Attack of renal colic: what to do and how to anesthetize, first aid, treatment at home and in the hospital

Renal colic is mainly caused by urolithiasis, more often in men of working age. Only 13% of cases of renal colic occur for other reasons, but each case requires medical intervention because of the danger of appendicitis, ectopic pregnancy, torsion of the spermatic cord, occurring with similar symptoms.

Treatment of renal colic

A condition in which free flow of urine is disturbed, accompanied by intense pain in the kidney region, is called renal colic. The main sign of kidney obstruction is the stinging unbearable pain in the lower back, which this phenomenon received its name.

Kidney pain occurs for many reasons. If the attack has appeared for the first time, it is necessary to call a doctor, who will determine how to treat. Especially, this applies to seizures in a child, a pregnant woman.

First aid

If colic occurs for the first time, it is more appropriate to call the doctor immediately. Pain in renal colic is sometimes compared to labor contractions. It is so strong that the usua

l means available in the medicine cabinet, it can not be removed. Analgin, baralgin in tablets will only prolong the patient's suffering.

If there is no possibility to call a doctor, you can try to cope with the pain yourself, by intramuscular injection:

  • no-shpy;
  • analgin with dimedrol;
  • papaverine;
  • of the baralgina;
  • spasmalgone.

The presence of a stone in the ureter causes inflammation. If nevertheless it was possible to independently stop the pain by taking spasmolytic drugs, the patient will necessarily need medical help.

Even if the stone is small, and it is likely that it will come out on its own, the patient is prescribed:

  • antibiotics, uroseptics for the treatment of inflammation in the ureter - nitroxoline, ceftriaxone, levofloxacin, phosphomycin;
  • drugs that improve blood circulation in the kidney - trental, pentoxifylline;
  • non-steroidal anti-inflammatory drugs - drotaverin, diclofenac, ketorolac, lornoxicam.

The patient is required to have a bed rest, and he can be left at home if the anesthetic effected. If the attack can not be removed, the patient is hospitalized in the hospital, where he is in urgent need of help.

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Mandatory hospitalization for renal colic:

  • patients with one kidney;
  • with bilateral colic;
  • of pregnant women;
  • of the elderly;
  • children.

Hospitalization is also necessary when suspicion of appendicitis, intestinal obstruction, ectopic pregnancy in women. It is also necessary to exclude hydronephrosis of the kidney, prostate cancer in men.

The examination is necessary for all cases of renal colic to exclude tumoral diseases of the pelvic organs, intestinal obstruction, which are also capable of inducing symptoms similar to colic manifestations.

Algorithm for the management of renal colic

Attack of renal colic at home and in hospital

Treatment at home

Treatment at home from renal colic is possible only with a diagnosed stone of small dimensions with a high enough probability of self-release. To reduce pain, you can put a rectal suppository with papaverine, diclofenac.

If colic is not accompanied by pyelonephritis, then you can remove it by attaching dry heat. At high temperatures, heating procedures are dangerous. They will increase blood flow, and with the blood flow, the spread of infection in the body will accelerate.

It is not necessary to be treated without recommendations of the urologist in old age, it is necessary to show the doctor at renal colic of the sick child.

In the absence of contraindications, the patient may take a hot bath during the onset of an attack with renal colic. In acute period the patient can not sit still, take a bath in a state close to shock, it is dangerous.

The best way to anesthetize renal colic is to inject an analgesic intramuscularly. After the attack subsides, you can use traditional medicine.

With urate stones it is useful to take infusion, which is included in the same amount:

  • birch buds;
  • parsley leaf;
  • flax seed;
  • leaves of strawberry;
  • rose hips( fruits).

For preparing infusion of 1 table.l.collection pour 0.25 liters of boiling water in a thermos, insist 6 hours. Drink during the day for 3 hours.

Phosphate and oxalate stones are treated with a collection that contains in equal proportions:

  • clover;
  • motherwort;
  • immortelle;
  • cranberries;
  • root of the madder.

To make the infusion, 2 tables.l.mix 0.5 liter of boiling water, insist 12 hours. Drink during the day in 5 receptions.

Reason to see a doctor

Immediately call a doctor for renal colic, accompanied by:

  • acute back pain, which can not be stopped with anesthetic;
  • temperature increase;
  • with nausea, vomiting, not bringing relief.

Patients with one kidney, persons over 60 years of age, as well as with a bilateral stroke of kidney colic in men, women and children should be called "ambulance" and do not refuse hospitalization.

Treatment in the hospital

The results of the diagnostic examination determine the size of the stone. If it is possible to independently remove the stone from the urinary tract, the patient is prescribed drugs that reduce pain, eliminating edema.

Most often, diclofenac, ibuprofen, indomethacin are used for renal colic caused by urolithiasis.

