Renal colic - Symptoms, Diagnosis, Emergency. Emergency care in the event of an attack of renal colic, an algorithm of actions First aid for an attack of renal colic

Symptoms, diagnosis and factors that provoke the disease
Restrictions and contraindications in the provision of first aid

Urgent care at renal colic should be provided in the first minutes, because an attack can have severe and irreversible consequences.

Properly rendered first aid for renal colic will help the patient recover, greatly facilitate the task of doctors to stabilize the person's condition.

Renal colic is an attack of sharp pain, which is associated with a violation of the outflow of urine from the pelvis of the kidney, but can also occur for other reasons. The attack may continue long time and occur both during physical activity and during periods of calm.

The pain spreads to the abdomen, thigh, shoulder, perineum, genitals. Dizziness, high blood pressure, nausea and vomiting may occur.

If there is inflammatory process, the temperature may rise. But such symptoms do not always occur, sometimes they can be erased.

It is necessary to differentiate the spasm associated with impaired functioning of the kidney and acute appendicitis when symptoms of irritated peritoneum are present. Diagnosis of the cause of an attack most often does not present any particular difficulties, because in patients the urine changes, there is frequent urination and the hypochondrium hurts on palpation.

Factors that can provoke an attack of renal colic:

diet violation;
excess or lack of fluid;
alcohol intake;
driving on a bad road;
physical or mental strain;
infections.

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First aid in case of an attack

The key to a favorable and successful treatment is correctly provided first aid and urgent hospitalization. Therapeutic measures are acceptable if the diagnosis is established earlier and you do not doubt its correctness.

To provide first aid for renal colic, you need to have an idea about the methods of stopping an attack. Urgent relief of acute pain is the main task of first aid, which can be solved with the help of thermal procedures and the use of antispasmodic and analgesic drugs.

First aid algorithm:

call a doctor;
provide peace;
determine the side and place where the pain is intense;
control the temperature;
collect urine for visual examination;
put a heating pad on the lumbar region or fill the bath with water;
make injections of one of the listed antispasmodic and analgesic drugs: noshpa, baralgin, ketan, cystenal, papaverine.

If the procedures do not bring the desired effect, you can use medications. The best drug for pain relief - baralgin. Do not use diuretics, because their use can provoke the movement of a stone in the ureter or other undesirable effects.

The attack should stop within 2-3 hours. In the absence of a positive effect, emergency hospitalization in the urological department is needed.

If an attack of renal colic is complicated by acute pyelonephritis and there is a high temperature, then it is impossible to carry out thermal procedures, it is urgent to call a doctor.

In most cases, increased heating of the affected area either reduces pain or removes it completely.

Proper and timely assistance will restore the functions of the organ and prevent serious complications.

Then it is necessary to be examined by a doctor, who will prescribe a more detailed examination and further treatment, depending on the severity of the disease.

Taking antibiotics, installing a stent to drain urine, novocaine blockade, surgical intervention- There are many treatment options.

Colic is an acute attack that occurs due to problems with internal organs. Spasms in various organs manifest themselves in different ways, although acute pain syndrome accompanies all attacks. Sometimes it becomes necessary to alleviate the patient's condition before the arrival of doctors. In this situation, you need to know what emergency care should be for renal colic.

Causes of renal colic

Renal colic is a sharp, paroxysmal pain that radiates to the lower back. Sometimes it is felt in the ureters (in the direction of urine) or in the lower abdomen. Most often, the pain focus is localized on one side.

Pain during renal colic is caused by stretching of the renal pelvis. Such pain is considered one of the most acute and intense.

Kidney spasm is a manifestation of the following pathologies in the body:

urolithiasis disease;
renal tuberculosis;
the presence of diseases causing problems with metabolism ( diabetes, gout).

Sometimes an attack of renal colic occurs due to trauma or the consequences of surgery. In almost half of the cases, it is not possible to determine the cause of spasms.

Symptoms and first aid

Attacks of colic are always sudden and very painful. In such a situation, first aid will help to significantly alleviate the suffering of the patient. Before taking any action, you need to understand the symptoms associated with an attack.

The main signs of colic

Renal colic occurs in both adults and children. This condition has no age or gender restrictions. The main symptom is a sharp, cramping pain.

Usually the pain is localized in the lumbar region or on the side of the kidney. When colic is caused by urolithiasis, discomfort can be felt in different places. This is caused by the movement of the stone through the ureter. Men often experience pain in the groin, testicles and penis, while women feel pain in the perineum, labia. Children usually complain of pain at the navel.

The pain is accompanied by the following symptoms:

the patient is restless, trying to take the most comfortable position of the body;
strong thirst;
pale skin;
high fever, chills;
false urge to urinate;
cutting pain when passing urine;
obstruction of the outflow of urine.

If the intensity of pain is very high, the patient may experience a state of shock up to loss of consciousness. The skin is covered with a cold sticky sweat, the pressure rises sharply.

Attention! If a patient has an attack of pain in the kidneys, you should immediately call a doctor. Renal colic can last from several hours to days.

