Kidney stones are a common problem. Many of those who have kidney stones often do not have symptoms.
However, when the stones try to escape the kidney and pass out in the urine, it can be quite painful. This is because they can get stuck on their way out.
Today, I will briefly discuss what kidney stones are, the common kidney stones symptoms and how they are treated. I will touch upon the prevention of kidney stones as well.
What Are Kidney Stones?
Yoru kidneys are the filtering system of the body. They not only remove toxic material; they also filter out extra minerals and salts as well.
These minerals and salts can sometimes combine together and form small, hard particles. These are kidney stones.
The size of kidney stones can vary from extremely tiny ones (a few mm in size) to large ones (measuring a few cms in size).
According to the Guinness Book of World Records, the largest recorded kidney stone ever removed was of Mr. Hemedra Shah back in 2014. It measured 13 cm! The most number of kidney stones ever passed is 5704 by Canadian Donald Winfield.
What Causes Kidney Stones?
Insufficient water intake is one of the most common kidney stone causes. The more concentrated the urine is, the higher the concentration of these minerals and salts. They form concretions that become larger with time.
Normally, there are compounds in the kidney that prevent minerals like calcium and other products such as uric acid and oxalates from sticking together. In people who are prone to kidney stones, these compounds may be lacking to an extent.
Types Of Kidney Stones
Broadly classified, there are 4 types of kidney stones.
A majority of kidney stones contain calcium. This is often combined with oxalates, which are natural compounds present in foods, certain fruits and veggies and nuts, and chocolate.
Patients taking high doses of Vitamin D supplements can also develop calcium stones. Certain medical conditions such as intestinal bypass surgery are known to lead to such calcium stones as well.
Uric Acid Stones
These type of stones are formed when the urine is acidic. It may also be related to a diet that is high in purines. People who do not consume sufficient amount of water every day can also develop uric acid kidney stones.
Interestingly, uric acid stones can run in families.
These are not very common stones. They usually form due to repeated infection in the kidney.
These stones are rare and occur in individuals who suffer from a condition called cystinuria. This is a genetic condition.
Kidney Stones Symptoms
Most patients who have kidney stones do not have symptoms. This is because the stones remain silently dormant within the structure of the kidney.
However, some patients may notice red-colored urine. This is because stones can lead to a small amount of blood leaking out of the kidney.
A small number of patients may experience back pain with kidney stones. If a stone attempts to pass out the kidney, it may get stuck in the ureter and cause significant pain.
The pain can be unbearable and can lead to vomiting. I have even seen patients pacing up and down the clinic due to the unbearable pain.
The pain generally radiates from loin to groin.
Kidney stones can sometimes get infected, leading to fever. The urine may be cloudy in such cases.
How Can Kidney Stones Be Diagnosed?
A diagnosis of kidney stones may not always be possible when a doctor sees a patient. This is because kidney stones can sometimes remain in the kidney and not cause any symptoms whatsoever.
However, when the kidney stone attempts to pass out from the kidney through the ureter into the urinary bladder, it may get stuck on its way. This can cause excruciating pain which I have described earlier in this article.
The first way to diagnose a kidney stone is through history. The pain is typical and quite characteristic. However, additional investigations are usually required to confirm the presence of stones.
Ultrasound scan of the abdomen
An ultrasound scan is a simple way of determining whether you have kidney stones. It is painless and risk-free.
By placing an ultrasound probe over the abdomen, it is possible to clearly visualize not just the kidneys but also any stones.
The number of stones in each kidney can also be determined fairly easily. If a stone has passed into the ureter, it may be visible though in some cases this may not be possible.
CT scan of the abdomen
In individuals who are suspected of having a stone that is causing problems, a CT scan of the kidney-ureter-bladder, also called CT KUB, is essential to determine the position of the stone and the size of the stone.
A CT scan helps determine the location of the stone, the size of the stone and whether it is causing any damage to the ureter. By doing so, further management can be easily decided.
Treatment Of Kidney Stones
Small stones that are less than 6 mm in size rarely require any treatment. If they are causing pain, then painkillers in the form of tablets or injections may be administered. Patients may be requested to drink a lot of water to try and flush out the kidney through the urine.
Unfortunately, not all stones pass by themselves and some can remain stuck in the ureter. This can place a great deal of pressure on the kidney leading to its size increasing slowly and sometimes dramatically.
This is called hydro-uretero-nephrosis (you may see this on your report) and is an indication that the kidney is under a great deal of strain from the stone.
If the situation is encountered, a consultation with a urologist is recommended as soon as possible. They may recommend medical therapy alone but sometimes may go on to perform certain interventions to remove the stones.
One such intervention is a procedure called a cystoscopy with stent insertion.
In brief, the urologist will pass a tiny tube through the urethra (the tube that allows urine to come out of the bladder). At the end of this tube is a tiny camera that allows the urologist to visualize the point where the unit is attached to the bladder.
Through this device is passed a small wire that can be manipulated into the ureter to remove the stone. As the stone would have caused a great deal of inflammation within the ureter, a stent is placed to keep the tube open.
This may remain in place for a few weeks and you may be prescribed antibiotics to prevent any infections.
Another procedure that may be performed is called extracorporeal shock wave lithotripsy. This is where high-frequency ultrasound waves are directed towards a stone to ”smash” it into small particulate matter. This matter is then expelled in the urine naturally.
However, this may not be recommended for all patients or even maybe advice along with stent insertion.
In rare cases, where there is pus or infection in the kidney as well, surgery may be recommended.
Your urologist will look at your scans in detail and decide on the best course of treatment.
Kidney stones are a nuisance. Drinking water regularly can help but does not take away the risk of developing them.
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