Some say the flank pain of a renal colic (kidney stone pain) is worse than that of childbirth. I can’t say much about either since I have never had renal colic and as a dude I don’t expect to experience labor. But I know this – patients admitted to my service for painful kidney stones are not messing around when they rate their pain at 12 out 10 ! One can have kidney stones that just hang out in renal pelvis part and never hurt, but the moment a small stone or chip off a larger stone travels down the ureter tube & gets stuck, the ureter goes all out with muscle contractions to try push that stone downstream to the bladder. And this colic is mighty painful !
In this situation, medical treatment tries to curtail the intensity of contractions and the inflammation from the ureter pressing on the stone while attempting a gentle push with a flood of urine. This ‘Medical Expulsion Therapy’ is shown to hasten the natural passage of stones if less than 5mm in size. Even if bigger & waiting for the Urololgist, I find it useful in toning down the pain & misery. This mnemonic helps recall steps you can take to ease the pain of renal colic and improve odds of natural passage of kidney stones:
F – Flomax (Tamsulosin) : Relaxes ureteric wall. Can do 0.4 mg immediately and then daily
L – Lotsa Liquids (Oral & IV ): Make more urine, helps washing down that stuck stone
A – Acetaminophen: Give a 1000 mg oral dose to start, then the usual frequency.
N – Nifedipine: Also relaxes ureteric wall. A 30 mg Oral dose daily if BP allows & not vomitting
N – Narcotics : if NSAIDs not enough or are contraindicated
K – Ketorolac (Toradol) : Tones down inflammation driving the pain. 15mg IV every 6 hours, if nausea better, can do Ibuprofen 400-600mg every 6-8 hours orally
💡 Summarizing Mnemonic for Kidney stone FLANK pain control & Medical Expulsion Therapy
F – Flomax 0.4mg
L – Lotsa Liquids (Oral + IV )
A – Acetaminophen 1000mg
N – Nifedipine 30mg orally , Narcotics (only if NSAIDs not enough or are contraindicated)
K – Ketorolac IV stat 15 mg
Don’t miss these fun posts! Subscribe via email 📩 | |
