Nephritic colic: symptoms, causes and treatment

The nephritic colic is one of the most intense pains that can be suffered. Those who have suffered, understand the power to which we refer. It is located in the lumbar area, at the height of the position of the kidneys or a little below, where the urinary tract is located.

The characteristic of any pain that is called 'colic' is in its spasmodic behavior. The pain appears and disappears, rhythmically, causing intense peaks of suffering with small periods of intermediate relaxation.

In the case of nephritic colic, the pain originates in the urinary system, due to an obstruction in the path that the urine must travel to reach the bladder. When an obstruction appears in the system, the urinary tract tries to overcome it by contracting its ducts. That contraction is expressed as a colic.

The pain of nephritic colic it is located in the lumbar region and radiates to the inguinal area of the person who suffers it, forming a semi-belt. It will be on the left or right side, depending on where the obstruction is located.

Causes of nephritic colic

The cause of the pain is an obstruction of the urinary tract. This obstruction does not allow the urine formed in the kidney to reach the bladder. While Kidney stones are the most frequent cause of obstruction, and for that reason we dedicate a specific section to him, also there are other causes.

Malignant causes of obstruction include cancerous tumors of the renal system, either kidney, ureters or those of the bladder that grow upwards. Also a malignant tumor of an adjacent organ can tighten the urinary tract, as is the case of intestinal cancers, for example.

Among the benign causes we have the aneurysm of the aorta: a dilation of the aortic artery as it passes through the abdomen, which can press on the ureter by squeezing it. Retroperitoneal fibrosis, a formation of fibrous tissue in the posterior part of the abdomen, also causes obstruction.

Kidney stones

As we said, The most frequent cause of nephritic colic are kidney stones. These are stones of different sizes that are located in the kidneys or in the ureter. When trying to descend to go outside cause obstruction and consequent pain.

The calculations are calcium in almost 80% of cases. Therefore, certain situations of the human body are linked to the increase in the probability of suffering them. Thus, when there is hypoparathyroidism, sedentary lifestyle, prostration for a long time or excessive consumption of external calcium – in pills – its formation is more possible.

People with recurrent urinary tract infections are also more likely to form kidney stones. It is more common among women than among men. Patients who carry a urinary catheter or a catheter are more exposed to infections and, therefore, more exposed to the stones.

Less than 10% of kidney stones are from uric acid. It is common in patients with gout disorder. Sometimes, excessively protein-rich diets – gym and muscle-building diets – increase uric acid in the blood, culminating in calculations.

Finally, less than 1% of the stones are linked to a genetic disease called cystinuria. It is rare and is transmitted from parents to children as an inheritance.

Kidney stones are the most frequent cause of nephritic colic

To continue reading: How to avoid the formation of kidney stones

Symptoms of nephritic colic

The predominant symptom of nephritic colic is pain that we already described. It appears suddenly and is extremely intense. It starts in the lower back and radiates forward towards the groin as a half belt. This pain is usually accompanied by:

• Fever: It is not always present. It can be caused by pain itself or by a concomitant urinary infection.
• Dysuria: is the difficulty to expel urine, which is related to the obstruction.
• Polaquiuria: is the increase in the frequency of urinations. The patient urinates more times, but small amounts each time.
• HematuriaIn some cases the stones can hurt the urethra and cause some blood in the urine.

Diagnosis and treatment

In general, the doctor quickly diagnoses nephritic colic once the symptoms are installed. The pain is very characteristic and almost no other pathology presents it that way. Urinalysis and x-rays may be done to supplement.

But The definitive diagnosis is achieved with renal and bladder ultrasound, where in the vast majority of cases it is possible to identify the presence of the obstruction and, in the case of calculations, the size of the obstructions. Only very doubtful clinical pictures require tomography.

Once diagnosed, the treatment is based on analgesia. It is a priority to calm the patient's pain. For this, anti-inflammatories and analgesics are used. They can be administered orally or intramuscularly. The intravenous line is used when the pain is too intense or the patient has vomiting.

To continue informing you: How analgesics are classified

Once the pain is resolved, the next step is to schedule the resolution of the obstruction. If it is a pathology that requires surgery, it will be scheduled with time. If it is kidney stones, the therapeutic options are varied:

• Hydration: in small calculations, it is preferable to wait for the spontaneous expulsion, helping the process with a lot of fluid.
• Shock wave lithotripsy: is a procedure that uses waves from outside the body to break the stones and to be urinated as grit.
• Ureteroscopy: it is the surgical extraction of larger stones through the endoscopic insertion of an appliance through the urinary tract, until reaching the calculations to extract them.