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.
What Is A Kidney Stone
A kidney stone is a hard object that is made from chemicals in the urine. There are four types of kidney stones: calcium oxalate, uric acid, struvite, and cystine. A kidney stone may be treated with shockwave lithotripsy, uteroscopy, percutaneous nephrolithomy or nephrolithotripsy. Common symptoms include severe pain in lower back, blood in your urine, nausea, vomiting, fever and chills, or urine that smells bad or looks cloudy.
Urine has various wastes dissolved in it. When there is too much waste in too little liquid, crystals begin to form. The crystals attract other elements and join together to form a solid that will get larger unless it is passed out of the body with the urine. Usually, these chemicals are eliminated in the urine by the body’s master chemist: the kidney. In most people, having enough liquid washes them out or other chemicals in urine stop a stone from forming. The stone-forming chemicals are calcium, oxalate, urate, cystine, xanthine, and phosphate.
After it is formed, the stone may stay in the kidney or travel down the urinary tract into the ureter. Sometimes, tiny stones move out of the body in the urine without causing too much pain. But stones that don’t move may cause a back-up of urine in the kidney, ureter, the bladder, or the urethra. This is what causes the pain.
Facts You Should Know About Kidney Stones
- A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract.
- Nephrolithiasis is the medical term for kidney stones.
- One in every 20 people develops kidney stones at some point in their life.
- A family history of kidney stones is also a risk factor for developing kidney stones
- Early signs of kidney stones often report the sudden onset of excruciating, cramping pain in their low back and/or side, groin, or abdomen.
- Kidney stones form when there is a decrease in urine volume and/or an excess of stone-forming substances in the urine.
- Dehydration is a major risk factor for kidney stone formation.
- Symptoms of a kidney stone include flank pain and blood in the urine .
- People with certain medical conditions, such as gout, and those who take certain medications or supplements are at risk for kidney stones.
- Diet and hereditary factors are also related to stone formation.
- Diagnosis of kidney stones is best accomplished using an ultrasound, intravenous pyleography , or a CT scan.
- Most kidney stones will pass through the ureter to the bladder on their own with time.
- Treatment includes pain-control medications and, in some cases, medications to facilitate the passage of urine.
- If needed, lithotripsy or surgical techniques may be used for stones that do not pass through the ureter to the bladder on their own.
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What To Expect At Home
It is normal to have a small amount of blood in your urine for a few days to a few weeks after this procedure.
You may have pain and nausea when the stone pieces pass. This can happen soon after treatment and may last for 4 to 8 weeks.
You may have some bruising on your back or side where the stone was treated if sound waves were used. You may also have some pain over the treatment area.
Ultrasound Procedure For Kidney Stones
A kidney ultrasound is a simple, painless, noninvasive, and very accurate exam that gives perfect insight in the very structure of the kidneys. A kidney ultrasound is performed to help doctors evaluate potential anatomical abnormalities of the organ and confirm or rule out certain medical conditions.
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Can Children Get Kidney Stones
Kidney stones are found in children as young as 5 years. In fact, this problem is so common in children that some hospitals conduct ‘stone’ clinics for pediatric patients. The increase in the United States has been attributed to several factors, mostly related to food choices. The two most important reasons are not drinking enough fluids and eating foods that are high in salt. Kids should eat less salty potato chips and French fries. There are other salty foods: sandwich meats, canned soups, packaged meals, and even some sports drinks. Sodas and other sweetened beverages can also increase the risk of stones if they contain high fructose corn syrup.
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Prevention Of Future Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no “one-size-fits-all” diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Diet Changes
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts . This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But it’s best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces of urine daily.
Reduce the amount of salt in your diet.
Eat the recommended amount of calcium.
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Pain Or Burning During Urination
Once the stone reaches the junction between your ureter and bladder, youll start to feel pain when you urinate. Your doctor might call this dysuria.
The pain can feel sharp or burning. If you dont know you have a kidney stone, you might mistake it for a UTI. Sometimes you can have an infection along with the stone.
How Can Kidney Stones Be Detected
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 .
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Can You See Kidney Stones On A Kub
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Results of a KUB study may show injuries to your stomach or intestines, fluid in your abdominal cavity, or a blockage of your intestines. In addition, results may show the presence of kidney stones or gallstones.
Secondly, does a KUB show hydronephrosis? KUB X-rays are used by some urologists to classify a kidney stone as radiodense or radiolucent and may use KUB X-rays to determine if the stone is able to migrate down the ureter into the bladder.
Keeping this in consideration, do kidney stones show up on ultrasound?
Ultrasound can detect cysts, tumors, abscesses, obstructions, fluid collection, and infection within or around the kidneys. Calculi of the kidneys and ureters may be detected by ultrasound.
What can a KUB detect?
A kidney, ureter, and bladder X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal system. A KUB X-ray may be the first diagnostic procedure used to assess the urinary system.
Can You See Kidney Stones On A Cat Scan? Both CT and ultrasound find most kidney stones.
Why is contrast hard on kidneys? Some medications can potentially cause a kidney problem by decreasing blood flow to the kidneys. Because contrast dyes can also decrease kidney blood flow, these medications and the dye should not be given at the same time.
Ct Scan For Kidney Stones
Every year more than half a million people suffer from the issue of kidney stones. The risk of this disease has increased because of other diseases that are linked with it such as high blood pressure, diabetes, and obesity.
How do you know you have kidney stones and treatment options are available? A Ct scan for kidney stones is conducted to detect the presence of stones in your kidney.
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What Are The Imaging Techniques Used To Diagnose Kidney Stone
Imaging of the kidney is usually performed. At present two options are widely available.
