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Ureteric Colic and Homoeopathy

 

Rajneesh Resource Page

Copyright 2011-2/All rights reserved © Dr Rajneesh 
Contact author for permission to use

                     

Definition

Ureteric colic is a pain due to the passage of a stone through the ureter.

Clinical Picture

Ureteric colic starts suddenly with pain in the loin. The pain radiates from the affected ureter to the front of the abdomen and down to the groin.  Occasionally it can also radiate into the testicle in a man and to the labia in a woman.

The degree of pain is very severe. The patient becomes very restless and uncomfortable and may want to lick the room. Typically each episode may last for half to one hour.  It is often spasmodic and tends to come and go with an hour or two between attacks.  The pain is caused by the stone passing down the ureter or due to its trial to pass down.

The pain is so intense that the patient may have nausea and vomiting. There may be a rise in temperature if there is an associated urinary tract infection.The stone lodged in the very lowest part of the ureter may cause marked urgency to pass urine. Anatomically, the last 02 cms of ureter are in the bladder wall. The irritation produced by the stone in the bladder wall causes the urgency to urinate.

Clinical Examination

Abdominal examination may be unremarkable. There may be no tenderness except the severe pain. Tenderness is elicited in the presence of infection along with raised temperature.

Differential Diagnosis

Ureteric stones may be misdiagnosed with the following:

  • Pyelonephritis
  • Abdominal aortic aneurysm
  • Appendicitis
  • Biliary colic
  • Peritonitis
  • Diverticulitis
  • Salpingitis
  • Torted ovarian cyst
  • Ectopic pregnancy
  • Herpes zoster
  • Complete blood count. White blood cells in the blood are raised in infection.
  • Serum calcium.
  • Urea and creatinine to assess renal function.
  • Haematuria. The vast majority of stones have microscopic haematuria.
  • MSU (mid stream specimen of urine) may detect infection.
  • KUB (Kidney Ureter and Bladder plain x ray). 90% of stones are radio-opaque and can be seen on x ray.
  • IVU (IntraVenous Urogram) may show stones and any obstruction.
  • Spiral CT is the most accurate method of detecting stones.
  • Retrograde ureterography may be performed in doubtful cases.
  • Ultrasound is not routinely used to diagnose stones.  It is however used to visualize stone during ESWL (Extracorporeal Shock Wave Lithotripsy).

Laboratory Investigations

Blood Tests

Urine Tests

Radiology

                        

Stone Examination

Any recovered stone should be analyzed biochemically. The stones may be-

Calcium oxalate stones- 80% of stones, dark brown, radio-opaque and show on an x ray.

 

Struvite stones- formed from infections.

 

Further investigations

  • Raised serum calcium (hypercalcaemia) needs further investigations. Primary hyperparathyroidism is one cause.
  • A raised serum uric acid is treated accordingly.
  • 24 hour urine collections to measure output of calcium urate or Cystine.

Homoeopathic Treatment

  • Top ten Homoeopathic Remedies for Ureteric Colic-
  • berb. > canth. > bell. > oci. > ter. > pareir. > apis > arg-n. > lyc. > coc-c.

