bath or applying a heating pad to the place of maximum pain. Drinking enough water (6-8 glasses a day) helps to move the stone into the lower parts of the urine excretory system. However, we do not recommend undertaking any thermal manipulations without the recommendation of a urologist. You may have a completely different disease in which warming is strictly prohibited, for example, appendicitis, inflammation of the ovaries (adnexitis) in women.

After stopping an attack of renal colic, the issue of further treatment attack of urolithiasis. It can be carried out by medical and surgical methods, which you can read about in articles on this issue.

Indications for hospitalization in a hospital:

• persistent pain after the administration of analgesics and antispasmodics;
• long-term vomiting, accompanied by severe dehydration;
• urination disorders up to total absence separation of urine;
• severe violations of the general condition of the patient, for example, high fever or other signs of infection;
• the impossibility of establishing the cause of the pain syndrome on an outpatient basis;
• renal colic of a single kidney or a transplanted kidney.

If the blockage persists for a long time, ureteroscopy, stone crushing (lithotripsy), or surgical removal of stones may be done.

Percutaneous nephrostomy. If it is impossible to restore the patency of the ureters, percutaneous nephrostomy can be performed. In this case, a drainage tube is inserted through the skin into the pelvicalyceal system of the kidney, which ensures free outflow of urine above the blockage and prevents damage to the kidney.

Ureteral stenting. This procedure consists in installing a drainage tube, which ensures the outflow of urine from the kidney to the bladder, bypassing the blockage.

Percutaneous nephrostomy and ureteral stenting- These are temporary measures that ensure the outflow of urine until the ureteral patency is restored.

Lithotripsy. Lithotripsy uses shock waves to break stones down to more small particles, which can be excreted in the urine on their own.

Ureteroscopy. Ureteroscopy uses an endoscopic device to view the ureter and remove the stone. An endoscope is a thin tube with a built-in camera and a light element.

More detailed information about surgical treatment renal colic you can find in the article "Operations for urolithiasis".

Improper nutrition, the use of large amounts of salt, violation of the drinking regime, a sedentary lifestyle - all this leads to disruption of the genitourinary system, the accumulation of salts in the kidneys. Today, many patients are diagnosed with urolithiasis - what to do during an attack and how to relieve pain at home? We'll talk about this in this article.

Kidney stone pain can come on quite unexpectedly. An attack develops due to blockage of the ureter with a calculus, and as a result of improper outflow of urine. At the same time, the walls of the ureter or renal capsule are stretched, spasm and acute pain occur.

The entire area of ​​the urinary system above the stone generates contractions to actively move the deposit along the urinary tract. To this is added tissue irritation, local inflammation. Most experts diagnose an attack of urolithiasis as renal colic. However, this is not entirely correct, since, unlike colic, pain can disturb the patient for a long time.

Source: belhope.ru

Severe and acute pain in urolithiasis occurs due to blockage of the ureter or when the calculus moves along the urinary tract. The first option is much more dangerous, as it can have dangerous consequences. The kidney swells, the capsules stretch.

Pain occurs due to irritation of receptors in the body. Gradually, blood circulation in the kidney slows down, and the pressure increases. In some cases, irreversible changes can begin as early as 5-14 days. That is why it is very important for an attack of urolithiasis to use the help of qualified doctors.

Most often, attacks of urolithiasis are unilateral. Renal colic is localized in the lumbar region, gradually turns into groin, may be localized in the hypochondrium. The severity of pain depends on various factors, but to a greater extent on the level of blockage of the ureter.

Nerve endings in the genitals and kidneys are combined into an integral system, and therefore discomfort can occur in the intimate area. In most cases, the pain syndrome is so strong that the patient cannot sit in one place. Additionally, the following warning signs may develop:

• Attacks of nausea, dizziness.
• Frequent urination or urinary retention.
• High body temperature.
• The appearance of blood in the urine.

If the calculus is small, it can pass out on its own with urine. If you find such a release, try to save it for chemical laboratory analysis. Renal colic can be easily confused with appendicitis, ovarian cyst, pyelonephritis, ectopic pregnancy. Only a qualified physician can correctly diagnose a patient's condition. Self-medication is dangerous, as improperly selected therapy can only aggravate the state of health.

Diagnostics

Pain in the kidneys with urolithiasis requires a qualified medical care. If you experience anxiety symptoms, be sure to seek help from an experienced physician. To distinguish an attack from other pathologies, it is necessary to carry out complex diagnostics. Such a survey may include:

First aid

If a patient with urolithiasis complains of sharp pain, an ambulance must be called immediately. Physicians must eliminate renal colic and associated unpleasant symptoms in a hospital setting. Then you can start self-treatment at home.

While waiting for the arrival of doctors, you can try to alleviate the suffering of the patient by giving him first aid.

