Renal colic

August 2017


Definition


Renal colic is a syndrome characterized by severe pain usually caused by the moving of a kidney stone from the kidney into the urethra. The channel in question is too narrow to evacuate a stone that consequently gets stuck. The ureter may also be compressed by another body, a tumor, an inflammation or by scarring. The pain caused is extremely violent and is one of the worst known in medicine.

Symptoms


An extremely severe pain is felt suddenly, originating at the lumbar and moving towards the genitals. One side is affected and the pain often radiates to the flank, genitals and inner thigh. The patient will sweat profusely, but there is no associated fever. The patient will become pale, anxious and agitated and no position manages to relieve the pain. Urine usually remains normal in appearance, but can sometimes contain blood.

Diagnosis


The diagnosis is made through tests including an ultrasound, which reveals the presence of an obstruction in the urethra and possible obstruction of the kidney due to a dilated renal pelvis cavity.
The doctor usually completes the ultrasound with:
  • X-rays that can eliminate other potential sources of pain (pyelonephritis, appendicitis, intestinal obstruction, inflammation of the colon ...), or sometimes help visualize the stone (some are not visible, depending on their constitution)
  • a CT scan,
  • intravenous urography,
  • urinary examinations, urine dipstick or urine culture (looking for a bacterium that could cause a urinary tract infection).

Treatment


The initial goal is to relieve pain: this is generally achieved with the intravenous use of anti-inflammatory drugs (Ibuprofene), anti-spasmodic (phloroglucinol), and sometimes morphine. The stone can sometimes evacuate itself spontaneously by natural means. However, it can also persist and its removal is necessary. A professional can destroy it with lithotripsy, a technique that breaks the stone via a shock. Unfortunately, this technique cannot be applied to all stones. Another solution is to pass a catheter into the ureter to disintegrate the stone (ureteroscopy). A last option, surgery, is used for certain types of stones.

Prevention


It is possible to prevent recurrence of renal colic by consuming plenty of water to maintain a diuresis (entire urine content replaced over 24 hours). Some foods rich in purines (sausages, meats) may induce stone formation: reduce their intake, but if this is insufficient, taking allopurinol helps prevent the formation of some calculi.

Related

Original article published by Jeff. Translated by Jeff. Latest update on June 10, 2013 at 06:30 AM by Jeff.
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