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Do Non Obstructing Kidney Stones Hurt

If The Kidney Stone Is Not Causing Any Symptoms Should I Still Be Treated

Observation: Non-surgical Approach to Kidney Stones

There are some instances when it is OK to leave a kidney stone untreated. If the stone is small and not causing any pain, there is a good chance that it will pass on its own after it falls into the ureter. Such stones may be followed with “watchful waiting.” This means that the stone is not actively treated, but instead your doctor keeps a check on the stone to be sure that it is not growing or changing. This can be done with periodic X-rays.

What Questions Should I Ask My Healthcare Provider

  • Do I have a kidney stone or is there another reason for my symptoms?
  • What type of kidney stone do I have?
  • What size is my kidney stone?
  • Where is my kidney stone located?
  • How many kidney stones do I have?
  • Do I need treatment or will I be able to pass the kidney stone?
  • Should I be tested for kidney disease?
  • What changes should I make to my diet?
  • What type of procedure should I have to get rid of the stones?

A note from Cleveland Clinic

Kidney stones can be frustrating at best and agonizingly painful at the worst. To stop your situation from getting worse, you should be evaluated by a healthcare provider as soon as possible. The pain can get severe, and surgery might be necessary. Remember: dont skip your prescriptions, drink lots of water and follow any dietary guidelines. Also, remember that kidney stones are a temporary condition. They wont bother you forever.

Last reviewed by a Cleveland Clinic medical professional on 05/03/2021.

References

Opinions Of Urologists In General

Though the physiologic basis of pain in the setting of obstruction is clear, it does not provide an explanation for one of the most commonly encountered conundrums in stone disease the symptomatic non-obstructing stone. These can be actual free stones that have not passed, stones attached to plaque, or actual plugs in the kidney tubules that are massed together enough to show up on a CT scan as stones though actually tissue calcifications.

There is perhaps as much variation in clinical opinion in such instances as any other clinical scenario in the field.

If one were to ask a group of urologists whether they believed that small nonobstructing stones could cause renal colic, opinions would range from absolute certainty to complete dismissal of the concept altogether.

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How Can I Tell If I Have A Kidney Stone

Routine screening for kidney stones common but not recommended for all people.

Kidney stones can be detected using imaging such as X-rays, ultrasound, CT scan, or MRI. The best imaging currently available for kidney stone detection is a CT scan.

If you have crystals in your urine, that does not mean that you have a kidney stone. Crystals in the urine are common. If you have crystals in your urine along with other symptoms of kidney stones, you should see a doctor for an exam and imaging.

Blocked Ureter And Kidney Infection

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A kidney stone that blocks the ureter can lead to a kidney infection. This is because waste products are unable to pass the blockage, which may cause a build-up of bacteria.

The symptoms of a kidney infection are similar to symptoms of kidney stones, but may also include:

  • a high temperature of 38C or over
  • chills and shivering

Kidney stones are usually formed following a build-up of certain chemicals in the body.

This build-up may be any of the following:

  • calcium
  • ammonia
  • uric acid a waste product produced when the body breaks down food to use as energy
  • cysteine an amino acid that helps to build protein

Certain medical conditions can lead to an unusually high level of these substances in your urine.

You’re also more likely to develop kidney stones if you don’t drink enough fluids.

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Medical Therapy For Kidney Stones

Most evidence suggests that stones less than 10 mm in diameter have a reasonable chance of passing through the urinary tract spontaneously. You may be offered medical expulsive therapy using an alpha blocker medication, such as tamsulosin. Its important to understand that this is an off-label use of the drug. Rarely, tamsulosin causes a condition called intraoperative floppy iris syndrome that can complicate cataract surgery.

Not all experts feel MET is worthwhile, and its use remains controversial. Discuss your options with your doctor or a urologist.

How Do Kidney Stones Form

Most stones form just under the inner surface of the kidney. Small crystals in your urine fuse together, similar to the way salt crystals form from evaporating saltwater.

More crystals can bind over time until a stone is formed. The stone can then continue to grow bigger and ultimately become so heavy that it breaks off within the kidney. Once free to move around, it can either stay in the kidney or try to pass down the ureter.

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How To Get Relief From Kidney Stone Pain

When pain does occur, it can be so severe that many patients have to go to the closest emergency room to seek immediate treatment. Often a single dose of pain medication given by an ER doctor is enough to alleviate the pain for a prolonged period of time, allowing the stone to pass, says Lieske.