• Give the patient as much purified non-carbonated water as possible.
• Apply to the lumbar region dry heat. It can be a heating pad or a bottle of hot water, handbag with hot sand. Such manipulations can be performed only if you are sure that renal colic is caused by the advancement of the calculus.
• A hot sitz bath can help relieve pain. Water procedures should be short - only 10-15 minutes.
• For short-term relaxation of smooth muscles, antispasmodics or painkillers should be given to the patient. The effect will come much faster if you make an intramuscular injection.

Remember that incorrect manipulations during first aid can further harm the patient. In no case should you take a lot of painkillers, especially if the drug does not relieve the attack. It is also not necessary to warm the kidneys for a long time. Dry warmth in the form of a scarf on the lower back is ideal. It is especially important to avoid heating during high temperature which indicates the development of inflammation.

Treatment

Patients with an attack of urolithiasis are usually hospitalized under the following conditions:

• When the pain syndrome is localized simultaneously in both kidneys.
• Symptoms disturb the pregnant woman or the child.
• The patient had previously undergone resection of one kidney.
• Treatment at home does not give the desired relief.
• The patient has a high risk of developing complications, tumors, pyelonephritis.
• High fever, constant vomiting.

Injectable medications - analgesics, antispasmodics (Novocain, Atropine, Ketanov, Maksigan, etc.) will help get rid of an attack. Non-steroidal anti-inflammatory drugs in tablets and suppositories can also be used. Medical therapy lasts until the kidney stone is completely gone. If the patient additionally develops pyelonephritis, you need to drink a course of antibiotics.

If therapy medicines does not give the desired effect, and the patient has serious urinary retention, a catheter can be inserted into the ureter. Large kidney stones can only be removed surgically. It can be endoscopy, ultrasound technique or abdominal surgery.

After discharge from the hospital, the patient needs to take medication at home to normalize blood circulation in the kidneys. Uroantiseptics will help relieve inflammation.

ethnoscience

In folk medicine, there are many recipes for decoctions and infusions that can eliminate an attack of urolithiasis. However, such medicines should be used only after consultation with a qualified doctor.

Consider some of the most effective recipes.

• Mix 1 tbsp dried horsetail and 2 liters. boiling water. Let the liquid steep and cool, strain and then pour into a warm bath. Bathe for 15-20 minutes.
• Daily eat 300-700 gr. watermelon. This year has a diuretic effect and promotes the rapid removal of stones from the kidneys.
• Big cabbage leaf lightly remember in the hands. Apply a compress to the sore spot, and wrap it with a warm scarf.
• Effective in renal colic Birch buds. They need to be brewed in proportion - 1 tbsp. for 1.5 st. boiling water. When the liquid is infused, divide it into 3 parts, and drink throughout the day. The course of therapy is 1-1.5 weeks.

Instead of tea, you can drink healthy decoctions based on laurel, chamomile, wild rose, with the addition of St. John's wort and bitter wormwood.

If you want to get rid of the disease forever, strictly follow all the recommendations of the doctor. It is not enough to eliminate an attack of pain, you need to remove stones from the kidney, and also find out the exact cause of their formation. Watch your diet carefully drinking regimen Try to eliminate salt from your diet. Quitting bad habits and active image lives will be the best prevention of ICD.

With urolithiasis in the body are violated metabolic processes and local changes occur in the kidneys, in which stones form in their tissues, pelvises and calyces, formed from organic and salt compounds of urine. This disease is a chronic disease known for quite a long time.

Stones are usually located in right kidney, more often it occurs in the pelvis, and in the cups - less often. In accordance with chemical composition stones are divided into phosphate, oxalate, urate and mixed types. Stones are formed as a result of dysfunction of the glands internal secretion, which govern water-salt exchange, which can be initiated, in particular, by benign tumors of the parathyroid glands.

frequent cause of urolithiasis is an unhealthy diet, which is dominated by foods with high content calcium salts, alkaline compounds, hard water, etc. Contributes to the development of this pathology and prolonged urinary retention, a violation of its outflow, which favors accelerated fallout salt crystals from urine. Usually these salts are in the urine in a dissolved state, but in similar condition they form kidney stones.

Symptoms of urolithiasis

Urolithiasis manifests itself depending on the location and size of the stones.

Fixed big Stone may not manifest itself until it becomes an obstacle to the free outflow of urine. This causes moderate pain and a feeling of heaviness in the lumbar region. These are usually dull and aching pains that increase with physical exertion and are especially noticeable when shaking in transport or when running.

Often, patients take such pain for backache and are in no hurry to see a doctor. At the same time, a vicious course of self-treatment begins, based on the recommendations of unscrupulous advisers.

However, the prolonged presence of stones in the renal pelvis does not slow down their growth, and a constant increase in their size provokes expansion and. That is, the time factor timely treatment to the doctor is very important.

Kidney stone disease often leads to complications in the form of chronic pyelonephritis, renal failure, hypertension. A neglected disease is fraught with lethal outcome due to the occurrence of uremia (urination).

