It is more commonly known as a kidney stone (or sometimes a ureteral stone if it is lodged in the ureter, causing ureteric colic) and it is one of the most common causes of admissions for urological complaints. It is extremely painful, to the extent that some compare the pain to childbirth. It begins with an intense, sharp and stabbing flank pain in the kidney region which then irradiates out towards the lower abdomen and the groin (referred pain). Pain may also appear in the lower back, spreading out towards the genitals.

Other symptoms are nausea, vomiting, heavy sweating, nervousness and agitation, frequent desire to urinate and a burning sensation when you do, muscular spasms in the area affected and a high temperature. Blood may appear in the urine during an attack.

One more thing: it comes on suddenly, often during along car journey and it is typical of hot times of the year.

What produces such pain?
Such an intense pain is caused by a solid body causing an obstruction in the kidneys or in the ureter which makes the passage of urine difficult. This solid body tends to be a stone made of calcium or much less commonly uric acid, a blood clot or a calcified fragment of the renal papilla.

What to do?
� Do not give any liquids to the patient.
� Put the patient to bed to see if the pain goes away.
� Take the patient�s temperature.
� Give them paracetamol to alleviate the pain and an antispasmodic like pargeverina or propinoxato.
� Go immediately to a hospital.

At the hospital
They will analyse the family history and the patient�s own medical history, they will take a simple X-ray of the urinary tract to see if there is a stone, and they will also make an analysis of blood and urine, and a scan to evaluate the state of the kidney.

Then they will prescribe a pharmacological treatment:
� Intramuscular or intravenous antispasmodic and anti-inflammatory injections to alleviate the symptoms. One intramuscular ampoule of the anti-inflammatory diclofenac sodium (Voltar�n) will relax the ureteric muscle. Also used are ketorolac tromethamine (Tonum, Droal and Toradol) and magnesium metamizole (Nolotil), in intramuscular ampoules.
� If this does not work morphine based drugs can be used.
� And as a last resort, surgery. The trapped urine is diverted from the kidney to the bladder using a ureteral catheter. This operation is painless and leaves no scarring.�

If no serious anomalies are detected and the scan shows the kidney is all right the patient can go home. However, he or she should make regular visits to the urologist from then on.

How to prevent a renal colic?
� You should drink at least two or three litres of water a day and pass water frequently.
� Avoid a sedentary life and excessive heat.
� Do not eat too many dairy products, no more than 400 or 500g. of calcium a day.
� Moderate your intake of proteins, no more than 150 g of meat (poultry, red meat) and fish a day.
� Reduce your intake of salt, cold meats, chocolate and alcohol.