RENAL COLIC: SIGNS, SYMPTOMS & WHAT YOU MUST KNOW WHEN TO SEEK HELP

Renal colic is more than just “bad back pain.” It’s a sharp, intense reaction your body has when a kidney stone (or other obstruction) blocks urine flow. If you’ve ever felt pain that seems to radiate from your back toward your groin, you might already be familiar with renal colic symptoms. It’s one of those conditions where knowing the warning signs—and the treatment options—can mean the difference between discomfort and complications.

What Exactly Is Renal Colic?

• Renal colic refers to sudden, severe pain caused by an obstruction in the urinary tract, most commonly a kidney stone lodged in the ureter (the tube carrying urine from kidney to bladder). 
• When urine backs up behind the obstruction, pressure builds up, the kidney swells, and the renal capsule stretches—causing intense pain. 
• The term acute renal colic is used when symptoms appear suddenly, are sharp or wave-like, and often happen without warning.  

Common Signs & Symptoms of Renal Colic

Here are the most frequent renal colic symptoms people experience:

Symptom	What It Feels Like / Why It Happens
Sudden, severe flank pain	Pain usually starts in the back or side, below the ribs (costovertebral angle), then moves toward lower abdomen or groin. Waves of pain as the urinary tract spasms to push the obstruction.
Radiation of pain	As stones move, the location of pain shifts—toward groin, testicle in men, lower abdomen.
Nausea & vomiting	Strong pain can be overwhelming; digestive upset often follows.
Blood in urine (hematuria)	Either visible or microscopic. A common sign of irritation from a stone.
Frequent urge to urinate, burning, urgency	If the stone is lower in the tract near the bladder or ureter-bladder junction.
Fever & chills (if infection present)	Danger sign. Requires urgent review by a healthcare provider.

When to Seek Help: Red Flags

You don’t want to shrug off an episode of renal colic. Seek medical attention immediately if:

• Pain is unrelenting or so severe you can’t sit still or find relief.
• Fever, chills, or signs of infection accompany the pain.
• Unable to urinate or pass any urine.
• Vomiting prevents staying hydrated.
• You have a solitary kidney, previously known kidney damage, or underlying kidney disease.

These are signs indicating acute renal colic with possible complications and need prompt evaluation.

How Is Renal Colic Diagnosed?

• History & physical examination to pinpoint pain type, risk factors (e.g., history of stones, dehydration, certain diets) 
• Urinalysis, checking for blood, infection, and crystals. 
• Imaging studies:
  ‒ Non-contrast CT scan is the gold standard for detecting stones and locating them.
  ‒ Ultrasound (especially if radiation exposure is a concern). 

First Reaction: What to Do Immediately

First Line of Treatment:

Your first reaction when you experience renal colic should be to stop drinking fluids immediately. If the kidney is already obstructed, it will not produce more urine. This helps reduce further swelling in the collecting system, offering temporary relief from intense pain. Once the pain is under control and treatment begins, fluid intake can be adjusted based on your doctor’s advice.

First-Line (Non-Surgical) Treatments

Renal colic treatment often begins conservatively, especially for stones under 10mm and without infection:

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
  These are typically the first choice for managing renal colic. They:
  • Reduce inflammation
  • Ease ureteral spasms
  • Lower pressure in the urinary tract
    Examples: Ibuprofen, Diclofenac
• Analgesics / Pain Relief
  If NSAIDs are insufficient, stronger pain relief such as opioids may be temporarily prescribed under close supervision.
• Medical Expulsive Therapy (MET)
  Medications that relax the ureter, such as alpha-blockers (e.g., tamsulosin), are used to help facilitate stone passage —
  especially for stones less than 10 mm in size.
  These medications improve flow and reduce pain as stones pass more easily through the urinary tract.
• Hydration & Supportive Care
  While hydration is usually encouraged, in the acute phase of renal colic, fluid intake should be paused initially to reduce kidney pressure.
  Once the obstruction improves:
  • Use antiemetics if nausea or vomiting is present.
  • Resume hydration gradually.

When Surgical or Interventional Procedures Are Needed

Surgery or intervention may be necessary if:

• Stones are larger than 10 mm
• Severe obstruction or signs of infection are present
• First-line treatments fail

Options include:

• Extracorporeal Shock Wave Lithotripsy (ESWL)
  Uses shock waves to break stones externally into smaller pieces for easier passage.
• Ureteroscopy (URS)
  A small scope is inserted via the urethra and bladder to visualize and extract or fragment stones directly.
• Percutaneous Nephrolithotomy (PCNL)
  A minimally invasive surgical procedure used for very large or complex stones.
• Ureteral Stent Placement
  Temporarily inserted to relieve blockage and allow urine to flow until the stone can be addressed.

Preventing Renal Colic From Coming Back

Prevention is crucial as kidney stones tend to recur. Proven strategies include:

• Stay Well Hydrated
  Drink enough water to maintain pale yellow urine throughout the day.
• Dietary Adjustments
  • Lower sodium and animal protein intake.
  • Reduce oxalate-rich foods (e.g., spinach, nuts, tea) if you’re prone to calcium oxalate stones.
  • Maintain adequate dietary calcium to bind oxalate in the gut.
• Medications for Metabolic Issues
  If tests reveal high calcium or uric acid in urine, doctors may prescribe:
  • Thiazide diuretics
  • Potassium citrate
  • Other specific agents based on metabolic analysis
• Follow-Up Imaging & Monitoring
  Regular monitoring ensures:
  • Timely detection of new or residual stones
  • Prevention of kidney damage from recurring obstructions

What to Expect at Reem Hospital

At Reem Hospital, your care for renal colic includes:

1. Rapid diagnosis: labs, imaging, specialist urology consultation.
2. Individualized pain management: balancing effectiveness with safety (especially for patients with kidney disease).
3. Procedural options available for stones that don’t pass or are too large.
4. Preventive care: diet, lifestyle, possibly medication to avoid recurrence.
5. Patient education: understanding red flags, when to go to the ER, how to manage symptoms at home.

Final Words: Acting Sooner Means Better Outcomes

Renal colic is excruciating—and often unpredictable. But it doesn’t have to lead to lasting damage. Recognizing renal colic symptoms early, distinguishing acute episodes, and knowing what your renal colic treatment options are can reduce suffering, prevent complications, and protect kidney function.

If you experience sudden flank pain, especially with nausea, blood in urine, or fever, don’t wait. Seek medical attention promptly. At Reem Hospital, we aim to give you fast, compassionate, evidence-based care so you can recover sooner and live healthier.