Nephritic colic is one of the most frequent urological pathologies. It is estimated that between 10% and 15% of the general population may suffer from this acute pain at some point in their lives.
Based on patient testimonials as well as medical knowledge, the health news portal Medical Daily compiled a list of the diseases that can cause the most pain to a human being, and nephritic colic took the top spots.
This incapacitating pain can be even more intense than that produced by childbirth, as it does not subside even when changing position, and therefore generates a situation of panic and anxiety in the person who suffers from it.
The treatment of this condition depends to a great extent on the knowledge of its causes and symptoms. These important issues are considered below.
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What is renal colic?
Nephritic or renal colic is an obstruction of the urinary tract caused mainly by kidney stones, which produces an episode of very intense lumbar pain, accompanied by general affectation, sweating and nausea or vomiting
Dr. Carmen González Enguita, head of the Urology Department of the Fundación Jiménez Díaz University Hospital in Madrid, says that: “Renal colic is nothing more than the clinical manifestation of the existence in our organism, in the urinary apparatus, of a stone which, detached from the renal cavities, starts a process of elimination to the outside through the flow of urine”.
The pain it causes usually starts in the flank and radiates through the abdomen to the groin or genital area. If the stone causing renal colic is in the lower ureter, near the bladder, voiding discomfort may occur
What are the causes of renal colic?
The most frequent cause of renal colic is the presence of stones in the ureter, which can obstruct the kidney causing it to retain urine. During the process of urine elimination, the stone can get stuck in some area of the urinary ducts, causing an acute renal obstruction, so the urinary tract dilates and this generates a very intense lumbar pain
The terrible pain originates in the costo-lumbar area, where the kidney is lodged, and radiates towards the bladder and genitals.
However, in addition to kidney stones, any other element that occupies the ureter and obstructs the kidney, such as tumors, clots or malformations, can trigger renal colic
On the other hand, benign diseases such as retroperitoneal fibrosis or vascular dilatations such as aortic aneurysm can cause this condition.
Risk factors that make people more susceptible to nephritic colic
Nephritic colic occurs more frequently in people with these risk factors:
- Men and women between the ages of 30 and 60
- People who drink little water
- Patients who drink large amounts of dairy products or abuse laxatives, diuretics or antacids.
- Having a family history
- Suffering from bone disease, hyperuricemia or gout, constant urinary tract infections or having had kidney stones or colic in the past.
- Although it is not so frequent, those who have diseases such as hypoparathyroidism, hyperoxaluria, cystinuria or some types of cancer could also suffer from them.
What symptoms does nephritic colic produce?
Dr. González Enguita says: “Although this terrifying pain is caused by the stones as they transit mainly through the ureters and urethra, and is only relieved with very powerful painkillers, derived from morphine, fever, which indicates urinary infection and can trigger sepsis -septicemia-, and anuria or lack of urine production, which can cause renal failure, are the two deadly conditions to take into account”
Nephritic colic presents very characteristic symptoms, such as:
- Sudden and intense pain. It usually starts on the right or left side of the lumbar area, and may extend through the abdomen towards the genitals, accompanied by frequent nausea and vomiting.
- Hematuria. This is the presence of blood in the urine. It may appear in small amounts, which is detected through urine tests, or it may be visible.
- Dysuria. Difficulty or pain when the patient urinates.
- Pollakiuria. Increase in the number of micturitions during the day, which are usually of small quantity.
- Anuria. Definitive cessation of urine secretion
Diagnosis of nephritic colic
The diagnosis of nephritic colic is usually clinical, based on the symptoms reported by the patient and the physician’s examination. For its determination some tests are used, such as:
- Simple radiography of the urinary tract
- Intravenous urography
- Retrograde ureteropyelography
- Computed tomography
Treatment of nephritic colic
The treatment of this condition should be focused on eliminating the pain and getting the stone expelled, which should be done as quickly as possible to avoid complications.
Medical specialists take the following measures to correct the causes and symptoms of renal colic:
- To treat pain and inflammation. They usually prescribe anti-inflammatory analgesics that are effective against pain and inflammation such as ibuprofen, dexketoprofen or diclofenac. The combination of paracetamol-codeine can be very useful. In very severe pain crises these drugs are applied intramuscularly or intravenously, or analgesics such as meperidine or opioid analgesics may be used.
- Medical procedures for stone expulsion. If the patient does not respond to analgesics, in order for the pain to subside, the specialist may place a ureteral catheter, an action that is best performed if alpha-blockers are also administered. If the stones need to be fragmented to facilitate their elimination, lithotripsy will be performed, using shock waves
- To treat vomiting and infection. It is usually necessary to administer drugs for vomiting such as metoclopramide and gastric protection, as well as antibiotherapy using quinolones.
This pathology should undoubtedly be treated urgently. Nephritic colic ends when the stone has been expelled, which occurs in 80 percent of the cases.