Attack with urolithiasis

An attack of renal colic occurs when a stone obstructs the outflow of urine from the renal pelvis. At the same time, the renal pelvis overflows, intrapelvic pressure increases, which is accompanied by swelling of its tissue. The renal capsule is stretched, and given that it has a large number of sensitive nerve fibers. In addition, pain can also occur during the migration of the stone, or its passage through the ureter.

The attack appears suddenly and can be provoked by physical stress, but often it occurs even at complete rest, during sleep, often it manifests itself after plentiful drink. The nature of the pain is cutting, with alternating periods of exacerbation and calm. often protracted, it can last for several days, with short breaks of relief.

Usually the pain takes in the lumbar region and goes further into the hypochondrium, and along the ureter in the direction of the bladder, labia in women or the scrotum in men. Often, even, it is more painful in the stomach or in the genitals than in the soil. The pain is felt against the background of the urge to urinate and pain in the urethra. When the stone leaves the kidney, the colic attack intensifies, while the pain radiates to the inguinal region and genitals, and the urge to urinate becomes more frequent. Nausea and vomiting may occur, cold sweat appears, sometimes the temperature rises, and bloating is observed. Tapping on the lumbar region in the area of ​​the diseased kidney leads to increased pain.

What to do during an attack?

If an attack of renal colic has begun, it is necessary to call an ambulance, and in anticipation of its arrival, conduct thermal procedures in the form of heating pads or hot baths, which will help reduce pain. If such an attack is not the first, you can give the patient dipyrone, and it is even better to make an intramuscular injection, from one to two milliliters. Effective and the introduction of antispasmodics - baralgin, papaverine, nikospan.

You can also reduce pain by traditional medicine methods. Three tablespoons of shepherd's purse herb is brewed with a glass of boiling water, insisted for two hours and removed from the sediment. You should drink a quarter cup three times a day. Twenty grams of dry grass "Ivan da Marya" brew a glass of boiling water and then boil for a quarter of an hour in a water bath, strain with a squeeze and add boiled water to a glass. Use a tablespoon three times a day. Twenty grams of dry chopped knotweed grass brew a glass of boiling water, insist for two hours, strain and drink half a glass three times a day. Well relieves pain and infusion of heather, for which forty grams of dry chopped grass is brewed with a liter of boiling water, insisted for an hour, filtered and taken two-thirds of a glass three times a day.

Kidney stones are observed in urolithiasis - a disease of the urinary system, characterized by the formation of stones in the urinary organs (kidneys, bladder, urinary tract).

Stones can be of various composition, shape and size. Men get kidney stones more often than women. There are such types of kidney stones:

Stones can have a smooth surface, rough, have sharp edges and protrusions.

Causes of kidney stones

If the stone begins its movement from the kidney through the ureter, then this process is accompanied by severe pain. The pain subsides when the stone enters the bladder. This process is called renal colic.

An attack of renal colic can last from several hours to several days. The pain can be unilateral or bilateral, depending on whether the stones began their movement in one or both kidneys.

An attack of renal colic

Kidney stones attack is characterized by severe pain in the lumbar region, which can radiate to the legs, groin. Often fever, nausea, sometimes vomiting, chills. It is important that close people are nearby, because the pain is often simply unbearable, and a timely reaction and competent actions will help to quickly stop an attack of kidney stones.

What to do immediately:

Give the patient an antispasmodic (baralgin, papaverine, no-shpa). It should be remembered that if the patient has never experienced an attack of renal colic, then first of all it is necessary to call an ambulance, since there is a possibility of an "acute abdomen". Those. this attack can be an attack of appendicitis, blockage of the bile duct, hepatic colic. In these cases, it is important not to give any painkillers to maintain the purity of the clinical picture and staging. correct diagnosis. If the patient suffers from urolithiasis, then the spasm should be relieved as soon as possible.

If there are no contraindications, then it helps well hot tub or a back warmer.

Try to take a comfortable position, make tilts or turns. Sometimes patients themselves assume a comfortable body position to facilitate the passage of the stone and reduce pain.

If nothing helps, and the pain becomes stronger, then it is imperative to call an ambulance, since further delay can have negative consequences for the health and even life of the patient. The stone may be too large, clog the lumen of the ureter, and also have sharp edges that injure the walls of the mucous membrane of the urinary organs, which can lead to bleeding.

It is important! Sometimes an attack of urolithiasis can end with surgery to save the patient's life. Therefore, it is very important to adequately assess the situation and not rely on chance and, of course, not self-medicate!

« ambulance» must be called if:

Why does renal colic appear and why is it dangerous?

The fact that the disease can worsen from time to time is also important, that is, renal colic can appear quite often. Usually, kidney stones attack can appear soon after a violation of the diet, the use of those foods that cannot be consumed if there is this disease.

For the prevention of diseases and the treatment of the kidneys and urinary system, our readers advise Cirrofit Drops. which consist of a set medicinal herbs reinforcing each other's actions. Drops can be used to cleanse the kidneys, treat urolithiasis, cystitis and pyelonephritis.

