What IS the Renal Colic and How Treat That ?


Intrinsic
That is, the individual’s own age, gender, family history and anatomical or functional abnormalities of the kidneys.

Extrinsic factors
That is, dependent on the diet and lifestyle of the patient.  Thus, for example, a diet rich in proteins, carbohydrates and sodium refined has an important role in the formation of calcium oxalate, and potassium intake of liquids is inversely related to the risk of kidney, ie protective effects.

What are its causes?
The fundamental cause of colic is the formation of kidney stones or calculi or stones in the kidney and urinary tract.All kidney stones are formed of materials, generally in the form of crystals, which are routinely excreted in urine, so that the stone can be formed only when urine is supersaturated with constituents such crystals.

The calculations are mainly composed of crystals of a substance called calcium oxalate (between 70% and 80% of cases), calcium phosphate, uric acid, magnesium based struvite, phosphate and ammonium in the presence of some bacteria that produce an enzyme called urease, and cystine.

In the formation of kidney stones and urinary tract involves two types of factors:

How do you diagnose this health problem?
As always in medicine, the doctor will do a medical history of the patient suffering from renal colic, researching their personal and family history, dietary habits, etc.., And complemented by a medical examination and certain tests such as blood tests and urine and certain imaging techniques, essentially an x-ray of the abdomen, including urinary tract infections, and sometimes urologic ultrasound.

Physical examination is usually normal and only in the acute phase of the disease is characterized by abdominal pain and lower back.

Radiography detects the presence of stones along the urinary tract, provided that they are greater than 2 millimeters in diameter and contain calcium. The uric acid and cystine are transparent and are not seen on plain radiographs.

Another more aggressive technique is called intravenous urography, in which a dye is injected into the patient’s blood is excreted in the urine and is at this stage that x-rays are performed to try to see the calculation.
Currently intravenous urography is indicated whenever not been able to visualize the calculations by the above methods.

In some patients more difficult to repeat colic or other risk factors for stone recurrence or in special situations (patients with one kidney, kidney or other diseases with very large stones) will require consultation with the specialist urologist.

Interestingly mineralogical study of the calculation, so that patients with this problem should try to retrieve the stone from the urine.The study of the composition of the calculation is performed in a laboratory by physicochemical methods.

The differential diagnosis of this disease should be established with other kidney diseases, abdominal, gynecological and vascular.

The most important complication of renal colic is the possibility of infection.

Extracorporeal shock wave lithotripsy
This technique uses ultrasound or shock waves to fragment high energy calculations. It is a safe technique and is currently the method of choice in most patients requiring surgical removal of kidney stones.  Calculations can treat up to 3 centimeters in diameter ejected most fragmented pieces within 2 to 4 weeks. It is contraindicated in pregnancy, when there is a complete obstruction of the urinary tract and severe diseases.

Transurethral ureteroscopy
Involves inserting a catheter through the urethra until it reaches the calculation and extraction directly when small.

Percutaneous nephrolithotomy
In large stones (greater than 3 cm in diameter). It consists of a small surgical procedure in which access to the place where the stone is located and removed.

Open surgery
In some cases of huge stones called staghorn (those that occupy the entire renal pelvis) and when they fail the above techniques.
Procedimientos Procedures

Destacamos los siguientes:
Include:

What treatments are used?
Initial treatment of renal colic is intended to relieve pain, facilitate stone passage and prevent the occurrence of new episodes. To relieve pain analgesics are used primarily moderate power / high, antispasmodics (drugs that help break the contraction of the smooth muscle fibers of the ureter) and, especially, anti-inflammatory, either orally or by intramuscular injection.

However, on occasion, given the intensity of the pain we use derivatives of morphine, the most potent analgesic we have.

Other measures such as rest and local heat application help patients improve their symptoms. To relieve nausea and vomiting use a metoclopramide-based medicine.

As has been seen, most of the calculations are expelled spontaneously, but sometimes it does not, and can cause pain, urine infection or obstruction of the urinary tract.

Currently existendistintos urological procedures to remove stones and are used depending on the size, location and composition thereof, of the labor and social situation of each individual patient, the hospital where you will be treated and the experience of the specialists who care for patients.

Dr. Salvador Pertusa Martinez , a specialist in Family and Community Medicine