Repertory of Ureteric Complaints 

  • BURNING, pain - extending, to - ureters, along bell. cedr. pin-s. ter.
  • BURNING, pain – ureters bell. cedr. pin-s. ter.
  • Calculus ureters med.
  • COLIC, kidney, pain - bleeding, with, of ureters, provoked by passage of stones canth. Pareir.
  • COLIC, kidney, pain - radiates, from left to groin, following course of ureter berb. Pareir.
  • COLIC, kidney, pain - right - right ureter to bladder LYC. sars.
  • CONSTRICTING, pain - extending, to - down, ureters to penis, pressure on glans amel., at times pain goes upward canth.
  • CONTRACTING, pain - down, ureters, to penis CANTH.
  • CONTRACTION - ureters, extending to penis, pressure amel. CANTH.
  • CONTRACTION, muscles and tendons - parts, of, supplied with involuntary muscles, as intestines, ureters, etc., with intense pain Tab.
  • CRAMPING, pain – ureters nit-ac. polyg-h.
  • CUTTING, pain – ureters aesc. Apis Arg-n. Arn. Ars. aspar. BELL. Benz-ac. BERB. cann-s. Canth. CARB-AN. chlol. coc-c. colch. con. Dios. equis-h. erig. eup-pur. indg. kali-ar. Kali-c. Lach. LYC. Med. nat-s. Nux-m. Nux-v. Oci. Op. PAREIR. Phos. psor. SARS. senec. sep. sil. Tab. VERAT. zinc-p. zinc.
  • CUTTING, pain, bladder – ureters bell. berb. carb-an. lyc. pareir. polyg-h. Sars. sep. ter. verat.
  • DRAGGING, pain, extending to bladder - dragging, ureters, like labor pain with urging to urinate Cham.
  • DRAWING, pain – ureters astac. berb. calad. cham. coc-c. Nat-m. sulph. thuj.
  • Gravel ureter hedeo.
  • HEAT - Ureters; in cedr.
  • INFLAMMATION – Ureters arn. Canth. ter.
  • INFLAMMATION - ureters, urethritis arn. CANTH. ter.
  • INFLAMMATION, kidneys - ureters, acute acon. arn. Ars. aur. Bell. Benz-ac. berb. bry. Cann-s. Canth. chim. chin. chinin-s. Cop. Cupr-ar. epig. Ferr. hecla hep. juni-c. kali-bi. Merc-c. nit-ac. ol-sant. pareir. Puls. Rhus-t. sep. sil. stigm. sulph. ter. thuj. Tritic. Uva Verat-v.
  • IRRITATION – Ureters spirae.
  • LABOR-like, pains, along ureters, dragging, with frequent urging to urinate Cham.
  • LANCINATING, pain - acute, prolonged, extending from left ureter into bladder coc-c.
  • PAIN - burning - extending - along ureters cedr. pin-s.
  • PAIN - burning - extending - ureters, along cedr. pin-s.
  • PAIN - burning – ureters cedr. pin-s. ter.
  • PAIN - constricting - extending - ureters, down to penis, pressure on glans amel., at times pain goes upward canth.
  • PAIN - constricting - extending, bladder, to - ureters, down to penis, pressure on glans amel., at times pain goes upward canth.
  • PAIN - constricting,extending - down ureters to penis,pressure on glans amel.,at times pain goes upward canth.
  • PAIN - contracting - down ureters to penis CANTH.
  • PAIN - contracting - ureters, down to penis CANTH.
  • PAIN - cramping – ureters nit-ac. polyg-h.
  • PAIN - cutting – ureters aesc. Apis Arg-n. Arn. Ars. aspar. BELL. Benz-ac. BERB. cann-s. Canth. CARB-AN. chlol. coc-c. colch. con. Dios. equis-h. erig. eup-pur. indg. kali-ar. Kali-c. Lach. LYC. Med. nat-s. Nux-m. Nux-v. Oci. Op. PAREIR. Phos. psor. SARS. senec. sep. sil. Tab. VERAT. zinc-phic. zinc.
  • PAIN - cutting – ureters aesc. Apis Arg-n. Arn. Ars. aspar. BELL. Benz-ac. BERB. cann-s. Canth. CARB-AN. chlol. coc-c. colch. con. Dios. equis-h. erig. eup-pur. indg. kali-ar. Kali-c. Lach. LYC. Med. nat-s. Nux-m. Nux-v. Oci. Op. PAREIR. Phos. psor. SARS. senec. sep. sil. Tab. VERAT. zinc.
