Acute flank pain: the renal colic

Renal colic is a painful condition caused by the movement of stones within the urinary tract, particularly the kidneys or ureters. Minerals and salts compose these calcium aggregates that accumulate in the kidneys or urinary tract and can range in size from sandy grains to pearl-sized stones.

Renal colic and commonly associated symptoms

The manifestation of renal colic can vary from person to person. Still, they usually describe a sudden, intense, sharp, and sometimes debilitating pain, often localized to the side or lower back, under the ribs. The pain may radiate to the abdomen, groin, and genital area. It is often associated with:

Nausea and vomiting: Pain related to renal colic can cause nausea and vomiting;
Difficulty finding a comfortable position: People with renal colic may have trouble finding a position that relieves pain;
Urinary frequency and burning: sensations of urinary urgency and burning may occur during urination;
Presence of blood in the urine: Some people may notice the presence of blood in the urine, known as hematuria.

Causes

Causes of renal colic may include:

Kidney stones: the most common cause is the presence of stones in the urinary tract;
Inflammation: inflammation or infection of the kidneys or urinary tract can cause obstruction or irritation, increasing the risk of renal colic;
Anatomical anomalies: obstructive malformations in the urinary tract can predispose to the formation of stones and the appearance of renal colic;
Dietary factors: a diet rich in salt, animal proteins, and sugar can increase the risk of stone formation;
Dehydration: poor hydration can promote the formation of stones in the urinary tract.

Diagnosis

The diagnostic tests in the case of renal colic are basically of two types:

Urine tests: These tests can detect the presence of blood in the urine or signs of infection;
Imaging tests: Imaging techniques such as ultrasound, computed tomography (CT), or nuclear magnetic resonance imaging (MRI) can help identify the presence of kidney stones and evaluate the extent of urinary tract obstruction.

Treatments

Treatment of renal colic depends on the severity of the symptoms and the underlying cause. Treatment options may include:

Analgesics: Pain-relieving drugs such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain;
Hydration: Drinking plenty of fluids can help push stones through the urinary tract;
Other drug therapies: in some cases, we may prescribe drugs that help relax the ureteral muscles to help the stones pass;
Medical procedure: If the stones are too large to pass spontaneously or if they cause complications, you may need surgery or a procedure such as extracorporeal shock wave lithotripsy (ESWL) or endoscopic removal and crushing of the stones with laser always endoscopically.

Prevention

To prevent renal colic and the formation of new stones, you can follow these tips:

Adequate hydration: Drinking plenty of fluids, especially water, can reduce the risk of kidney stone formation;
Balanced diet: following a balanced diet rich in fruit, vegetables, and whole grains and limiting the consumption of salt, animal proteins, and sugars can reduce the risk of kidney stones;
Regular physical activity: Maintaining healthy body weight and doing regular physical activity can help prevent stone formation;
Avoid foods high in oxalates and purines: Some foods high in oxalates (such as spinach, beets, and chocolate) and purines (such as organ meats and seafood) may increase the risk of kidney stone formation and should be consumed in moderation or avoided;
Regular medical check-ups: Getting regular medical check-ups and talking to your doctor if you have a family history of kidney stones or have suspicious symptoms can help diagnose and treat any kidney problems early.