India is a vast country with wide seasonal diversities and there are specific diseases and health problems that arise as per the particular season. It’s a common observation that as soon as summer strikes in India, hospital Emergencies start getting flooded with patients with acute ureteric colic. Now what’s Acute ureteric colic? Ureteric colic is a sudden, severe,

spasmodic pain, arising from one side of the abdomen and radiates towards the groin region. Ureteric colic is caused by the obstruction of the ureter: a 20-25 cm long, thin tube that connects the respective kidney to the urinary bladder and transmits urine from the kidney, which forms the urine, to the bladder, the urine reservoir. The stones obstructing the ureter are called ureteric stones.

 Almost all ureteric stones are formed in the kidney, and they are formed around the year in susceptible populations. But then why does the incidence of ureteric colic happen most in the summers? And here lies the answer: The summers! During summer, people drink a lot of water and other liquids out of thirst and thus form more urine from their kidneys. 

In susceptible populations more prone to stone formation, the kidney forms small stones around the year because of various reasons, which get flushed to the ureter with the flow of urine and occasionally the larger ones get stuck into ureteric lumen which is typically 3-4 mm in diameter. 

Thus, it’s not necessarily the stone formation is more in the summers and cause of ureteric colic but is the excess formation of urine secondary to increased liquid intake which flush the already formed stones out of kidneys into the ureters and occasionally blocks the ureteric lumen leading to ureteric colic. 

Now as the cases of ureteric colic increase in summer, the apprehension regarding its management also increases. The problem is so common and so ancient, that there is hardly anyone in our country who is left unheard of ureteric colic in their lifetime. And with such a voluminous problem for such a long time, there are a multitude of remedies, Desi (with assurance!), as well as approved, which include medical or surgical means of removal of ureteric stones.

 As everyone prefers a non-surgical solution over the surgical options initially, the Desi or non-surgical solutions loom large at the start. But here lies the catch: sometimes the delay in definitive treatment due to extended conservative therapy costs the function of the respective kidney of that person! Small stones (<5 -6 mm) usually pass with conservative management if other factors are favorable but unjustified delay in false hope of self-clearance may cost dearly. The prolonged obstruction of the ureter leads to the pooling of urine in the kidney with stretching and thinning of kidney tissue ultimately leading to partial or total loss of function. Patients with comorbidities such as Diabetes or Hypertension are especially prone for early damage if the ureter remains obstructed. 

There is a myth looming larger than the reality in our society that drinking BEER flushes the stones out of ureters. Beware: Beer is just a diuretic, it forms more urine in a well-hydrated person, and that’s it. But imagine what will happen if the flood of urine strikes an already obstructed narrow tube? There is sudden back pressure formation which may damage the kidneys even more! Thus, it’s not a good idea to use flush therapy with BEER or diuretics to avoid surgery. With the advancement of medical science, there are so many minimally invasive techniques available that it hardly takes a few minutes to remove the stones definitively without any external cuts and the patient goes home in a few hours, cured. So, the simple advice is, that although ureteric stones are common, don’t take them lightly. Not necessarily in the beginning, but keep the option of timely surgical remedy open for the best care of your kidneys, they are invaluable! Good luck!