Colicky Pain -What are the Symptoms of Renal Colic?
The Pain due to Kidney Stones;Is it Colicky or Continuous?
What is renal colic? Renal colic is a term used to refer to the pain from the development of stones in the kidneysand ureters. Many people believe that pain due to renal stone is colicky pain. It may be difficult for the common man to correctly identify the symptoms of renal colic. Patients describe renal colic as abdominal pain or stomach pain due to kidney stones. This hub explains what is renal colic and what are the renal colic symptoms.
What are Kidney Stones?
Kidney stones are formed by the deposition of minerals in the urine. Genetic factors, metabolic factors, lifestyle and diet etc. can contribute to the development of kidney stones. The types of kidney stones include calcium stones, uric acid stones, cystine stones and struvite stones.
Intensity of Renal Colic
Renal colic is very severe and people with kidney stones usually experience sudden severe excruciating pain without any previous warning. The intensity could be worse than the pain of child birth, fractured bones or pain of surgery.
Pattern of Renal Colic:
Pain which comes and goes as waves is referred to as colic. Even though it is referred to as renal colic the pain from kidney stones does not occur at intervals. It is more of a continuous pain. The intensity of pain depends upon the peristaltic movement of ureters, the movement of stones and the spasm caused by the tilting and twisting of stones. A stone that is moving can cause intermittent obstructions and may be more painful than a stationary stone. The pain will also depend upon the degree and site of obstruction caused by the moving stones and not by the size of the stones.
Development of Renal Colic
The renal colic starts at the back (upper lateral) portion and radiates down towards the groin. It is caused by the dilation, stretching and spasm of ureters.
Inflammation and the resultant interstitial oedema produced as a result of the kidney stones causes stretching of the renal capsule and enlarge the kidneys. Stimulation of the nerve endings by stretching at the renal capsule causes flank pain, while stimulation of the nerve endings at renal pelvis and calices causes typical renal colic. Distension of the renal pelvis because of inflammation will start peristaltic movement of the ureters.
Anatomy of Ureter
Location and Characteristics of Pain due to Kidney Stones
Mostly kidney stones originate in the kidneys and move down along the ureter. While they move, they can be lodged in the narrow junction at the ureter and pelvis or the junction of ureter and bladder.
If they cause obstruction to the junction between ureter and pelvis, pain may be experienced at the flank which is felt deeply and not spreading to the groin.
If they get stuck within the ureter severe pain is felt at the flank with radiation to lower abdomen, testicles or vulva. It may be associated with nausea and vomiting.
Distribution of Nerves in Flank
If the stones are in the lower ureter, pain will be felt in the flank along the distibution of ileoinguinal nerves as shown in the picture.
If asked to locate, the patient may point towards the area of maximum tenderness.
Patient may be confused and may say 'Iam having pain in abdomen or pain abdomen".
Distribution of Renal and Ureteral Pain
Phases of Acute Renal Colic Attack
In the first phase, increasingly severe and continuous pain occurs. Mostly it starts in the early morning or at night awakening the patient.
During the second phase, the intensity of pain remains constant for few hours and in the last phase, it spontaneously resolves or resolves with the help of medications.
A patient experiencing the symptoms of renal colic due to kidney stones should seek immediate medical attention in an emergency department. The renal colic symptoms may be confused with the pain of cholelithiasis, pancreatitis, appendicitis etc.It is very essential to correctly identify the symptoms of renal colic and give appropriate treatment for renal colic to reduce the suffering of the person as early aspossible.
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