How to stop pain at home

An attack overtakes a person without choosing a place and time. If this happens, first aid is needed for renal colic.

In order not to harm the patient and not provoke amplification pain, you need to follow the emergency care algorithm for renal colic.

Immediately call the ambulance.
Try to calm the patient, find out the symptoms of his condition.
Measure body temperature.
Attach a heating pad filled with hot water to the lower back (pre-wrap with a cloth).
Place the patient in a warm bath.

It is allowed to enter antispasmodics only with the ability to make intramuscular injections (No-shpa, Baralgin). If it is not possible to administer the drug intramuscularly, the listed drugs can be used in the form of tablets.

Thermal exposure can cause uterine bleeding and even a miscarriage, so it is better for pregnant women in case of a kidney attack to refuse a heating pad and a bath. It is allowed to take a pill No-shpy and wait for the arrival of a doctor.

Attention! If the patient cannot urinate, in no case should you give him diuretics. They will only increase the speed of stone movement and worsen the patient's condition.

Alternative Treatments

Medicinal herbs can also help with renal colic. To achieve a positive effect, you can use the following plants:

celandine;
flax-seed;
carrot seeds;
rose hip.

Celandine: 2 tbsp. spoons of crushed raw materials are poured with a glass of boiling water. After cooling, the broth is decanted and taken twice a day before meals.

Flaxseed: 1 teaspoon of seeds should be boiled in 1 glass of water, take half a glass a day every 2 hours. The decoction may be diluted with water. Take the remedy for two days.

Carrot seeds: 1 tbsp. a spoon is diluted with a glass of boiling water. The broth is infused, wrapped in a cloth, for about 12 hours, after which it is decanted. Take 1/2 cup of warm decoction before meals for 2 days.

Rose hips: chopped roots in the amount of 2 tablespoons are boiled in two glasses of water for about 15 minutes. The resulting liquid is wrapped with a cloth and infused until completely cooled, decanted. Apply the resulting remedy up to four times a day, drinking 1/2 cup at a time. The course lasts seven days.

Important! Self-medication can be hazardous to health.

Accept folk remedies stands with caution, being sure of the good tolerance of the drug components.

Specialized medical care in a hospital

A urologist or a surgeon can state renal colic, they also prescribe the optimal treatment. Since seizures often begin suddenly, emergency care is provided by emergency doctors. After examining the patient, doctors decide whether a referral to the urological or therapeutic department is necessary.

Immediate hospitalization is necessary in the following cases:

medical care at home does not give the expected results (severe pain persists);
temperature above 39 degrees;
the patient's only kidney;
pregnancy of any term or suspicion of it.

After the patient is admitted to the hospital, a set of measures is taken to confirm the diagnosis:

Ultrasound (will help to see the stone);
radiography;
laboratory and clinical research.

When the diagnosis is confirmed, the patient is assigned to inpatient treatment. At this stage, the following methods of therapy are used:

further use of antispasmodics;
appointment of stronger
control is exercised blood pressure and cardiac activity;
the use of antibiotics (in the event of inflammatory processes);
prescribing a course of vitamins.

The patient must understand that the relief of pain syndromes and even the removal of stones does not guarantee recovery. After a certain period of time, a new calculus may form. To prevent new attacks, the patient must comply with all the doctor's instructions: important, right choice physical activity and taking the necessary medications.

Restrictions and possible contraindications

It is necessary to provide first aid in case of attacks of renal colic, taking into account the following features of the patient:

the reasons that caused the attack;
the age group in which the patient is included;
the presence or absence of comorbidities.

If the patient is taking any medications, taking antispasmodics should be excluded - such drugs do not always go well with other medicines. The age of the patient must also be taken into account. Elderly people are not recommended to be put in a warm bath - this is a big burden on the body. Also, the bath is prohibited for people who have had a heart attack or stroke. It is enough to limit yourself to a heating pad or mustard plasters.

An attack of renal colic is not only painful, but also extremely dangerous. Fortunately, you can beat the attack and

The main thing in this situation is not to get confused and know a clear first aid algorithm. It must be remembered that the temporary elimination of the symptoms of colic does not exclude the obligatory trip to a specialist in the future.

Immediate assistance in these situations is to call the ambulance team - the doctors will take the necessary measures to eliminate the attack.

Renal colic is a manifestation of a concomitant symptom of many diseases of the kidneys or the genitourinary system. A characteristic feature of colic is their abrupt onset and severe pain that continues throughout the attack.

This condition is dangerous for its severe, often irreversible consequences, so it is important to know the emergency care algorithm for renal colic.

Causes and symptoms

Before proceeding with the relief of renal colic, you need to understand the cause of their occurrence and the features of the manifestation.

An attack, characterized by the manifestation of sudden pain, is manifested due to the following pathological changes in the body:

The presence of tumor processes in the tissues of the kidneys;
Movement of stones in the urinary tract;
Damage to the kidneys as a result of mechanical impact;
Renal tuberculosis;
Excessive physical activity;
alcohol abuse;
Narrow lumen in the ureter;
Education of a benign or malignant nature in the uterine region, thyroid gland or in the digestive tract;
Omission of the kidney.