The probability of spontaneous deviation of the stone is:

  • 85%, if the dimensions do not exceed 4 mm;
  • 50% with a diameter of 5 mm;
  • 10% if the stone is more than 6 mm across.

Concrement with dimensions over 6 mm is removed promptly. When you select the delete method, its localization matters.

Chances of self-separation if the stone is located:

  • in the upper part of the ureter - 35%;
  • in the middle part - 49%;
  • at the bottom - 78%.

The final decision of the urologist is affected by the nature of the stone itself, its shape, the absence of sharp, cutting surfaces, and:

  • treatment failure;
  • infectious diseases of the kidneys accompanying colic;
  • danger of sepsis;
  • risk of bilateral obstruction.

Conservative treatment

Conservative treatment of renal colic Drugs are prescribed with a high probability of self-release of the calculus. In addition to anti-inflammatory and analgesic drugs, the patient is prescribed antibiotics if obstruction of the ureter is complicated by a bacterial infection.

Acute attack is stopped with anesthetic drugs. In men, additionally anesthetic analgesia novokainom spermatic cord, and in women make a Novocain blockade of the circular ligament( conduct intracellular blockade).

For the expulsion of stones prescribe medications:

  • progesterone;
  • glucagon;
  • nifedipine.

After arresting the attack, the patient is prescribed antispasmodic drugs avisan, dye madder, urolucane, spasmocystenal, pinabine.

As additional methods of treatment are used:

  • sedentary bath with decoction of horsetail;
  • the volume of the liquid being drunk - 2.5 l / day;
  • kidney tea;
  • Morse from cranberry.

With urate stones:

  • is assigned potassium hydrogencarbonate, sodium citrate to alkalinize urine;
  • is prescribed for allopurinol, a drug that regulates the exchange of uric acid.

For urinary diversion, nephrostomy is sometimes required, for which an output is created for the urine flow, using excretion through the renal pelvis or from the bladder.

Operative intervention

Surgical intervention in renal colic aimed at destroying the stone and extracting its fragments, called lithotripsy, is performed:

  • by the contact method;
  • non-contact.

The most common contactless method of removing stones of small diameter is ultrasound crushing. The shock wave force with this method is used for crushing stones up to 2.5 mm in size.

The stone is sonicated for 40 minutes, after 14 days, a kidney control study is performed. During this period of time, the fragments of the stone must completely leave the ureters.

For the crushing, laser destruction of a stone can be used. Carry out laser treatment of the stone under anesthesia. The stone after this procedure turns into dust.

This contact form of action is carried out using a probe equipped with a laser source. The probe is inserted into the ureter, brought directly to the stone.

A special holmium laser is used for processing the stone, without damaging the surrounding tissues. Enter the probe after the administration of antibiotics, which are prescribed because of the high risk of infection.

Diet

Diet in the treatment of renal colic For the prevention of colic resort to diet number 7, except for the case of oxalate stones, when prescribed diet number 6, which is used to treat gout.

Renal Diet No. 7 restricts consumption of table salt, mainly includes plant foods and increased volume of daily fluid intake.

Oxalates

Oxalatite stones are similar to thorns of dark color. When moving in the ureter sharp edges injure the internal surface of the urinary tract, which leads to the appearance of blood in the urine.

There are oxalate stones with normal acidity of urine. The reason for the appearance of oxalate stones is a lack of fluid in the body.

Excluded from the menu are sorrel, spinach, beans, tomato, limit beets, carrots, black and green tea. It is useful when using oxalate stones to eat dishes with cucumbers, pears, apricots, grapes, mineral water Essentuki โ„–20 are useful.

Phosphates

Rounded grayish phosphate stones occur in alkaline urine, easily break up when laser is crushed.

With phosphate stones, curd, milk, liver, kidneys are limited. You can not use sharp spices, smoked products, cocoa, alcohol, coffee. Limit mushrooms, chicken eggs in the diet, sour cream.

It is useful to drink birch sap, Arzni mineral water. Apples with sour taste, cranberries, currants, cranberries are recommended, carotenoids and vitamin D. are needed.

Urids

Solid, yellowish-colored urate stones are formed in acidic medium with an excess of uric acid. With urate stones it is useful to drink alkaline mineral waters of Essentuki โ„–4, โ„–17, Slavyanovskaya, Smirnovskaya.

It is recommended to limit meat products containing purines, to increase the amount of plant food, except beans. At uratnyh stones it is useful to enter in the menu of a dish with a parsley, a celery, to drink broth of seeds of a pumpkin.

After a renal colic caused by urolithiasis, a patient of 5 years is on a dispensary record. To prevent renal colic, patients must comply with diet, drinking regimen, avoid excessive physical exertion, and avoid hypothermia.
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