Nervous, physical stress can also provoke the movement of kidney stones, exacerbation of urolithiasis. Taking a large amount of liquid at one time can also cause an attack, especially after intense physical exertion.

If left untreated, this disease can lead to kidney stones in the future. chronic pyelonephritis, acute or chronic renal failure, kidney loss. That is, there is real threat health and life of the patient.

Particular attention should be paid when there are kidney stones, an attack may occur during pregnancy. This can lead to miscarriage. During an exacerbation of urolithiasis in pregnant women, hospitalization in a hospital is required!

What rules to follow if there are kidney stones?

Renal colic - causes, symptoms, diagnosis, treatment, diet

What is renal colic?

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

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

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

Renal colic- the most common pathology of the urinary tract. The prevalence of this syndrome is associated with the epidemiology of urolithiasis, since the most common blockage of the upper urinary tract is caused by calculi (stones).

All about renal colic - video

Causes of an attack of renal colic

Urolithiasis disease

About 90% of attacks of renal colic are caused by urolithiasis - a chronic disease of the upper urinary tract, accompanied by the formation of stones in them.

The causes and mechanism of development of urolithiasis (UCD) are not fully understood to date. It is believed that KSD is a polyetiological disease, that is, an ailment, the development of which is based on several reasons.

For a long time there was the so-called geographical theory of the development of the ICD. Indeed, this disease is widespread in Central Asia, in the North Caucasus, in the Volga region, in the Urals, in the Far North, in Australia, the Netherlands, Yugoslavia, Greece, Turkey, Brazil, in the eastern regions of the United States, and is practically not found in South Africa, many parts of Japan and Iceland.

More detailed analysis geographical factors of morbidity showed that the risk factors for KSD are a lack or, conversely, an excess of vitamin D. In addition, the development of this pathology is facilitated by a tendency to catarrh of the upper respiratory tract caused by climatic conditions, and endemic (regional) deficiency of certain trace elements in food and water, such as molybdenum and silicon.

The likelihood of developing KSD, and hence the risk of attacks of renal colic, is associated with age. Less often, the disease develops in childhood and adolescence, a little more often in the elderly. The peak incidence occurs at the age of 30-50 years. In men, KSD develops somewhat more often than in women.

With ICD, both right and left kidney are affected with the same frequency, so that attacks of both right-sided and left-sided renal colic are possible. In 15-30% of patients, stones form in both kidneys.

Risk factors for the development of attacks of renal colic (ICD)

Apart from common factors the risk of developing KSD (place of residence, gender, age), there are private ones, such as:

In addition, attacks of renal colic are more likely to occur in people who prefer salty foods containing a large amount of protein, predominantly of animal origin. The water regime is of some importance - the lack of fluid contributes to the formation of stones.

Differential diagnosis of the causes of attacks of acute renal colic

In 10% of cases of renal colic, upper urinary tract obstruction is not caused by KSD, but by other severe kidney lesions, such as:

In addition, an attack of renal colic can be caused by compression of the urinary tract from the outside with severe injuries (extensive hematomas) or neoplasms of the pelvic organs.

As a rule, the diagnosis in such cases does not cause any particular difficulties, since renal colic develops against the background of a pronounced picture of the underlying disease. However, when making a diagnosis of KSD, the above diseases should be excluded (laboratory blood and urine tests, ultrasound, etc.). In doubtful cases, consultation with a phthisiatrician is necessary. oncologist or gynecologist.

Separately, it is necessary to single out such a rare pathology as a wandering (lowered) kidney. In such cases, attacks of renal colic are caused by an inflection of the ureter, and have certain characteristics: as a rule, they occur after a bumpy ride, long walk, physical activity, etc. The pain intensifies in vertical position and subsides in the supine position.

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

(pathogenesis of renal colic)

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

Besides, significant role in the development of a pronounced pain syndrome, a violation of the outflow of urine plays, leading to an increase in intrapelvic pressure, venous stasis and a violation of the microcirculation of the kidney. As a result, there is an increase in the size of the affected organ, accompanied by overstretching of the richly innervated capsule.

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

Symptoms of an attack of renal colic

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

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

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

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

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

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

The pain syndrome is often accompanied by nausea. and unrelieved vomiting. This kind of symptoms are especially characteristic when the obstruction is located in the upper sections (kidney pelvis, upper ureter).

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

When the obstruction is located in the lower parts of the ureters, dysuric phenomena may occur (frequent painful urges to urination).

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

Differential Diagnosis

General rules

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

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

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

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

If the concretions are located in the very lower segment ureters, the clinical picture is supplemented by signs of dysuria (frequent painful urination. pain in the urethra, urge to urinate), so that cystitis should be ruled out, and in men also prostatitis and urethritis.

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

Differential diagnosis of right-sided renal colic

Attack of renal colic and acute appendicitis

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

In addition, with the location of the calculus in the right ureter, pain in renal colic can be localized in the right iliac region - just as in acute appendicitis.