With these diseases, the kidneys often hurt, and a sharp attack of pain can overtake at any time.

However, at the time of assistance with renal colic, it is important to know not only about the presence of pathological changes, but also about the reasons that caused them:

Stones that are in the kidneys;
Blood clots formed in the space of the kidneys;
Plugs of pus in the urinary tract;
Bend or swelling in the ureter.

If there is no information about clinical picture diseases, emergency care for renal colic is based on the symptoms of an attack.

Sharp, severe pain during spasm, which can cause fainting or pain shock.
Blood clots appear in the urine.
Without first aid, the pain syndrome, felt in the abdomen, groin and sides, intensifies.
When emptying the bladder, urine passes weakly or not at all.
Inability to defecate.

In case of impaired renal function, the symptoms intensify and manifest themselves in such disorders:

Manifestations of pain during urination;

Dizziness;
A rapid increase in body temperature and blood pressure;
Nausea;
Vomit.

Note!

Important symptoms of colic are the inability to eliminate pain when changing the position of the body and its paroxysmal nature.

The duration of the attack depends on individual features organism, as well as the causes that caused renal colic. So, cases of colic were recorded, which lasted from 2 hours to 3 days.

These symptoms require immediate medical attention, and first aid is used to alleviate the pain syndrome.

First aid

Conditions accompanied by renal colic require careful diagnosis and complex treatment medical means.

First aid with renal colic, it is needed in order to relieve pain, preventing loss of consciousness and the manifestation of pain shock in the patient. To achieve these goals, the following algorithm of actions was developed:

Urgently call medical personnel;
Provide the patient with a vertical position so that the lower back is slightly raised;
For pain in the kidneys, you can use heat in the form of a heating pad applied to the lower back;
At the first manifestations of spasm, you can invite the patient to take a bath filled with warm water;
If, after the attack has passed, the kidneys are very sore, you can take medications that relieve spasm by relaxing the muscles;
Any urge to urinate cannot be ignored, therefore, if care is provided at home, it is necessary to ensure that the patient is able to satisfy his needs even while lying down.

Note!

At the time of emergency care, it is forbidden to use analgesics, as the symptoms will be distorted, and it will be difficult for doctors to diagnose.

It must be remembered that it is imperative to seek medical help, even if emergency help eliminated spasm, accompanied by colic. After all, so that the attack does not recur, it is necessary to eliminate the root cause that caused it, and this can only be done with medical help.

Precautionary measures

When providing first aid for renal colic, you need to remember about contraindications for concomitant diseases:

Hot baths should not be used by people old age, persons with pathological changes in the cardiovascular system;
The use of localized heating is prohibited for patients diagnosed with inflammation of the internal organs;
In diseases of the kidneys, accompanied by colic, diuretics create a reverse character, increasing the pain syndrome.

When assisting with spasms in the kidneys at home, you need to remember that at this stage you can use only those methods that will not cause harm and will not increase the pain syndrome.

First aid for renal colic is considered effective if the patient has ceased to feel spasmodic pain, and his condition has improved significantly.

If the symptoms begin to intensify, the patient must be urgently hospitalized.

Patients who develop the following symptoms are subject to immediate hospitalization:

Body temperature and blood pressure are very high;
Spasmodic and analgesic drugs did not bring relief;
An acute development of the infectious process occurs when the stone blocks the urinary systems.

In these cases, what to do to alleviate the patient's condition should be decided by the doctors of the ambulance team.

Specificity of medical care

Initially, medical care consists in pain relief with medications:

Use intramuscularly and intravenously medicines that stop the pain and the cause of its appearance. The most commonly used drugs are "Ketorolac" and "Diclofenac", which have not only analgesic, but also anti-inflammatory properties.

Action to eliminate vomiting consists in the introduction of antiemetics, such as metoclopramide.
As an emergency, myotropic antispasmodics are used, which are administered simultaneously with analgesics.
In the event that the action of these funds did not have the desired effect, assistance is provided with the help of narcotic analgesics("Morphine", Tramadol"), which are administered in combination with Atropine, which relieves spasms.
If kidney stones are diagnosed, the patient can be helped with medications that have an alkalizing effect on urine: Sodium Bicarbonate or Potassium Citrate. These drugs help the stones dissolve and leave the body as painlessly as possible.

After the alarming symptoms are eliminated, the patient is hospitalized to diagnose the cause that caused renal colic.

The first study is an ultrasound examination of the kidneys. Then the doctor analyzes the clinical, laboratory and X-ray diagnostics to confirm the diagnosis.

At the time of diagnostic studies, the patient continues to receive medical assistance, which consists in taking diuretic drugs and synthetic vitamin-mineral complexes.

With pronounced symptoms and weak relief of the pain syndrome, surgical intervention is performed in such cases:

Renal hydronephrosis;
The presence of large stones that blocked the ureter;
Shrinkage of the kidneys.

