Renal colic: symptoms of the disease and emergency care

Urolithiasis or nephrolithiasis develops when there is a metabolic disorder and is manifested by the formation of stones in the renal pelvis .

A typical manifestation of this disease is an attack of renal colic. If renal colic develops , its symptoms rarely precede prodromal pain in the lumbar region. As a rule, renal colic occurs suddenly without any precursors indicating the presence of urolithiasis, and within a short time reaches a high intensity. Acute pain quickly spreads to one half of the abdominal cavity. Changing the position of the body does not reduce the intensity of pain, so patients behave extremely restlessly. Intense pain lasts for several minutes, hours or even a few days, can lead a patient to a loss of consciousness.

The attack of renal colic often accompanies nausea, vomiting, dysuria, reflex paresis of the intestine and tension of the muscles of the abdominal wall. Less common is the development of anuria of reflex origin. The intoxication syndrome is expressed by the appearance of weakness, dry mouth, headache, fever, chills.

Renal colic during pregnancy can be with a history of urolithiasis. Similar symptoms can cause acute pyelonephritis, the development of which often provokes pregnancy. Most often, renal colic happens in the second half of pregnancy.

Renal colic. Symptoms identified in a clinical trial

To diagnose the disease, subjective signs of renal colic are supplemented with an objective examination. A clinical study helps confirm the diagnosis of renal colic. Pain increases with bimanual palpation of the kidney. A sharply positive symptom of Pasternatsky is detected , which is revealed by tapping in the area of the kidney projection.

In a number of cases, soreness is determined by pressing on the abdominal wall at the level of the so-called ureteral points:

- The upper point is located 7-8 cm outside of the navel;

- middle - at the intersection of the horizontal line connecting the upper protuberances of the iliac bones with the vertical, passing at the point between the median and the two outer thirds of the fallopian arcade;

- lower - at the level of the ureter in the bladder.

Renal colic: symptoms determined by instrumental studies

In the urinary sediment with urolithiasis, crystals of salts or small concretions are determined. Some time after the attack of renal colic in the general analysis of urine revealed hematuria.

For the diagnosis of renal colic, survey radiography is used, but this study can reveal only radiopaque stones. An indirect sign of a stone in the urinary tract is a large number of gases in the intestine, mainly on the side of the renal colic. This phenomenon develops due to the paresis of individual loops of the small intestine.

With ultrasound examination of the kidneys, stones of any chemical composition whose size exceeds 0.15-0.20 cm are diagnosed.

Excretory urography is carried out in case if it is necessary to find out the functional state of the kidneys, for example, when planning an operative intervention for urolithiasis.

First aid for renal colic

If renal colic develops, the symptoms of which we reviewed above, pre-medical care can be provided independently before the ambulance arrives. To remove the spasm of the ureters on the waist, you can put a hot water bottle. If the patient's condition allows, you can use a hot bath. Water in the bathroom should reach the bottom corners of the blades. The use of heat causes relaxation of the muscles, including the muscular layer of the ureters, as a result of which renal colic can completely stop. If there is no result, antispasmodics and analgesics are used. If renal colic does not cease after parenteral administration of drugs, the patient is hospitalized in a hospital.

In pregnancy, renal colic can lead to early onset of labor. Therefore, before the ambulance arrives, no action is taken.