What is Colic Abdomen ?

What is abdominal colic?

Abdominal colic is severe pain due to obstruction of a hollow organ in the human body, which usually occurs in the internal organs of the stomach. Colic is pain with very high intensity accompanied by accompanying symptoms such as cold sweat, heartburn, nausea and even vomiting. It is not uncommon for someone experiencing colic to seek help from a hospital emergency department because the pain is severe. The most common cause of abdominal colic is obstruction of the urinary tract in both the kidneys and ureters by stones.

 

Character of renal and ureteric colic pain

Patients with renal or ureteral colic usually present with complaints of severe pain in the waist that radiates to the stomach or groin. Pain is usually sudden, not influenced by activity or body movement caused by stretching of the kidney capsule and ureteral peristalsis. Accompanying symptoms such as cold sweat, heartburn, nausea and vomiting may also occur.

 

What causes renal and ureteral colic?

The cause of renal and ureteral colic is blockage of the smooth muscle channels from the kidneys to the ureters and stretching of the kidney capsule due to obstruction of urine flow. Blockages are most often caused by stones, but other causes such as tumors and smooth muscle spasms can also play a role.

 

What is first aid for colic?

If you experience severe pain that originates from within the stomach, the first step you can take is to take non-steroidal analgesic drugs which can be purchased freely at pharmacies or drug stores. If the pain does not improve, immediately seek help from the nearest hospital emergency room, you may need an analgesic injection into a blood vessel.

 

The next step after colic is resolved

After the colic has been resolved, you need a supporting examination in the form of a complete urine examination, routine blood, urea, creatinine (to estimate kidney function) and abdominal ultrasound. If there is a suspicion that there is a blockage in the urinary tract, a non-contrast urography CT scan should be done to determine the cause of the blockage (stones or non-stone).

 

What should I do if there are stones in my urinary tract?

As time goes by, urinary tract stones can be removed with non-surgical therapy or minimally invasive surgical therapy with small or no wounds.

Urinary tract stones have different treatments according to the location and size of the stone, but in general stones measuring less than 5 mm can pass spontaneously with lots of drinking and the help of medication. Large kidney stones (more than 2 cm) can be treated with percutaneous nephrolithotripsy (PCNL) with small incisions in the skin or open surgery. For kidney stones under 2 cm, extracorporeal shockwave lithotripsy (ESWL) can be performed with shock waves focused directly on the kidney and without incisions.

For large ureteral stones and heavy blockages, laparoscopic or open surgery can be performed, for medium to small sized stones ESWL or endoscopic stone splitting (URS) can be performed.

 

 

Reference

Engeler DS, et al. The ideal analgesic treatment for acute renal colic-theory and practice. Scand J Urol Nephrol. 2008;42:137.

Panduan Praktik Klinis RSCM. Departemen Urologi RSUPN Dr. Cipto Mangunkusumo. 2016.

Krum H, et al. Blood pressure and cardiovascular outcomes in patients taking non-steroidal anti-inflammatory drugs. Cardiovasc Ther. 2012;30:342.

Holdgate A, et al. Systematic review of the relative efficacy of non-steroidal anti inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004;328:1401