It should be noted that renal colic is a serious manifestation of pathological changes in the kidneys and nearby organs. Therefore, as soon as the kidney or abdominal area begins to hurt, you need to urgently contact medical institution for making an accurate diagnosis.

Despite the fact that traditional medicine offers several recipes for pain relief, the treatment of renal colic with home remedies is prohibited, and the use of medications is possible only after an accurate diagnosis and medical prescriptions.

A patient who first encountered severe pain in the kidney area may confuse the pain syndrome with appendicitis, ulcers or pancreatitis with colic. Therefore, any medications and infusions from medicinal herbs without specification of the diagnosis can cause significant harm to human health.

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Characteristics of the disease

Colic is a severe, paroxysmal pain. The prevalence of this condition among the population reaches 10%. Pain syndrome can occur in people of any age and gender. The development of this symptom may be based on the following processes:

blockage of the ureter;
the formation of a blood clot that interferes with the passage of urine;
deposition of salts of uric acid;
blockage of the urinary tract with necrotic masses;
muscle spasm of the ureter;
spasm of the pelvis;
accumulation of mucus or pus;
renal ischemia.

Depending on the level of the lesion, pain may be felt in the lower back, lower abdomen, or along the ureters. Most often, colic is felt on one side. Pain is the result of stretching of the renal pelvis and renal capsule. Such pain is one of the most intense in medical practice. This condition requires emergency care.

Etiological factors

Colic occurs when the following diseases and pathological conditions

urolithiasis;
kidney tuberculosis;
benign and malignant tumors;
hydronephrosis;
narrowing of the ureter;
acute pyelonephritis;
torsion of the ureter;
prolapse of the kidneys;
dystopias;
prostate cancer;
benign prostatic hyperplasia.

The cause may be post-traumatic hematomas. The most common cause is the presence of stones in the kidneys or ureter. In the presence of a kidney stone, colic develops in every second patient. With blockage of the ureter - in almost all patients. Severe pain syndrome like colic can occur with inflammatory diseases (urethritis, prostatitis). Rarely, the reason lies in vascular pathology(vein thrombosis in the kidney area, embolism). In some patients, colic is due to congenital organ anomalies (achalasia, spongy kidney).

In women, colic can develop against the background of gynecological diseases (salpingoophoritis, uterine fibroids). These diseases often lead to adhesive disease, which is a trigger for increased pressure in the kidneys. Predisposing factors for the development of renal colic include aggravated heredity (cases of colic in close relatives), previous urolithiasis, poor nutrition (excess in the diet meat products and canned food), insufficient fluid intake, heavy physical labor, hypothermia, the presence of foci chronic infection, the presence of systemic connective tissue diseases and urethritis.

Signs of the disease

Colic appears suddenly against the background of complete well-being. In this situation, there is no triggering factor ( exercise stress, stress). Pain syndrome can overtake a person at work, school or at home. The main symptom of colic is pain. It has the following features:

high intensity;
acute;
cramping;
appears unexpectedly;
does not depend on human movements;
localized in the lower back, on the side of the kidney or in the inguinal region;
gives to the genitals, inguinal region, anus;
often associated with nausea and vomiting;
often manifested by a change in the nature of urine (blood appears in it).

Nausea and vomiting are observed with colic, which is caused by a violation of the outflow of urine in the kidneys or ureters. Vomiting does not improve the condition of a sick person. With obstruction of the lower ureter, the appearance of dysuric phenomena (frequent and painful urination) is possible. In some cases, ischuria occurs. Fever, chills, and general malaise indicate an inflammatory process. Stagnation of urine is a favorable factor for the activation of microorganisms, which leads to inflammation.

The duration of colic varies. It can last from 3 hours to a day or more. The pain may wax and wane. All this significantly worsens the patient's condition. He can't find a place for himself. There is marked excitability. In severe cases, colic can cause loss of consciousness. Against the background of colic, the patient may be disturbed by the following complaints:

cutting in urethra;
dry mouth;
decrease in diuresis;
anuria;
increased blood pressure;
increase in heart rate.

Severe pain can lead to shock. In this case, pallor skin, the presence of cold sweat, bradycardia, pressure drop.

Patient examination plan

Cramping pain can be observed not only in diseases of the genitourinary system. To establish the underlying disease, a series of studies should be carried out. Diagnosis includes taking an anamnesis, palpation of the abdomen, determining the symptom of concussion of the lumbar region, ultrasound of the kidneys and bladder, blood and urine tests, urography. Statement of diagnosis begins with a survey of the patient. During it, the characteristics of the pain syndrome and related complaints are determined. Of no small importance is the patient's indication of a violation of urination and a change in the color of urine.

With kidney damage, a positive symptom of Pasternatsky is very often detected. The most informative is general analysis urine. Availability a large number leukocyte count indicates the presence of pyelonephritis. Leukocytosis in combination with hematuria may indicate urolithiasis or glomerulonephritis. With urolithiasis, fresh red blood cells are found. Ultrasound is required to rule out glomerulonephritis. Differential diagnosis of renal colic is carried out with pain in other acute diseases(appendicitis, cholecystitis, pancreatitis, peptic ulcer).