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

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

Renal and hepatic (biliary) colic

Pain in hepatic (biliary) colic can radiate to the right lumbar region. In addition, the nature of the pain syndrome is in many ways reminiscent of renal colic (extremely severe pain, accompanied by vomiting that does not bring relief). Just as in the case of renal colic, patients with hepatic colic rush around the ward, since the intensity of the pain syndrome does not depend on the position of the body, and the general condition of the patients is relatively satisfactory.

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

Renal colic and acute intestinal obstruction

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

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

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

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

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

In addition, an acute attack of renal colic is often accompanied by symptoms of local peritonitis on the side of the lesion, such as severe pain abdominal wall and the absence of bowel sounds when listening to the abdomen.

Therefore, it can be difficult to make a differential diagnosis with abdominal catastrophes, such as acute pancreatitis, perforated gastric ulcer, acute cholecystitis.

In such cases, pay attention to the behavior of the patient. At " acute abdomen» patients, as a rule, due to their serious condition, are in bed, while patients with renal colic rush around the room, since they have a strong pain syndrome combined with a relatively satisfactory general condition.

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

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

Acute pancreatitis often develops after feasts (New Year's disease), and is characterized by girdle pain with an unusually wide irradiation, repeated vomiting and extremely severe general condition of the patient.

In acute cholecystitis, it is necessary to carefully collect an anamnesis, since most often its attack develops against the background of diagnosed diseases of the biliary tract ( cholelithiasis. biliary dyskinesia, etc.) after dietary errors (fatty fried foods).

Pain in acute cholecystitis is permanent, localized in the right hypochondrium, radiating under the right shoulder blade and into the right subclavian region, accompanied by repeated vomiting, which brings little relief.

Renal colic in women

With obstruction of the urinary tract in the middle and lower parts of the ureter, pain can be localized in the iliac region, and give to the thigh, inguinal ligament, external genitalia on the affected side. In such cases, differential diagnosis with acute pathology of the female genital area is necessary. Primarily, we are talking about such surgical diseases how:

With all these pathologies, the pain syndrome occurs suddenly, and is unusually intense. However, unlike renal colic, pain in acute diseases the female genital area depends on the position of the body, so that patients try to be in bed in a position that relieves pain.

Significant assistance will be provided by a survey (delayed menstruation when terminating an ectopic pregnancy, increased exercise stress with cyst torsion, connection with ovulation in ovarian apoplexy).

In addition, in cases of acute gynecological accidents, additional symptoms attract attention, such as rapid pulse, low pressure. pallor of the skin, dizziness. cold sweat.

Differential diagnosis of renal colic and acute neurological diseases (radiculitis attack, herniated disc, intercostal neuralgia)

The localization of pain in renal colic often coincides with the localization of pain in acute attack radiculitis. intercostal neuralgia, etc.

In such cases, attention should be paid to the behavior of the patient. In acute sciatica, the patient freezes from pain, and is unable to straighten up, and in renal colic, the pain is not associated with the position of the body.

In addition, pain with sciatica radiates down and back (on the buttocks), and with renal pain - down and forward (in the inguinal ligament, on inner surface thighs, in the area of ​​​​the external genital organs).

It should be borne in mind that an attack of renal colic can occur against the background of sciatica.

Diagnosis of acute renal colic

Diagnosis of renal colic is made on the basis of a survey and examination of the patient, a characteristic clinical picture, as well as laboratory tests and instrumental methods examinations ( Ultrasound of the kidneys (make an appointment) and urinary tract urography (make an appointment) or computed tomography).

First of all, the doctor conducts a survey, during which he asks about the features of the pain - when the pains began, how they changed over time, where they are felt, where they give off, what is the nature of the pains (acute, dull, aching, constantly present or occurs in episodic attacks), changes whether the intensity of pain when changing postures, whether the pain decreased after taking painkillers. The doctor also asks if there was nausea and vomiting, what provoked them, did they bring relief to the condition. Be sure the doctor is interested in changes in urination - whether there were any and what nature they are (for example, blood in the urine, pain when urinating, etc.). After that, the doctor is interested in whether there were similar attacks in the past, whether a diagnosis of urolithiasis was made in the past, whether the person has urinary tract diseases and whether he had injuries or operations in the lumbar region during his life.

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

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

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

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

In renal colic without fail a general urine test is ordered. If red blood cells are found in the urine in large numbers or blood is visible to the naked eye, then this is a sign of renal colic.

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

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

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

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

Forecast

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

After the cessation of an attack of renal colic, dull pains in the lumbar region persist for some time, but the general condition of the patient improves significantly.

Further prognosis depends on the cause that caused renal colic. In the case of urolithiasis, a long, actually lifelong treatment is ahead.

Complications

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

The most common complications include:

Which doctor should I contact with renal colic?

