Renal Colic

What is renal colic?

Renal colic is severe pain in your lower back area.

What causes renal colic?

Renal colic is caused by a blockage in your urinary tract. The urinary tract includes your kidneys, ureters, bladder, and urethra. The most common cause of a blockage in the urinary tract is kidney stones. Kidney stones are rock-like objects that form in your kidneys and may move into your ureters. You may have kidney stones in one or both of your kidneys or ureters. Blood clots, ureter spasms (tightening and relaxing), and dead tissue may also block your urinary tract.

What are the signs and symptoms of renal colic?

Renal colic pain is usually on one side, but may be in both sides of your back. The pain may spread to other areas of your body. The pain may start quickly, come and go, and may become worse over time. You may have any of the following:

• Severe low back, abdominal, or groin pain. Your groin is the area between your upper legs and hips. Your pain may be so bad that you are not able to sit still. You may have pain when you urinate. The pain may also cause you to sweat and feel like your heart is beating faster than usual.
  
  
• Nausea and vomiting.
  
  
• Feeling the need to urinate often, or right away.
  
  
• Urinating less than what is normal for you, or not at all.
  
  
• Fever.

How is renal colic diagnosed?

Your caregiver will ask about your signs and symptoms and how long you have had them. He may ask about your health history and any medical problems you have. He may also do a physical exam. You may also need the following:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Urine sample: A sample of your urine is collected and sent to a lab for tests.
  
  
• Imaging tests: You may be given dye before certain imaging tests. The dye is used to help your caregiver see the pictures better. People who are allergic to shellfish may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies.
  
  
  • Computed tomography scan: A computed tomography (CT) scan is a special x-ray using a computer to take pictures of your urinary tract. A CT scan may be done to check for stones and their size. A CT scan may also be done to check for other causes of your pain.
    
    
  • KUB x-ray: A KUB x-ray is a picture of your kidneys (K), ureters (U), and bladder (B).
    
    
  • Intravenous pyelogram: An intravenous pyelogram (IVP) is an x-ray of your kidneys, ureters, and bladder. Dye is put into your IV before the pictures are taken. An IV is a tube put into a blood vessel to give medicines and liquids. You may need to have more than one x-ray over short periods of time during your IVP.
    
    
  • Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your urinary tract to check for stones. An MRI may also be used to check for blood clots and growths. You will need to lie still during an MRI. Never enter an MRI room with any metal objects. This can cause serious injury.
    
    
  • Renal ultrasound: A renal ultrasound is a test using sound waves to look at your kidneys. Pictures of your kidneys will show up on a TV-like screen. An ultrasound may show if you have a kidney stone or other problems that are causing your pain.

How is renal colic treated?

If you have a very small kidney stone, you may be sent home. The stone may come out on its own when you urinate. Your caregiver may have you strain your urine to look for stones. Treatment may also include medicines and surgery. Treatment may decrease or take away your pain. Treatment may also prevent your blockage from causing damage to one or both of your kidneys. Treatment may include any of the following:

• Medicines:
  
  
  • Pain medicine: You may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you take your medicine.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and stop vomiting.
    
    
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Steroids: Steroids may help decrease pain and swelling.
    
    
  • Antispasmodics: Antispasmodics relax the muscles in your urinary tract, and may help decrease your pain. When the muscles are relaxed, it may be easier to move any stones out in your urine.
  
  
• Surgery: Surgery is commonly done to remove a blockage if you have uncontrolled pain. You may need surgery if you have blockages in both of your kidneys and ureters. Surgery may also be done if you have an infection, or your kidneys are not working as they should. Ask your caregiver for more information about the following:
  
  
  • Lithotripsy: Lithotripsy uses sound waves to break up large stones into small pieces. The smaller stones can then come out in your urine.
    
    
  • Ureteroscopy: An endoscope is used to look inside your ureters and remove any blockages. An endoscope is a thin tube with a light and camera on the end. If your ureter is swollen or narrowed, you may need a stent placed to keep it open. A stent is a small hollow tube, which is usually made from plastic or metal. A stent may also be needed to open a blockage that is not caused by a stone.
    
    
  • Percutaneous nephrostomy: A small rubber tube is inserted through your skin and into your kidney. The tube is used to drain urine that has backed up due to your blockage. The urine is drained to decrease pressure in your kidney and bladder.

How can I decrease my risk for getting stones that cause renal colic?

• Drink at least 8 to 12, eight ounce cups of water each day.
  
  
• Eat more citrus fruit, such as oranges.
  
  
• You may need to change some of the foods you eat. Follow your caregiver's instructions about the amount of salt, calcium, and protein you should eat.

Where can I get more information?

• National Kidney and Urologic Diseases Information Clearinghouse
  3 Information Way
  Bethesda , MD 20892-3580
  Phone: 1- 800 - 891-5390
  Web Address: http://kidney.niddk.nih.gov/
  

When should I call my caregiver?

Call your caregiver if:

• You have fever.
  
  
• You feel you need to urinate more often than usual.
  
  
• You see a stone in your urine strainer after you urinate.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You cannot stop vomiting.
  
  
• You see new or increased bleeding when you urinate.
  
  
• You are suddenly urinating very little, or not at all.
  
  
• Your pain is not getting better even after you take your medicine.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Renal Colic