First aid

With renal colic, first aid has great importance, since his further condition depends on the timeliness of the provision of medical care and hospitalization of a sick person. The main goal of emergency care for colic is to eliminate pain. Often there are cases when first aid for renal colic is provided at home. Colic can occur quite unexpectedly at home, on the street or at work. Everyone should know what to do in this situation. Emergency care for renal colic includes the following activities:

calling a doctor or an ambulance;
providing rest for the victim;
elimination of pain syndrome;
warming the patient (using a heating pad);
determination of body temperature and general condition the victim;
determining the location of pain.

If possible, urine should be collected. First, it is necessary to eliminate the pain with the help of thermal procedures. To do this, you can put a heating pad on the area where the pain is felt. An alternative way is to seat the victim in a bath of hot water. Heat will reduce pain and relieve the patient's condition. The use of heat is justified only in the absence of an acute inflammatory process. Hot baths are contraindicated for people who have had a stroke or heart attack. At high temperature body and other signs of intoxication warming is not applied. If thermal procedures do not help, pain relievers (antispasmodics or analgesics) are used.

If skills allow, it is better to administer the medicine intramuscularly. To eliminate colic, you can use the following drugs:

No-shpa;
Papaverine;
Drotaverine;
Baralgin;
Pentalgin;
Platifillin;
Diclofenac;
Ibuprofen.

If colic does not disappear, medical workers novocaine blockades can be carried out. In a hospital setting, catheterization or stenting can be performed. Diuretics are not used to eliminate renal colic, since stimulation of the urinary stream can lead to the movement of the stone, which can cause increased pain. Emergency care for renal colic should be carried out as early as possible. To avoid complications and pain shock, this must be done within 2-3 hours from the onset of colic. After stopping colic, a thorough examination is carried out. Further treatment is aimed at eliminating the underlying cause of colic.

Therapeutic measures

After establishing the underlying disease, treatment is carried out. With nephrolithiasis (kidney stones), treatment can be conservative or surgical. Small stones less than 3 mm in size can be removed independently. In this case, the patient is prescribed a strict diet depending on the type of stones, drinking plenty of water. Medicines are used to dissolve the stones. Antibiotics and nitrofurans are used to eliminate the inflammatory process. With frequent colic against the background of kidney stones, lithotripsy and lithoextraction can be performed. If after that the stones do not disappear, it is carried out radical operation. If kidney tuberculosis is detected, long-term therapy with anti-tuberculosis drugs is carried out. Colic on the background acute pyelonephritis requires antibiotics. Thus, if a person has developed renal colic, the symptoms will be very pronounced. First aid is to eliminate pain and call an ambulance.

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Characteristics of renal colic

What's happening

This condition occurs due to a violation of the outflow of urine due to stretching of the renal pelvis.

When an obstacle appears in the path of urine, the following phenomena occur:

the renal pelvis overflows, the pressure in it rises,
venous congestion occurs
kidney ischemia develops (edema of the interstitial tissue, stretching of the renal capsule).

Origins of pathology

Among reasons of this disease are leading:

Stone migration.
Blockage of the ureter by caseous masses or blood clot.
Tuberculosis and tumors of the urinary system.
Inflammatory processes or kink of the ureter, disrupting its patency.

Colic is often referred to as a complication of urolithiasis in the stage of obstruction of the lumen of the ureter by a stone. The response to blockage is spasm, which causes pain.

How the disease manifests itself

Renal colic is characterized by a sudden onset of an attack. First, there is unbearable pain in the lumbar region.

Then it spreads to the area of the hypochondrium, abdomen. The pain moves from the ureter to the bladder, scrotum (in men), labia (in women), thighs. Often the pain is strongest at the level of the abdomen or genitals, and less in the region of the kidneys.

In addition to pain, there are frequent urge to urinate, pain in the urethra. After an attack, an increase in the level of leukocytes and erythrocytes in the urine is detected.

In parallel with colic, there may be:

irritation of the peritoneum, as well as the solar plexus,
nausea with vomiting,
desire to defecate
dizziness.

Diagnosis scheme

The first task of diagnostic measures is differentiation with the state of "acute abdomen", an exception:

appendicitis,
pancreatitis,
cholecystitis,
thrombosis of mesenteric vessels (intestinal mesentery),
intestinal obstruction,
radiculitis,
perforated stomach ulcer (duodenal ulcer),
adnexitis (inflammation of the appendages),
ectopic pregnancy,
ovarian cyst torsion,
intercostal neuralgia,
shingles.

Evidence of renal colic

It is not difficult to distinguish this condition from other diseases. In addition to traditional symptoms with a history, evidence of colic serve:

pain in the vertebral-costal angle,
bimanual palpation causes pain in the hypochondrium,
Availability positive symptom Pasternatsky (pain from tapping the lumbar region).

