All About Renal Colic And Its Treatment!

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in the form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in the flank region starting from the back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lie there without causing any pain. But whenever they are dislodged and stuck at the mouth of kidney (pelvis) or anywhere in the ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is a protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get the credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in the long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

1. Most stones which are lying in calyces of the kidney are asymptomatic 
2. Nausea & vomiting 
3. Frequent urinary tract infections 
4. Fever with chills 
5. Foul smelling urine 
6. Hesitancy, frequency and burning in urination 
7. Blood in the urine (urine with a reddish, pink or brownish hue) 
8. Passage of small stones in the urine 

Treatment of renal colic-

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

1. Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
2. Lithotripsy: This method involves breaking of stones by shock waves into small dust particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is the non-operative treatment which can be done on OPD or Daycare basis. 
3. Ureteroscopy (URS): This method involves entry of very thin semirigid scope through the urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
4. RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in manoeuvred through the urethra into the upper ureter and pelvi-calyceal system of the kidney. Stones in the kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
5. Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through the back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and requires two to three days of admission.