With the development of renal colic, you can act in two ways. Firstly, you can use your own transport to get to any hospital where there is a department of urology, nephrology or surgery. and refer accordingly to urologist (make an appointment). nephrologist (make an appointment) or surgeon (make an appointment). It is optimal to contact a urologist or nephrologist, since these specialists are engaged in the diagnosis and treatment of diseases of the urinary system. However, if there is no urologist or nephrologist, then you can contact a surgeon who also has the necessary qualifications to diagnose and treat renal colic.

Secondly, you can call an ambulance, and the arriving team of doctors will take the person to the hospital on duty in the city, where they receive patients with a similar diagnosis and where there are appropriate specialists.

Treatment of renal colic

First aid

First first aid with renal colic, it is performed in cases where the diagnosis is beyond doubt, that is, with repeated typical attacks in patients with an established diagnosis of urolithiasis.

A warm bath or heating pad on the lumbar region helps to relieve spasm of the ureter and the discharge of stones. You can use antispasmodics from the home first aid kit. Most often, Baralgin is recommended (a medical preparation containing antispasmodics and an analgesic). Instead, you can take No-shpu or papaverine (antispasmodics).

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

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

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

Emergency medical care

Drugs to help relieve pain in renal colic

After making a preliminary diagnosis of renal colic, first of all, it is necessary to remove the pain syndrome. For this, the patient is administered antispasmodics or analgesics.

Drugs of choice:

1. Metamizole sodium (Baralgin M). Non-steroidal anti-inflammatory drug, analgesic. It is used for pain syndrome of moderate intensity. Adults and adolescents over 15 years of age are administered intravenously, slowly (at a rate of 1 ml / min). Before the introduction of the ampoule should be warmed in the hand. After injection, staining of urine in pink color(no clinical significance). Not compatible with alcohol, so that chronic alcoholism is a relative contraindication to the administration of the drug. Baralgin M is also better not to prescribe to patients with chronic diseases kidneys (pyelo- and glomerulonephritis), and renal failure is absolute contraindication. In addition, the drug is contraindicated in case of hypersensitivity to pyrazolones (Analgin).

2. Ketorolac. Non-steroidal anti-inflammatory drug, analgesic. Used for severe pain. The drug is administered at a dose of 1 ml intravenously, slowly (1 ml / 15 seconds). Age under 16 years is a contraindication to prescribing the drug. In addition, the drug is contraindicated in bronchial asthma. severe renal failure and peptic ulcer in the acute stage.

3. Drotaverine (No-shpa). Antispasmodic. Enter intravenously, slowly 2-4 ml of a standard solution (2%). Contraindicated in hypersensitivity to the drug and severe renal failure. Use with caution with a tendency to hypotension, open-angle glaucoma. severe atherosclerosis coronary arteries, prostatic hyperplasia.

Indications for hospitalization in renal colic syndrome

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

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

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

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

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

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

It is necessary to empty the bladder in a timely manner. using at the same time a special vessel for the subsequent control of an otkhozhdeniye of calculi.

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

To all the sick left on ambulatory treatment, it is recommended to visit a urologist in the clinic, and undergo an additional examination. Often in the future, treatment is prescribed in a hospital.

Diet

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

Treatment table N10 implies some reduction energy value diet by reducing the intake of fats and carbohydrates. The amount of sodium chloride is significantly limited (food is prepared without salt). Exclude heavy, indigestible food (meat and fish are served boiled), as well as foods that irritate the liver and kidneys, contributing to flatulence. exciting nervous system, such as:

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

If the cause of renal colic is established, then during an attack, medical nutrition according to the underlying disease. Of course, this also takes into account comorbidities (obesity. diabetes. hypertonic disease etc.).

Therapeutic nutrition as a prevention of attacks of renal colic in urolithiasis (ICD)

It has been statistically established that the risk of recurrent seizures in established diagnosis urolithiasis is about 80%.

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

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

In addition, the water regime has a significant impact on the formation of stones, so the amount of fluid you drink in the absence of contraindications should be increased to 3-3.5 liters or more.

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

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

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

Diet for the prevention of renal colic caused by KSD with a tendency to form urates

If urolithiasis occurs with the formation of stones from uric acid (urates), then a diet that has an alkalizing effect on urine is necessary.

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

Diet for the prevention of renal colic caused by KSD with a tendency to form oxalates

With the formation of oxalate stones, they try to limit foods containing oxalic acid and increase the consumption of foods containing the calcium antagonist - magnesium. Magnesium-rich foods include wheat and rye bran, wholemeal bread, oatmeal, buckwheat and pearl barley, millet, dried fruits.

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

Thus, the following are banned:

In addition, they limit beets, carrots, onions, tomatoes, black currants. blueberries. sweets, jam, confectionery, fig.

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

Diet for the prevention of renal colic caused by KSD with a tendency to phosphaturia

If the study showed the phosphorus-calcium nature of the stones, a tendency to phosphaturia and an alkaline urine reaction, then it is necessary to increase the acidity of the urine by increasing the proportion of "sour" meat products.