Other signals are the localization of pain under the "spoon", then in the right hypochondrium, its spread across the abdomen. When inhaling, the pain intensifies, it gives to the right shoulder, shoulder blade. Soreness occurs on palpation of the gallbladder zone.

Importance of emergency care

What to do at the beginning of an attack

Proper management of emergency care after the onset of symptoms of renal colic contributes to successful treatment. They may be sufficient without hospitalization of the patient.

First you need to call an ambulance.

If the attack did not occur for the first time, and the patient is sure that this is renal colic, then before the doctor arrives, his condition can be alleviated. When providing first aid for renal colic, a specific algorithm of actions should be followed.

It is necessary to provide the patient with complete rest, put a heating pad on the lower back (you can make a hot bath). At the same time, give antispasmodics and painkillers from the home medicine cabinet. These include:

baralgin (1 tab.),
avisan (1 year),
papaverine (1 tab.),
cystenal (15-20 drops).

The help of a physician consists in the appointment of thermal procedures with the simultaneous introduction antispasmodics, painkillers:

baralgin 5 ml intravenously or intramuscularly,
atropine (1% solution),
subcutaneously pantopon, platyfillin.

When stopping the attack and improving well-being, hospitalization is not needed.

If you don't trust medical methods, then you can use the secrets traditional medicine for kidney pain relief or prevention.

If colic has not passed in two hours, the patient is hospitalized in the urology department.

When urgent hospitalization is needed

Indications for hospitalization and surgical intervention are:

stones in the ureters,
the presence of a single kidney with a stone,
stone in the pelvis in the presence of acute pyelonephritis,
gross hematuria (blood in the urine) due to a stone that does not respond to conservative treatment,
a state of acute urinary retention due to the presence of stones in the urinary tract.

Required knowledge

If you have problems with the kidneys, you should be aware of the factors provoking colic:

excess or lack of fluid in the diet,
eating disorders,
bumpy ride,
alcohol intake,
physical, mental, mental stress,
acute respiratory or intestinal infections.

In a state of attack of renal colic, it is unacceptable to leave the patient without medical care. Frivolity and short-sightedness of the patient and his environment can cost him his life. With the rapid spread of bleeding through abdominal cavity it is difficult to cope with the disease. Even if you managed to overcome the attack with home remedies, a visit to the urologist is mandatory.

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Infusion therapy

There is no evidence that routine fluid therapy is indicated for patients with renal colic. Rather, on the contrary, active infusion therapy can contribute to an increase in intrapelvic pressure. To the introduction of balanced saline solutions they resort if there are signs of dehydration, and enteral fluid intake is difficult for some reason.

Antibacterial therapy

Early prescription of antibiotics is certainly indicated if there are signs of pyelonephritis and (or) sepsis. Antibiotics are also usually prescribed for a PC attack that lasts for several hours. III-IV generation cephalosporins (cefotaxime, ceftriaxone, cefoperazone, cefepime, cefoperazone/sulbactam) are often used as initial therapy. Ceftriaxone also has an analgesic effect.

Nausea and vomiting

With nausea and vomiting, selective serotonin 5-HT3 receptor blockers are most effective: tropisetron 5 mg 1 time per day IV or ondansetron 4-8 mg 2 times a day IV. But the high cost limits the possibility of using these drugs. Droperidol, used at a dose of 0.6-1.2 mg IV 1-3 times a day, is practically safe (almost does not lengthen Q-T interval) and is quite effective for the treatment and prevention of PONV. If you use higher doses, the risk of side effects of droperidol increases dramatically. Dopamine receptor blocker metoclopramide hydrochloride (Cerukal), administered 10 mg 3-4 times a day in/in.

Survey

After reducing the pain syndrome, the patient is examined.

Laboratory methods

General blood analysis. Changes in indicators are generally not characteristic of renal colic. In dehydrated patients, the concentration of hemoglobin and the number of red blood cells may increase.

Creatinine, urea. High rates are a contraindication to the implementation of excretory urography and the appointment of NSAIDs;

General urine analysis. Erythrocyturia occurs in approximately 80% of patients with renal colic. Leukocyturia and bacteriuria are indicative of a urinary tract infection.

Instrumental examination methods

Ultrasound examination of the kidneys and upper urinary tract is the most accessible method to detect stones in the kidneys, upper and, in some cases, lower third ureter, as well as the expansion of the pelvicalyceal system. It should be noted that approximately 25% of patients do not find pathological changes and expansion of the pelvicalyceal system, which requires additional methods research.

Non-contrast spiral computed tomography (CT) - this method provides the most complete information about the cause of the obstruction that caused the development of PC. And, at the same time, to identify / exclude many diseases of the abdominal organs.

