Renal Colic

What is renal colic?

Renal (kidney) colic is pain that’s often a symptom of a stone stuck in part of your urinary tract. Stones form when minerals or other substances build up, stick together and create crystals. You can have these stones in any part of your urinary system, like your:

• Kidneys (kidney stones)
• Bladder (bladder stones)
• Ureters (ureteral stones)

A stone in your urinary tract can be as small as a grain of sand or as big as a golf ball. The larger the stones grow, the more painful they may become. Depending on the size and location of the stone, renal colic can range from mild to severe.

Renal colic usually happens because of a stone that blocks the flow of pee (urine). If a stone isn’t obstructing your urinary tract, it usually won’t cause symptoms, even if it’s large. But you should still see a urologist because you may need to have them remove it.

Renal colic is the reason for more than 1 million emergency room visits each year in the U.S.

What does it feel like?

Renal colic is intense flank pain on the affected side of your body, between your lower ribs and hip. This pain can radiate to your back, groin or lower belly (abdomen). You may have a dull pain that doesn’t stop. But you may also feel sharp pain off and on.

Kidney colic can come in waves. Waves of renal colic can last anywhere from 20 to 60 minutes. In severe cases, the pain can last even longer.

The pain is usually at its worst one or two hours after it starts.

It’s common to have nausea and vomiting at the same time as renal colic. Other symptoms that might appear at the same time include:

• Pain when you pee (dysuria)
• Blood in your pee (hematuria)
• Cloudy urine
• Urine changes, like stinky pee
• Peeing more or less than usual or more often
• Crystals in your urine
• Fever
• Chills

What are the most common causes of this symptom?

Ureteral stones are the main cause of renal colic. If the stone restricts your flow of pee (urine), it can cause increased pressure and inflammation.

Stones can form in your urinary tract for several reasons, including:

• Dehydration
• Urinary tract infection
• Excess calcium in your pee (hypercalciuria)
• Excess oxalate in your pee (hyperoxaluria)
• Excess uric acid in your pee (hyperuricemia)
• Excess protein in the foods you eat
• Low citrate in your pee (hypocitraturia)
• Certain medicines
• Conditions of your digestive tract, like ulcerative colitis or Crohn’s disease
• Excess hormones leading to high calcium (hyperparathyroidism)

Can I have renal colic without stones?

Yes. Other things can cause kidney colic. If stones aren’t the source of your pain, your healthcare provider may refer you to a urologist for further testing. Many conditions in your belly can cause pain. Some of these are from your urinary system.

Ureteral or bladder spasms can mimic renal colic. These spasms happen when your ureter or bladder muscles contract suddenly. This results in burning or cramping pain. These spasms can happen with or without urinary stones.

How is renal colic treated?

For mild renal colic, you can take pain relievers, like:

• Acetaminophen
• Ibuprofen
• Naproxen

If you have severe pain, your provider may prescribe stronger pain medicine.

Treatment for the source of renal colic depends on the type and size of stone you have. If you have a small urinary stone, you may be able to pass it when you pee. Your healthcare provider may ask you to pee through a strainer. This catches any urinary stone fragments so a lab can analyze them.

You should drink lots of fluids to help pass the stone. You may receive medicine to help you stop throwing up or fight an infection.

It’s unlikely that you’ll pass larger stones when you pee. So, your provider may use a procedure to remove them or make them easier for you to pass. In some cases, you may need more than one surgery to remove the stone(s) completely.

If renal colic is due to ureteral spasms, your provider can give you medications to relax your muscles and reduce discomfort.

What are the possible complications or risks of not treating it?

If you don’t get rid of a kidney stone, it can make pee build up in your kidney or go other places it’s not supposed to go. It can also stretch out your ureter or the tissue around the outside of your kidney. When one of your kidneys can’t filter as much blood as usual, your other kidney works harder.

Your kidney on the side with the blockage may stop working. The longer your kidney is blocked, the higher the risk of irreversible kidney damage.

Can this symptom be prevented?

To reduce the risk of kidney colic, you can lessen the chances of urinary stones. Here are some helpful tips if you’re experiencing or have had kidney stones:

• Drink more water and cut back on dark soda.
• Reduce the amount of salt in your diet to less than 2,000 milligrams (mg) daily.
• Limit animal protein — like beef, chicken, pork and fish — to a palm-size serving per day.
• Reduce your intake of foods that have high oxalate content, like nuts and spinach.
• Don’t restrict calcium in your diet. It’s important to get calcium from food sources.

If you’ve passed a stone or your healthcare provider has performed surgery to remove a stone, they can send the stone to a lab for analysis. This can show exactly what your stone is made of, so you can get specific dietary recommendations.

If you’ve had urinary stones in the past, your provider may prescribe medications like potassium citrate or thiazide diuretics. These drugs can help reduce the recurrence (return) of urinary stones.

You may be at a higher risk of having renal colic again if you have:

• Diabetes
• Obesity
• High blood pressure
• Cardiovascular disease
• Kidney issues

When should you see a doctor or healthcare provider?

If you develop flank pain that radiates to your groin, back or lower abdomen, schedule a visit with your provider. They can find out whether your pain is from renal colic or another condition. In many cases, your provider can give you medications that will quickly relieve pain from urinary stones.

Go to your nearest emergency room if:

• You experience kidney colic that doesn’t improve
• You have an infection with renal colic (fever, chills or other symptoms of infection)
• You have renal colic with nausea and vomiting