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

Exclude:

Renal colic during pregnancy: causes, signs, relief

Clinical picture

It should be noted that upper urinary tract stones are the most common cause severe pain in the abdomen, for which pregnant women are hospitalized. Statistics show that about 0.2 - 0.8 pregnant women suffer from urolithiasis.

Pregnancy itself is not a predisposing factor to stone formation (it has been statistically proven that with an increase in the number of pregnancies, the incidence of KSD does not increase), but in the case of latent KSD, pregnancy can contribute to the manifestation of pathology. Especially often attacks of renal colic in ICD in pregnant women occur in the last trimester.

Other causes of renal colic in pregnant women are extremely rare.

The clinic of renal colic in pregnant women consists of the classic triad of symptoms: attacks of cramping pain, hematuria and stone discharge.

Often, pregnant women with renal colic are mistakenly sent to maternity ward, since the symptoms of pathology are mistaken for contractions.

It should be noted that a severe attack of renal colic not only simulates tribal activity, but can also cause premature birth. In such cases, one must be extremely careful when making a diagnosis.

How to relieve pain?

First aid for renal colic in pregnant women is aimed at relieving pain and preventing complications.

Thermal procedures (hot heating pad, bath) are contraindicated for pregnant women.

To eliminate the pain syndrome, antispasmodics are used: 2% solution of papaverine hydrochloride 2 ml subcutaneously, 2% No-shpa solution 2 ml subcutaneously, 0.2% solution of platyfillin hydrotartrate 2 ml subcutaneously.

Sometimes an attack of renal colic in pregnant women can be stopped with antispasmodics that selectively act on the smooth muscles of the ureters (Cistenal or Avisan).

Cystenal in an attack of renal colic is prescribed 20 drops once (on a piece of sugar under the tongue), and with repeated attacks - 10 drops 3 times a day, during or after meals.

Avisan take 2 tablets after meals. It should be noted that Cystenal and Avisan have not only antispasmodic, but also anti-inflammatory effects.

Renal colic in pregnant women is stopped in a hospital to prevent the possibility of serious complications. The fact is that during pregnancy, the possibility of infection increases many times over. In addition, an attack of renal colic can provoke premature birth.

Acute renal colic in children

Features of an attack of renal colic in children

Renal colic in children is much less common than in adults, and proceeds atypically. These circumstances cause a large number of medical errors in the diagnosis.

Just like adults, children during an attack behave very restlessly, cry, scream, do not allow to touch the stomach. Often there is reflex vomiting, intestinal paresis, leading to bloating and stool retention.

Young and middle-aged children cannot correctly localize the pain syndrome and, as a rule, point to the navel as the most painful place.

For correct diagnosis renal colic, it is necessary to examine the muscle tone and soreness of the lumbar regions. Pasternatsky's symptom in children is determined by shaking the lower back with the tips of the fingers placed under the lower back in the area of ​​the kidneys.

When making a diagnosis, remember that positive symptom Pasternatsky is often found in acute appendicitis in case of atypical location appendix, with intestinal obstruction and with thrombosis of the mesenteric vessels.

In doubtful cases, an invaluable service will be provided by ultrasound of the upper urinary tract, which allows you to identify the pathological expansion of the pyelocaliceal system of the kidneys and / or ureters.

Any calculi, including non-radiocontrast ones, larger than 1 mm, are clearly visible on the monitor screen in the form of echo-negative shadows, if they are located in pelvicalyceal system or in upper section ureter.

What to do with renal colic in a child?

The treatment of renal colic in a child is started in cases where the diagnosis is not in doubt, and surgical pathology of the abdominal cavity is excluded.

You should start with a warm bath (37-39 degrees), since often this procedure alone is enough to completely stop the attack.

If it was not possible to stop the attack with the help of a thermal procedure, antispasmodics and analgesics are prescribed in age dosages. As a rule, No-shpa and Baralgin give a good effect.

Before use, you should consult with a specialist.

Urolithiasis is a common and extremely insidious pathology. Her chronic course often complicated by attacks of renal colic, which gives the patient intense excruciating pain. Let's try to figure out what the pain is associated with kidney stones, and what consequences they carry in themselves. About the reasons characteristic features and measures emergency care during an attack of renal colic, read our review.

Causes of pain in urolithiasis

Urolithiasis (urolithiasis, ICD) is a disease accompanied by the formation of stones in the lumen of the renal calyces and pelvis. Kidney stones are the result of rather complex biochemical processes. Their formation is associated with crystallization and subsequent precipitation of salts that make up urine on the walls of the PCS.

In this case, the stone can have different sizes - from 0.5-1 mm (in this case they talk about sand in the kidneys) to tens of centimeters. Huge calculi lead to significant disruption of the kidneys, but small stones can also cause a lot of discomfort to the patient.