Excretory urography, until recently the "gold standard" in the diagnosis of PC, is currently performed when CT is not possible. Excretory urography reveals radiopaque urinary tract stones. During an attack of renal colic, when there is a segmental spasm of the pyelocaliceal or ureteral muscles with a simultaneous weakening of blood flow in the cortical zone of the renal parenchyma, the contrast agent is not excreted by the kidney, which is noted on the urogram as a sign of the so-called “silent kidney”. But if the increase in intrapelvic pressure is not so critical (65-100 mm Hg), then the images clearly show a nephrogram (the so-called "white kidney"), indicating impregnation of the renal parenchyma with a contrast agent, but without its penetration into the upper urinary tract ;

Retrograde ureterography is indicated in difficult cases differential diagnosis between renal colic and diseases of the abdominal organs, when the results of spiral computed tomography and excretory urography are ambiguous.

June 15, 2017 Vrach

If a person has renal colic, his health is seriously affected. There is a strong pain syndrome, sometimes it becomes simply unbearable. How to relieve pain? There are many ways, but it is important to use only those that do not harm and will be aimed at treating the underlying disease.

First aid

With the development of a painful attack, it is urgent to call ambulance. Patients, as a rule, are taken to a hospital, and after acute colic is removed, treatment is carried out at home. Before the arrival of a team of doctors, you need to try to alleviate the suffering of the patient by removing the pain syndrome. First aid is allowed to be provided to a person with left-sided colic and with a history of renal pathologies, when there is no doubt about the diagnosis. If there is right-sided colic, the diagnosis of inflammation of the appendix should be ruled out before taking any drugs.

To reduce the strength of the attack, the following measures are allowed:

Strengthen the drinking regime.
Apply a warm heating pad, a bottle, a bag of sand to the lumbar region (allowed only for recurring colic against the background of the movement of a large stone with an established diagnosis). You can also take a hot sitz bath for 10-15 minutes.
Give the patient painkillers or antispasmodics to relax smooth muscles, against inflammation and acute pain. Baralgin, Papaverin, No-shpa, Revalgin tablets help well. If there is a health worker in the family, the same drugs can be administered intramuscularly.
With absence these drugs it is allowed to dissolve a Nitroglycerin tablet to anesthetize an attack.

What can not be done as first aid measures? It is forbidden to take large doses of analgesics, especially if they do not have the desired effect. Also, do not heat the lumbar area for a long time, it is better to carry out a short thermal procedure, and then apply dry heat to the back (wrap it with a scarf, scarf). Any heating is prohibited, if any. fever body, because in this case the cause of the disease is the inflammatory process.

Treatment in the hospital and at home

There are a number of indications for hospitalization and treatment in a hospital:

renal colic on both sides;
an attack in a child or a pregnant woman;
the presence of only one kidney;
lack of effect from home therapy;
elderly age;
the presence of complications;
development of colic against the background of pyelonephritis, tumors;
the appearance of frequent, severe vomiting;
a sharp increase in body temperature;
lack of urination.

To relieve an attack, drugs are injected in injections, using the above antispasmodics, non-narcotic analgesics(a mixture of Novocain with glucose, Pipolfen, Galidor, Atropine, Diphenhydramine, Diclofenac, Ketonal, Promedol, Platifillin, Maxigan). You can use non-steroidal anti-inflammatory drugs in tablets, suppositories.

The use of painkillers and drugs for spasms of smooth muscles is continued until the stone passes, the patient's condition improves. Antibiotics are prescribed if the cause of colic is an inflammatory process, or it occurs against the background of pyelonephritis. In the absence of the effect of medications and acute urinary retention, ureteral catheterization is performed. Often you have to do emergency surgery (endoscopic or abdominal methods) to remove the calculus.

As the attack subsides and the patient's health returns to normal, the patient is discharged. At home, a further course of therapy is necessarily performed. It may include such drugs:

Means for optimizing blood circulation in the renal vessels - Pentoxifylline, Trental.
Uroantiseptics to relieve inflammation - Furomag, Nitroxoline.
Medicines to improve the functioning of the entire urinary system and dissolve calculi - Olimetin, Urocholum, Litovit, Uro-Vaksom, Canephron, Cyston.

Folk recipes

Any folk ways therapy is allowed to be used only with the approval of a doctor. Renal colic may be associated serious illnesses urinary system, which are dangerous and sometimes lead to death. It is important not to delay treatment in a hospital, hoping for folk remedies.

Stories from our readers

“I was able to cure the KIDNEYS with the help of a simple remedy, which I learned about from an article by a UROLOGIST with 24 years of experience Pushkar D.Yu ...”

There are the following recipes:

Brew a glass of horsetail grass in 2 liters of boiling water, leave for 2 hours. Strain, pour into a warm bath. Take a bath for 15 minutes.
You need to eat watermelons (300-700 g per day), since this product has a diuretic effect and relieves colic attacks - removes stones from the ureter.
With acute pain, take a cabbage leaf, crush it in your hands. Apply to the area of the affected kidney with a warm cloth, leave until the condition is relieved.
Brew a tablespoon of birch buds with 300 ml of boiling water, leave for an hour. Drink 100 ml of infusion three times a day. It is advisable to use such therapy in a course of 7-10 days.

