Unfortunately, kidney stones are an everyday occurrence. One in ten Americans will experience a renal stone at some point in their lives. They are more common in the Southern United States, hence “The Stone Belt”. Even though a lot of tiny stones are unlikely to be recognized during passage, they can become excruciating when they reach a few millimeters. It is usually a sharp pain below the ribs on one or both of the backs that radiates down to the bladder area of your groin. These pains are often accompanied with nausea and vomiting. Patients may move around constantly trying to find a comfortable position. The stone is trapped in a section or ureter of the tubular structure that runs from the bladder to the kidney.
Pain Factor
Some of the pain may be caused by a restricted or blocked urine flow. The ureter is also contracting vigorously and trying to move stone along. The stone can often tear the delicate lining of a ureter, causing blood to seep into the urine. This continues until the stone moves into the bladder, or until medical therapy is initiated. What can a doctor do to treat an acute kidney stone? He may first attach a few I.V. bags to the patient. He may give an injection of a Nonsteroidal Inflammatory Drug, such as ketoralac, to reduce inflammation. Or, he may decide to inject an opioid drug to relieve the pain and dilute the urine. Sometimes, he may use a diuretic to increase the urine flow. 90% of stones less than 4mm in size will pass, which is a good thing. After the initial pain is gone, he may send the patient home to test your urine for the stone. Stone analysis can help prevent future stones.
Sometimes, it is obvious that the stone is much larger than expected and will not move. For more specific treatment, he may refer you to a specialist in urology. This specialist has many options. The specialist may examine the ureter using a special scope. He may decide to place a tube around the obstruction to allow urine to flow past it. If the stone is not too large, he may place a stone basket in order to remove it. He may use ultrasound to break up the stone or recommend the Extracorporeal Lithotripsy Treatment, which is a powerful sound wave directed at the stone from the outside. This technique can sometimes cause damage to other organs so it must be used with care. The stone will usually pass through the ureter once it is broken.
What causes a stone?
Have you ever seen the experiment where a string is suspended into a saturated sugar solution and crystals begin to grow on it. This is what happens to kidney stones. Crystals form when there is too much of a mineral, or another substance in the urine. The crystal grows larger and larger until it is impossible to pass. Calcium oxalate is the most common type of stone (e.g. crystal). This makes up more than 80% of all stones. Calcium phosphate is the next most common type of stone. About 5% to 10% of all stones are made from uric acid, which is the same process that causes gout in joints. Structuvite stones can be formed by bacteria splitting urea in chronic urinary tract infections. Stone formation can also be caused by other metabolic conditions.
Stone analysis can indicate several of these conditions, while laboratory tests like blood chemistry or urinalysis may suggest others. If a kidney stone is suspected, there are many ways to diagnose it. One is a KUB (plain x-ray of abdomen). This study can measure and show the calcium content of many stones. Ultrasound is another technique. Sometimes, this shows the actual stone but more often the enlarged condition of the blocked renal. A CT scan can be very helpful in determining the size and location of stones.
Radiation
There has been some concern recently about the radiation exposure from CT scans. This may or may not be an option. To show the location of the blockage and its extent, a special dye can be used in conjunction with plain xrays or CT scans. There are some caveats to preventing kidney stones. One is adequate fluid intake. This means drinking 6-8 glasses of water per day. Calcium oxalate stones (the most common type) should be avoided. This includes foods rich in oxalate such as chocolate, nuts and spinach.
Oxalate stones can be prevented by orange juice. Stone formation can be caused by taking large amounts of Vitamin C. Treatment with the medicine allopurinol, which reduces the formation of uric acids, is recommended if there are high levels of uric Acid in the blood. Sometimes, the doctor may recommend thiazide diuretics to decrease calcium excretion in urine. A proper treatment of urinary tract infections will reduce the likelihood of struvite stones formation. Regular visits to your doctor may result in treatment for underlying medical conditions like hyperparathyroidism. This would prevent future kidney stone formation.