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Renal colic Diagnosis and Pain Management

What is Renal colic ?

Renal colic refers to pain due to obstruction of the urinary tract. It is manifested by acute pain felt suddenly in the lumbar region, and is due to a sudden increase in the pressure of urine that can no longer flow.

Causes of renal colic

Renal colic is due to an obstacle in the urinary tract that prevents the flow of urine.

In 3/4 of the cases, the pains are triggered by a urolithiasis , more commonly called renal calculus .

Kidney stones (= small solid compounds such as small pebbles of variable size, usually containing calcium or uric acid) are formed in the urinary tract, usually in the kidneys or ureters (canals that connect kidneys to the bladder).

When a calculus is blocked in one of the ureters, it prevents or slows down the passage of urine. However, the kidney continues to make urine at a level too narrow for its passage. The flow of urine is then strongly slowed or stopped, while the kidney continues to secrete. The hyperpressure caused by the accumulation of urine, upstream of the obstacle, causes intense pain .

Other causes of renal colic may be:

  • inflammation of the ureter (= ureteritis due to tuberculosis, a history of irradiation),
  • kidney tumor,
  •  a pregnancy whose volume compresses a ureter,
  • ganglions,
  • fibrosis of the area,
  • a pelvic tumor, etc.

Risk factors for renal colic

The formation of these calculations can be favored by various factors:

  • high urinary tract infections
  • dehydration,
  • diet too rich in offal and deli meats,
  • family history of lithiasis,
  • anatomical malformations of the kidney ,
  • certain pathologies (hyperparathyroidism, gout, obesity, diabetes, chronic diarrhea, medullary sponge kidney, renal tubular acidosis type 1, Crohn’s disease, renal failure, hypercalciuria, cystinuria, sarcoidosis …).

Sometimes the risk of renal colic is increased by taking certain medications .

The cause of renal colic may remain unknown and it is called idiopathic lithiasis.

Symptoms of renal colic

The pain is abruptly pronounced in the lumbar region, most often in the morning and / or at night. It is felt on one side , in the affected kidney It can extend from the back to the flank and to the belly, the groin and typically, this pain radiates to the external genitalia.

The pain is of variable intensity but has particularly sharp peaks. A dull pain often persists between each episode of crisis , which can last from ten minutes to a few hours.

The pains are accompanied, sometimes digestive disorders (nausea, vomiting, bloating) or urinary (urge to urinate frequently or brutally). The presence of blood in the urine is relatively frequent. There is often agitation and anxiety.

In contrast, the general condition is not altered and there is no fever.

What to do in case of renal colic?

Because of the intensity of the pain, the renal colic crisis is a medical emergency  : it is important to contact a doctor as soon as the symptoms appear. Therapeutic management is based on the degree of severity, but the priority remains whatever happens to relieve pain and evacuate the obstacle.

The medical treatment of nephritic colic due to kidney stones consists of injecting, antispasmodics and especially non-steroidal anti-inflammatory drugs , alphablockers and calcium channel blockers. Morphine may also be used as an anti-pain medication.

Limit water intake, less than 1 liter per 24 hours: this may increase the pressure in the kidneys as long as the urinary tract remains blocked.

In 10 to 20% of the cases, a surgical intervention is necessary when it is about a renal colic due to a computation.

How to prevent renal colic?

It is possible to reduce the daily risks by regular hydration and sufficient (1.5 to 2 liters of water per day) because it helps to dilute the urine and reduce the risk of stone formation.

Prevention mainly concerns people who have already suffered from
renal colic.

According to the cause of renal colic, it is treated.
If the cause of colic is a kidney stone problem, dietary measures are recommended, they depend on the nature of the calculations already observed in each person. Preventive treatment of stones can also be implemented.
Complementary approaches to treat renal colic

Phytotherapy

The use of plants with diuretic properties makes it possible to increase the volume of urine and thus to avoid the formation of kidney stones responsible for nephritic colic.

We can particularly look at burdock, borage, blackcurrant, mate, nettle, dandelion, field horsetail, elderberry or tea.

Warning: these plants are more preventive. They are therefore not suitable in case of acute crisis.

Homeopathy

  • Prevention :
    • for calculations of phosphates and oxalates, Oxalicum acidum is recommended in 5 CH at the rate of 3 granules three times a day,
    • for kidney stones with albuminuria, Formica rufa is recommended at the same dosage.
  • In anticipation of renal colic and pain: dilute 5 CH granules of Belladonna, Berberis vulgaris, Lycopodium and Pareira brava in spring water and drink all day long.
  • If you have trouble passing urine, take 3 granules of Sarsaparilla three times a day.
  • In cases of chronic renal colic (the volume of urine varies constantly): opt for Berberis vulgaris respecting the same dosage.
  • In field treatment to avoid recurrences:
    • 5 granules per day of a 200 K mixture to be made in pharmacy composed of Calcarea carbonica, Collubrina and Lycopodium,
    • if it is phosphatic stones, take Calcarea phosphoricum or Phosphoricum acidum (same dilution, same dosage).

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