  • PAIN - dragging - labor pain, like, ureters, with urging to urinate CHAM.
  • PAIN - dragging - ureters, like labor pain with urging to urinate Cham.
  • PAIN - drawing – ureters berb. cham. Nat-m. sulph. thuj.
  • PAIN - extending - ureters, along bell. BERB. canth. cedr. IPOM-P. pareir. pin-s. ter.
  • PAIN - General - region of - extending to – ureters berb. canth. chel. oci. phyt.
  • PAIN - General – ureters arg-n. coc-c. ozone scroph-n.
  • PAIN - piercing - ureters, with urging to urinate nat-s.
  • PAIN - piercing in both ureters, with urging to urinate nat-s.
  • PAIN - region of - extending to – ureters berb. canth. chel. oci. phyt.
  • PAIN - region of - extending to – ureters canth. chel. oci. phyt.
  • PAIN - region of - right - extending to ureters canth.
  • PAIN - sore, bruised – ureters apis berb. oci.
  • PAIN - sore, tender – ureters apis berb. oci.
  • PAIN - stitching, stinging, sticking - extending to - ureters, down apis arg-n. bell. BERB. calad. Chel. coc-c. cupr-act. KALI-BI. Lach. LYC. pareir. tab. ter.
  • PAIN - stitching, stinging, sticking – ureters carl. cere-b.
  • PAIN - tearing - ureters, extending downward, touch, motion and inspiration agg. arg-n. bell.
  • PAIN – ureters aesc. agar. aloe apis arg-n. bell. benz-ac. berb. bov. calad. cann-i. cann-s. canth. carl. cedr. cere-b. clem. coc-c. con. dios. epig. hedeo. indg. ipom-p. kali-c. lith-c. lyc. nat-m. nat-s. nit-ac. nux-v. oci. ozone pareir. polyg-h. sars. scroph-n. tab. tarent. thuj. zinc-phic.
  • PAIN, kidneys - left, in - paroxysms of pain running along ureter and in back, with Ipom-p.
  • PAIN, kidneys - region, of kidneys - extending, to – ureters berb. canth. chel. oci. phyt.
  • PAIN, kidneys – ureters Aesc. agar. aloe Apis arg-n. benz-ac. Berb. bor-ac. calad. calc. cann-i. cann-s. Canth. Chel. chinin-s. clem. coc-c. con. Dios. epig. equis-h. gal-ac. Hedeo. hydrang. indg. Ipom-p. kali-c. lith-c. LYC. mel-c-s. merc. Nux-v. Oci. ozone Pareir. phyt. pic-ac. Sars. scroph-n. sep. tab. tarent. Ter. urt-u. uva
  • partial heat - in ureters cedr.
  • Passing - ureters, calculus were med.
  • PIERCING, pain, in both ureters, with urging to urinate Berb. nat-s.
  • RESTLESS sensation – ureters phyt.
  • SHARP, pain - downward, apparently through ureters Lach.
  • SHARP, pain - extending, to - ureters, down apis arg-n. bell. BERB. calad. Chel. coc-c. cupr-act. KALI-BI. Lach. LYC. pareir. tab. ter.
  • SHARP, pain - extending, to - ureters, down, worse touch or motion, deep inspiration arg-n.
  • SHOOTING, pain - ureters, from below upward, in left - down left ureter berb. pareir.
  • SHOOTING, pain - ureters, from below upward, in left aesc.
  • SORE, pain – ureters apis berb. oci.
  • SORE, pain, tender – ureters apis berb. oci.
  • Squeezing ureter op.
  • STINGING, pain - ureters, in left calad.
  • Stone - impacted in left ureter cere-b.
  • Stone - passing ureters med.
  • TEARING, pain - ureters, extending downwards, touch, motion and inspiration agg. arg-n. bell.
  • TUMORS – Ureters Anil.
  • Ureter calculus cere-b.
  • Ureter pinching scroph-n.
  • Ureters apis Bell. Berb. canth. carb-an. Lyc. oci. par. polyg-h. SARS. sep. ter. verat.
  • Ureters boiling cedr.
  • Ureters calculus med.
  • URGING, ureters, night, when bladder is empty cund.