While narcotic pain medications can be carefully given for this purpose, studies suggest that nonsteroidal anti-inflammatory drugs milder pain medications with fewer side effects can be as effective. A review of 36 clinical trials that compared NSAIDs with stronger pain medications for kidney stone pain relief found that NSAIDs were equivalent when it came to pain reduction and led to fewer side effects. 30977-6/fulltext” rel=”nofollow”> 7)

Tamsulosin is also widely used to help relax the muscles of the ureter, increasing the chance of passing the stone and helping reduce symptoms of pain, Bechis notes. However, new evidence suggests this medication may not add as much benefit as previously thought, he adds. A study published in July 2015 in the Lancet found that tamsulosin didnt help stones pass. 60933-3/fulltext” rel=”nofollow”> 8)

How long does kidney stone pain last? It depends on how long it takes to pass the stone.

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What Are Kidney Stones

Kidney stones are hard collections of salt and minerals often made up of calcium or uric acid. They form inside the kidney and can travel to other parts of the urinary tract.

Stones vary in size. Some are as small as the period at the end of this sentence a fraction of an inch. Others can grow to a few inches across. Some kidney stones can become so large they take up the entire kidney.

A kidney stone forms when too much of certain minerals in your body accumulate in your urine. When you arent well hydrated, your urine becomes more concentrated with higher levels of certain minerals. When mineral levels are higher, its more likely that a kidney stone will form.

About 1 out of every 11 people in the United States will get a kidney stone. Stones are more common in men, people who are obese, and those who have diabetes .

Smaller kidney stones that remain in the kidney often dont cause any symptoms. You might not notice anything is amiss until the stone moves into your ureter the tube that urine travels through to get from your kidney to your bladder.

Kidney stones are typically very painful. Most stones will pass on their own without treatment. However, you may need a procedure to break up or remove stones that dont pass.

Here are eight signs and symptoms that you may have kidney stones.

2 ). Some people whove experienced kidney stones compare the pain to childbirth or getting stabbed with a knife.

4 ). Your doctor might call this dysuria.

Diagnosis Of Kidney Stones

Many kidney stones are discovered by chance during examinations for other conditions. Urine and blood tests can help with finding out the cause of the stone. Further tests may include:

  • ultrasound
  • CT scans
  • x-rays, including an intravenous pyelogram , where dye is injected into the bloodstream before the x-rays are taken.

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Confirmation Of The Diagnosis

The diagnosis of urinary tract calculi begins with a focused history. Key elements include past or family history of calculi, duration and evolution of symptoms, and signs or symptoms of sepsis. The physical examination is often more valuable for ruling out nonurologic disease.

Urinalysis should be performed in all patients with suspected calculi. Aside from the typical microhematuria, important findings to note are the urine pH and the presence of crystals, which may help to identify the stone composition. Patients with uric acid stones usually present with an acidic urine, and those with stone formation resulting from infection have an alkaline urine. Identification of bacteria is important in planning therapy, and a urine culture should be routinely performed. Limited pyuria is a fairly common response to irritation caused by a stone and, in absence of bacteriuria, is not generally indicative of coexistent urinary tract infection.

Because of the various presentations of renal colic and its broad differential diagnosis, an organized diagnostic approach is useful . Symptomatic stones essentially present as abdominal pain. Renal colic may be suspected based on the history and physical examination, but diagnostic imaging is essential to confirm or exclude the presence of urinary calculi. Several imaging modalities are available, and each has advantages and limitations .

What Side Do You Lay On For Kidney Stones

Kidney Stones

Using patients as their own internal controls, it was demonstrated that 80% of patients lying in a lateral decubitus position with the left side down had demonstrably increased renal perfusion in the dependent kidney and 90% of patients who lay with their right side down had similar increased perfusion.

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Complications Of Kidney Stones

Kidney stones can range in size from a grain of sand to that of a pearl or even larger. They can be smooth or jagged, and are usually yellow or brown. A large stone may get stuck in the urinary system. This can block the flow of urine and may cause strong pain.

Kidney stones can cause permanent kidney damage. Stones also increase the risk of urinary and kidney infection, which can result in germs spreading into the bloodstream.

Pain From Stone Passage

Patients have been suffering from renal colic secondary to stone disease for over two thousand years. As a matter of fact, it is remarkable how little has changed in its clinical presentation over this time period. In 400 B.C. Hippocrates referred to it asfirst disease of the kidneys. He was one of the initial observers to comprehend the association between urinary obstruction and pain, writing:

An acute pain is felt in the kidney, the loins, the flank and the testis of the affected side the patient passes urine frequently gradually the urine is suppressed. With the urine, sand is passed as the sand passes along the urethra, it causes severe pain which is relieved when it is expelled then the same sufferings begin again.

We have since come to appreciate the complex physiologic basis for this relationship at a much deeper level.

