Renal colic during pregnancy

Any severe pain during pregnancy is cause for concern and should not be ignored. Renal colic is one such condition – it is accompanied by sharp, intense pain, often described as more severe than labor contractions. Renal colic does not directly threaten the health and life of the mother or baby, but colic attacks should not be ignored, and any disturbing symptom should be reported to a doctor.

What is renal colic and how does it occur?

Renal colic most often appears in the second or third trimester of pregnancy and affects an average of 1 in 3,000 women. The characteristic pain is located in the lower back; it most often affects one side and can sometimes radiate to the perineum or groin. The pain is dull, very severe, sharp, disabling, and can become more severe. The pain may also be accompanied (but not always have to be) by nausea or vomiting, increased body temperature, weakness, painful bladder pressure, and a change in urine consistency or blood in the urine.

What are the causes of renal colic during pregnancy?

There are several causes of renal colic during pregnancy – these include kidney stones, untreated or complicated urinary tract infections, pressure of the enlarged uterus on the bladder, kidneys or ureters, or hormonal changes typical of pregnancy.

Renal colic in the course of urolithiasis is merely a consequence, a pain that occurs as a result of deposits forming in the urinary tract. These stones can be detected on abdominal ultrasound, most often in the kidneys or bladder. Their formation is facilitated by abnormal urine pH, resulting from factors such as poor diet, taking certain medications, and dehydration, often resulting from insufficient fluid intake. A colic attack in urolithiasis is associated with the movement of the stones through the urinary tract, which can lead to urinary retention in the kidney and the associated increase in pressure in the upper urinary tract.

What should you do in case of renal colic?

If severe pain occurs, you should schedule an appointment with an obstetrician-gynecologist as soon as possible, preferably the same one who is managing your pregnancy, or if necessary, with a urologist. During the appointment, a thorough interview will be conducted, tests will be analyzed, and appropriate tests will be ordered (e.g., urinalysis, urine culture, abdominal ultrasound, complete blood count, CRP). Appropriate treatment and management will also be implemented, including non-pharmacological options. Antispasmodic, anti-inflammatory, and analgesic medications approved for use during pregnancy are helpful. In the case of urolithiasis, medications to dissolve urinary tract stones may be necessary. Fortunately, hospitalization is only necessary in severe cases or if treatment fails.

What can you do to prevent renal colic or alleviate the symptoms?

It's recommended to drink a sufficient amount of water daily – at least 2 liters on average (more at high temperatures), which will help with frequent urination and prevent the formation of deposits. Physical activity, such as walking, is recommended to prevent the uterus from pressing on the urinary tract, promote the spontaneous excretion of deposits in the urine, and prevent urinary retention. A proper diet also plays a significant role – it's recommended to avoid highly processed foods (ready-made products, cakes, sweets, etc.), large amounts of salt, and spicy foods, minimize the consumption of foods high in oxalates (spinach, rhubarb, sorrel, beets, strong teas, coffee), and avoid calcium supplements – calcium intake in a standard diet, which includes dairy products, is sufficient to meet the needs of both the mother and the baby. It's also worth consulting with a doctor about the use of warming compresses on the lower back for renal colic during pregnancy.