References

  • Radar 10
  • Encyclopedia      Homoeopathica
  • Chapter      97. Urologic Stone Disease Tintinalli's Emergency Medicine           
  • Renal      & Ureteral Stones Smith's General Urology > Chapter 16. Urinary      Stone Disease           
  • Ureteral      Stone CURRENT Diagnosis & Treatment: Surgery, 13e > Chapter 38.      Urology > Calculi           
  • Urolithiasis      Schwartz's Principles of Surgery > Chapter 40. Urology > Upper      Urinary Tract Obstruction          
  • Calcifications      and Opacities CURRENT Diagnosis & Treatment Emergency Medicine, 7e      > Chapter 15. Abdominal Pain > Further Evaluation of the Patient      with Abdominal Pain > Radiologic Examination > Interpretation           
  • Ureteral      Stones Smith's General Urology > Chapter 8. Percutaneous Endourology      & Ureterorenoscopy > Ureterorenoscopy           
  • Ureteral      Stones CURRENT Medical Dx & Tx > Chapter 23. Urologic Disorders      > Genitourinary Tract Infections > Urinary Stone Disease >      Surgical Treatment           
  • Ureteral      Stones Smith's General Urology > Chapter 27. Neuropathic Bladder      Disorders > Abnormal Vesical Function > Complications of Neuropathic      Bladder > Calculus           
  • Fig.      40-10. Hydronephrosis and ureteral calculus. A. Left... Schwartz's      Principles of Surgery > Chapter 40. Urology > Upper Urinary Tract      Obstruction           
  • 8-6.      What is the most likely diagnosis in Case 8-6 (Figure 8-12)? Basic      Radiology, 2e > Chapter 8. Plain Film of the Abdomen > Exercises      8-2. Pelvic Calcifications           
  • 9-8.      What is the most likely diagnosis for the patient in Case 9-8 (Figure      9-25)? Basic Radiology, 2e > Chapter 9. Radiology of the Urinary Tract      > Exercise 9-3. Stone Disease           
  • Balloon      dilators can be used to ease passage of ureteroscopes (rigid or flexible;      see Chapter 8)... Smith's General Urology > Chapter 10. Retrograde      Instrumentation of the Urinary Tract > Ureteral Catheterization           
  • Figure      11–7.. Changes in bladder, ureters, and kidneys caused by obstruction.      A:... Smith's General Urology > Chapter 11. Urinary Obstruction &      Stasis > Clinical Findings > X-Ray Findings (Figure 11–7)           
  • Figure      6–25.. Sonography with comparative study. Film from IVP (left) and... Smith's      General Urology > Chapter 6. Radiology of the Urinary Tract >      Sonography           
  • Ureteral      calculi are always a consideration in patients with hematuria. About 50%      of urinary... Basic Radiology, 2e > Chapter 8. Plain Film of the      Abdomen > Exercises 8-2. Pelvic Calcifications > Discussion           
  • Figure      65-1. Plate A is a plain x-ray showing a large, right ureteral stone (red      arrow) somewhat... The Color Atlas of Family Medicine > Chapter 65.      Kidney Stones > Patient Story           
  • Figure      66-2. Large irregular calcification (arrow) representing ureterolithiasis      in the left side... The Color Atlas of Family Medicine > Chapter 66.      Hydronephrosis > Diagnosis > Imaging

For well formatted article with colour photographs, pl. see attached pdf.

Ureteric Colic and homoeopathy.pdf

 

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Comment by Dr Rajneesh Kumar Sharma MD(Hom) on July 15, 2012 at 6:52am

Thanks Dr. Sajjad. Regards...

Comment by sajjadakram on July 15, 2012 at 4:06am

Thanks Rajneesh,

I think the top ten remedies mentioned by you are sufficient to treat almost every emergency condition.

Regards.

sajjad.

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