Prevention of pathology

To no longer suffer from pain symptoms, you should follow the doctor's recommendations for the treatment of all kidney diseases. It is necessary to find out the causes of the appearance of stones in the kidneys and act on them with the help of drugs, diet. In the absence of contraindications, it is necessary to increase the water regime. Salt in the diet should not exceed the norm allowed by the doctor. Also, as a preventive measure, you should give up smoking and alcohol, lead an active lifestyle, prevent hypothermia and the appearance of foci of infection in the body. In this case, the risk of exacerbations of kidney disease will be minimal.

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Renal colic is a fairly common and at the same time dangerous condition that requires immediate first aid to the patient, otherwise an attack can lead to serious and irreversible consequences.

Colic is not an independent disease. This ailment is clinical syndrome that occurs against the background of some pathologies of the kidneys and other organs of the urinary system. Renal colic is characterized by a sudden onset of severe paroxysmal burning, stabbing or cutting soreness. Emergency care for renal colic helps to alleviate the patient's condition, as well as prevent various complications.

According to statistics, the prevalence of this condition among the population is 10%. Pain syndrome can occur in any person, regardless of gender and age. The first and main symptom of the disease is intense pain in the region of the lower parts of the spinal column. The pain can be given to the abdomen, perineum, shoulder. Moreover, the pain is often paroxysmal in nature. A characteristic sign of renal colic is the inability to relieve pain by changing the position of the body.

An attack can occur both after physical exertion and at rest. Renal colic is usually caused by:

blockage of the ureter;
the formation of a blood clot that interferes with the passage of urine;
renal ischemia;
accumulation of purulent or mucous contents;
spasm of the pelvis;
genetic predisposition;
muscle spasm of the ureter;
deposition of salts of uric acid;
blockage of the urinary tract;
physical stress;
alcohol abuse;
diet violation;
kidney tuberculosis;
benign or malignant neoplasm;
acute pyelonephritis;
prolapse of the kidneys;
dystopia;

In addition, the disease can develop due to post-traumatic hematomas. One of the most common causes an attack of colic is the presence of stones in the ureter or kidneys. With kidney stones, colic occurs in every second person, and with blockage of the ureter - in almost everyone.

The occurrence of a pain syndrome of the type of colic can be triggered by inflammatory diseases (urethritis, prostatitis). Rarely, but still possible, the cause of the disease lies in the presence of vascular pathology (thrombosis or embolism).

In some cases, the appearance of an attack is due to congenital anomalies of the urinary system (spongy kidney, achalasia). In representatives of the weaker half of society, colic may occur due to gynecological ailments. Uterine fibroids and salpingo-oophoritis provoke the appearance of adhesions, which is the starting factor for increasing pressure in the kidneys.

The main signs of renal colic

The attack occurs, as a rule, suddenly. In this situation, there is no trigger, for example, a stressful situation or intense physical activity. Pain is the main symptom of colic. Soreness given state intense, acute, paroxysmal. Occurs for no apparent reason.

In addition to pain, colic is characterized by nausea, vomiting, blood in the urine, pain in the urethra, xerostomia, decreased diuresis, anuria, increased blood pressure, increased heart rate.

Due to severe pain syndrome, it is possible to develop state of shock, accompanied by blanching of the dermis, cold sweat, bradycardia, tremor of the limbs, malaise, pre-syncope and syncope.

The duration of an attack may vary. Colic can last from several hours to days. At the same time, painful sensations can either intensify or weaken.

First aid

Timely and correct assistance, and urgent hospitalization is the key to a favorable and successful therapy. The main goal of first aid for colic is to eliminate pain.

Quite often, emergency care for an illness is provided at home. An attack can appear suddenly at home, at work or on the street. Every person should know the algorithm for providing first aid during an attack.

Help with colic includes the following activities:

call an ambulance;
providing the victim with rest;
elimination of pain;
application of heat;
body temperature measurement;
assessment of the general condition of the patient;
determination of the location of pain.

All actions must be balanced and as correct as possible. Do not worry, your excitement will be passed on to the patient, and now he feels bad without it. Get together and start to act in order.

Provide the patient with as much rest as possible.
If possible, collect urine. Next, it must be transferred to a specialist who will check it for the presence of stones.

Doctors advise starting therapy with the use of any thermal procedures. It can be a warm bath or a heating pad on the stomach or lower back.

It is contraindicated to use heat if a person has had a heart attack or stroke.

If the patient has a fever and other signs of intoxication are present, warming is not used. If thermal procedures did not bring relief, and the person still complains about severe pain, it is necessary to give him an analgesic or antispasmodic. Pain can be eliminated with No-shpa, Papaverine, Pentalgin, Baralgin, Platifillin, Diclofenac or Ibuprofen.

If all of the above actions turned out to be ineffective, the patient must be injected intramuscularly with a narcotic pain reliever: Promedol or Morphine.

At total absence the expected effect after all these measures, the patient must be hospitalized in the urological or surgical department. There, an urgent ureteral catheterization or puncture nephrostomy or other surgical treatment will be performed.