Pain - frequent companion urolithiasis, and with this pathology there are several options for its development. It is important to understand that the intensity and frequency of occurrence of discomfort depends on:

• localization;
• forms;
• the nature of the surface;
• sizes;
• quantities;
• stone mobility.

Small calculi with a smooth surface that are attached to the wall of the PCS and do not interfere with the outflow of urine can for a long time not cause discomfort to the patient. Large stones that compress the kidney tissue are the cause of constant dull aching pain in the lower back.

Often, urolithiasis is complicated by an attack of renal colic - acute intense pain in the lower back. This condition is associated with the promotion of small stones with sharp edges from the kidney into the ureter.

Mechanical and chemical irritation of the hollow wall muscular organ causes its reflex spasm and sharp violation outflow of urine. This leads to an increase in pressure inside the kidney, overstretching of the walls of the pelvis and calyces, and then the fibrous capsule of the organ. Irritation of nerve endings located in the perirenal region causes an attack of severe, often unbearable, excruciating pain in the patient.

Symptoms of renal colic

According to statistics, the incidence of urolithiasis among the adult population of the planet ranges from 0.5 to 5.3%. Among all the pathologies of the excretory system, urolithiasis ranks third in prevalence.

Kidney stones are more commonly diagnosed in men than in women. Despite this, among the representatives of the beautiful half of humanity, severe forms of the disease, complicated by renal colic, are more common. There are frequent cases of development of urolithiasis in childhood.

In addition to intense pain, which is cramp-like in nature and is localized in the lumbar region in the projection zone of the kidneys with spread to the groin, vulva and thighs, an attack of renal colic is accompanied by:

• nausea and vomiting that does not bring relief;
• muscle tension of the abdominal wall from the side of the lesion;
• a sharp increase in body temperature up to 40 ° C, fever, shaking chills;
• violation (sometimes - complete cessation) of urination;
• turbidity, discoloration of urine: an admixture of bright scarlet blood may appear in it;
• an increase in blood pressure.

During renal colic, patients behave restlessly, scream in pain, toss and turn in bed, trying to take a position that alleviates their suffering. The attack will continue until the calculus leaves the body naturally, or will not be removed surgically.

Emergency care during an attack

The main question that worries a person who is faced with renal colic is “How to relieve pain?”. An attack that has begun is an indication for an immediate call to an ambulance. Deal with yourself dangerous complication almost impossible.

What can be done at home

While the ambulance is on its way, you can try to alleviate the patient's condition. First aid for a disease includes taking painkillers and antispasmodics, which are in the home medicine cabinet:

• analgesics (Ketanol, Nimesil);
• antipyretics from the group of NSAIDs (Ibuprofen, Paracetamol);
• antispasmodics (No-shpy, Papaverine).

Well relieves muscle tension and reduces pain dry heat. However, heating pads or other warming agents should be used with caution, only after consulting a doctor.

Medical care for patients with renal colic

After the arrival of doctors and assessment of the general condition of the patient, a specialist conducts urgent measures aimed at reducing pain and restoring the disturbed outflow of urine.

Injections are used with:

• narcotic / non-narcotic analgesics - Pantopon, Promedol;
• antispasmodics - No-shpoy, Platifillin.

In case of ineffectiveness of the measures taken or severe general condition patient, he is hospitalized in the urological or surgery department hospital. specialized assistance while providing in stages:

Diagnosis To confirm the diagnosis and determine the localization of the calculus, an examination is performed - ultrasound of the kidneys and urinary tract, radiography of the abdominal cavity. Appointment of blockades

To facilitate the movement of the stone through the ureter and its evacuation in a natural way, blockades are prescribed:

• according to Larin-Epstein (introduction of a 0.5% solution of novocaine into round ligament uterus in females and spermatic cord in males);
• according to Shkolnikov (intrapelvic injection of the drug).

If these measures are ineffective, it is possible to stop renal colic only with the help of an operation - surgical removal stone and drainage of the urinary tract.

Further hospital treatment It is aimed at preventing infectious complications, removing salts and other stones from the kidneys. Patients with KSD are prescribed a diet with restriction of heavy protein foods and salt, it is recommended to drink enough fluids throughout the day.

With a preventive purpose are appointed:

• phytopreparations based on horsetail, bearberry, lingonberry leaves;
• uroseptics (Canephron, Urolesan, Fitolizin).

Concomitant inflammatory changes in the renal tissue (for example, pyelonephritis) - an indication for a course of antibiotic therapy, the use of antispasmodics to restore impaired urine flow and prevent deposition urinary salts in the CLS cavity.

Prevention measures: how to prevent the development of an attack in the future

The main preventive measure for the development of repeated attacks of renal colic is to follow a fortified diet, the use of 1.5-2 liters clean water daily, regular examinations of the kidneys. You should not postpone a visit to the doctor even if you are periodically disturbed by non-intense dull or aching pain in the lower back. Perhaps this is a consequence of the formation of new stones in the kidneys. This process significantly increases the risk of recurrence of renal colic.