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How Are Kidney Stones Treated

Once diagnosed, your healthcare provider will first determine if you even need treatment. Some smaller kidney stones may leave your system when you urinate. This can be very painful. If your provider decides that you do need treatment, your options include medications and surgery.

Medications. Medications may be prescribed to:

  • Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen or, if youre in the emergency room, an IV narcotic.
  • Manage nausea/vomiting.
  • Relax your ureter so that the stones pass. Commonly prescribed medicines include tamsulosin and nifedipine .

You should ask your healthcare provider before you take ibuprofen. This drug can increase the risk of kidney failure if taken while youre having an acute attack of kidney stones especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension and obesity.

Surgery. There are four types of surgeries used to treat kidney stones. The first three are minimally invasive, meaning that the surgeon enters your body through a natural opening , or makes a small incision.

Dietary Calcium And Kidney Stones

Nonsurgical kidney stone treatments | National Kidney Foundation

Only lower your calcium intake below that of a normal diet if instructed by your doctor. Decreased calcium intake is only necessary in some cases where absorption of calcium from the bowel is high.

A low-calcium diet has not been shown to be useful in preventing the recurrence of kidney stones and may worsen the problem of weak bones. People with calcium-containing stones may be at greater risk of developing weak bones and osteoporosis. Discuss this risk with your doctor.

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Can A Large Kidney Stone Cause An Injury

Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.

Should I Cut Calcium Out Of My Diet If I Develop Calcium Oxalate Kidney Stones

If you develop kidney stones composed of calcium, you may be tempted to stop eating foods that include calcium. However, this is the opposite of what you should do. If you have calcium oxalate stones, the most common type, its recommended that you have a diet higher in calcium and lower in oxalate.

Foods that are high in calcium include:

  • Cows milk.

Its also important to drink plenty of fluids to dilute the substances in your urine.

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Whats The Urinary Tract How Does It Work

Your urinary tract is vital to your body because it gets rid of waste and extra fluid. Its made up of both your kidneys, two ureters, your bladder and your urethra. Each organ has an important job :

  • Kidneys: Your fist-sized, bean-shaped kidneys are located on either side of your spine, below your rib cage. Each day they filter 120 to 150 quarts of your blood to remove waste and balance fluids. Your kidneys make one to two quarts of urine every day.
  • Ureters: After your kidney creates urine, the liquid travels through the tube-shaped ureter to the bladder. There is one ureter per kidney. Kidney stones can pass through the ureters or, if theyre too big, get stuck in them. You may require surgery if the stone is too large.
  • Bladder: Between your hip bones is your bladder, an organ that stores urine. It stretches to hold about one and a half to two cups.
  • Urethra: Like a ureter, your urethra is a tube through which urine passes. Its the final stop of the urinary tract where your urine leaves your body. This is called urination.

Avoiding Recurrence Of Kidney Stones

Kidney Stones: How to Manage the Pain and Discomfort

If you have had one kidney stone, some tips that may help to prevent a second stone forming include:

  • Talk to your doctor about the cause of the previous stone.
  • Ask your doctor to check whether the medications you are on could be causing your stones. Do not stop your medications without talking to your doctor.
  • Get quick and proper treatment of urinary infections.
  • Avoid dehydration. Drink enough fluids to keep your urine volume at or above two litres a day. This can halve your risk of getting a second stone by lowering the concentration of stone-forming chemicals in your urine.
  • Avoid drinking too much tea or coffee. Juices may reduce the risk of some stones, particularly orange, grapefruit and cranberry. Ask your doctor for advice.
  • Reduce your salt intake to lower the risk of calcium-containing stones. Dont add salt while cooking and leave the saltshaker off the table. Choose low- or no-salt processed foods.
  • Avoid drinking more than one litre per week of drinks that contain phosphoric acid, which is used to flavour carbonated drinks such as cola and beer.
  • Always talk to your doctor before making changes to your diet.

Drinking mineral water is fine it cannot cause kidney stones because it contains only trace elements of minerals.

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Preventing Future Kidney Stones

Having one kidney stone means you might develop kidney stones in the future. Here are some steps you can take to help prevent kidney stones from forming:

  • Drink about 2-1/2 liters of water per day unless a doctor advises otherwise. How much water each person needs may vary.
  • Maintain a low-salt diet.
  • Limit animal protein to 6 to 8 ounces a day.
  • Lower sugar consumption.
  • Include plenty of fruits and vegetables in your daily diet.
  • If you take a vitamin C supplement, make sure its less than 1,000 milligrams per day.

If you have a history of kidney stones, a dietician can review your eating habits and provide specific dietary tips that can help lower risks of kidney stones.

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