- Computerized tomography of the abdomen is the most reliable way of making the diagnosis of a kidney stone. Added benefits include knowing the size and location of the stone or stones that can help plan treatment, plus being able to evaluate other organs within the abdominal cavity. However, the risk of CT is radiation.
- Ultrasound of the urinary tract including the kidneys, ureter, and bladder can detect a kidney stone as well as associated abnormalities. Swelling of the kidney , an indirect sign of obstruction from the stone, can be detected and it is often possible to visualize the stone.
Historically, intravenous pyelograms were performed to image the urinary tract. Dye was injected into a vein and serial X-rays were performed as the kidneys excreted the dye, revealing the anatomy and any abnormalities.
What Other Treatment Choices Are Available
About 90 percent of stones pass through the urinary system without treatment. In cases where this does not occur, treatment to remove stones may be needed. Some stones may be dissolved by medicines. In other cases, one of the following methods of stone removal may be needed:
Percutaneous Stone RemovalWhen stones are quite large or in a location that does not allow effective lithotripsy, a technique called percutaneous stone removal may be used. In this method, the surgeon makes a small incision in the back and creates a tunnel directly into the kidney. A tube is inserted and the stone is removed through this tube.
Ureteroscopic Stone RemovalFor stones found in the lower part of the urinary tract, the doctor may pass a ureteroscope up into the bladder and ureter. A basket-like device may be passed through the tube to grasp and withdraw the stone.
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Rising Rates Of Kidney Stones
Kidney stone rates are increasing, and in a 2010 National Health and Nutrition Examination Survey, one in 11 people reported having had at least one kidney stone. The use of CT to diagnose kidney stones has risen 10-fold in the last 15 years. CT exams generally are conducted by radiologists, while ultrasound exams may be conducted by emergency room physicians as well as radiologists.
An ultrasound image of the bladder showing a ureter blocked by a kidney stone.
Emergency room patients whose pain was suspected to be due to kidney stones were randomly assigned in the NEJM study to one of three imaging groups. In one group patients received an ultrasound exam performed by an emergency room physician on site. A second group received similar ultrasonography performed by a radiologist, a specialist in the procedure. The third group received an abdominal CT scan, also conducted by a radiologist.
With six months of patient follow-up, the study found that health outcomes for 2,759 patients were just as good with ultrasound as with CT, and that patients fared no worse when emergency physicians instead of radiologists performed the ultrasound exam. Serious adverse events, pain, return trips to the emergency department or hospitalizations did not differ significantly among groups.
The study sites were emergency departments at academic medical centers throughout the country, and included four safety-net hospitals serving low-income communities.
Reducing Kidney Stone Risk
Drinking enough fluid will help keep your urine less concentrated with waste products. Darker urine is more concentrated, so your urine should appear very light yellow to clear if you are well hydrated. Most of the fluid you drink should be water. Most people should drink more than 12 glasses of water a day. Speak with a healthcare professional about the right amount of water that’s best for you. Water is better than soda, sports drinks or coffee/tea. lf you exercise or if it is hot outside, you should drink more. Sugar and high-fructose corn syrup should be limited to small quantities.
Eat more fruits and vegetables, which make the urine less acid. When the urine is less acid, then stones may be less able to form. Animal protein produces urine that has more acid, which can then increase your risk for kidney stones.
You can reduce excess salt in your diet. What foods are high in salt? Everyone thinks of salty potato chips and French fries. Those should be rarely eaten. There are other products that are salty: sandwich meats, canned soups, packaged meals, and even sports drinks.
Some herbal substances are promoted as helping prevent stones. You should know that there is insufficient published medical evidence to support the use of any herb or supplement in preventing stones.
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What Do The Results Mean
Your results will show what your kidney stone is made of. Once your health care provider has these results, he or she can recommend steps and/or medicines that may prevent you from forming more stones. The recommendations will depend on the chemical makeup of your stone.
If you have questions about your results, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Checking For Kidney Stones In The Emergency Department
First, the emergency doctor will give you medicine to help stop your pain. The medicine may be given by mouth. Or, it may be given through an intravenous needle placed in a vein in your arm. You may also be given medicine to help stop your nausea and vomiting. If you are dehydrated from vomiting, you may be given liquids through an IV tube.
Next, the emergency doctor will talk with you about your symptoms and medical history. If the emergency doctor thinks you might have a kidney stone, several tests may be done.
These may include:
- Urine Tests: To check for blood or mineral crystals in your urine or for signs of infection.
- Blood Tests: To check the health of your kidneys and for signs of a kidney or blood infection.
- Imaging Tests: To check for kidney stones in your urinary tract . Imaging tests may include a CT scan or an ultrasound.
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Kidney Stones Can Range In Size And Shape
They can be as small as a grain of sand or as large as a golf ball. But, big stones are rare.
Symptoms of kidney stones may include:
- Sharp pain in your back, side, lower belly , or groin that may come and go
- Nausea and vomiting
- The feeling of sand or small particles passing through when you urinate
- Pain when you urinate
- Feeling like you need to urinate but cannot
How Can I Prevent Kidney Stones
There are several ways to decrease your risk of kidney stones, including:
- Drink water. Drink at least six to eight 8-ounce glasses every day . Staying hydrated helps you urinate more often, which helps flush away the buildup of the substances that cause kidney stones. If you sweat a lot, be sure to drink even more.
- Limit salt. Eat less sodium. You may want to connect with a dietician for help with planning what foods you eat.
- Lose weight. If youre overweight, try to lose some pounds. Talk to your healthcare provider about an ideal weight.
- Take prescriptions. Your healthcare provider may prescribe some medications that help prevent kidney stones. The type of medication may depend on the type of stones you get.
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