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What Are Kidney Stones And How Are They Treated

How Painful Are Kidney Stones

How common are kidney stones and how can they be treated?

Kidney stones are incredibly painful, with many sufferers claiming that the experience is one they will never forget.

The stones have potential to cause severe pain, and while most pass on their own through the ureter – the tube between the kidney and the bladder – some require to be medically removed with surgery.

People are advised to seek medical help if they experience pain so severe that they can’t sit still or find a comfortable position and/or pain accompanied by nausea and vomiting.

They are also urged to seek advice if they have pain accompanied by fever and chills, blood in their urine and difficulty passing urine.

Extracorporeal Shock Wave Lithotripsy

All shock wave lithotripsy machines deliver shock waves through the skin to the stone in the kidney. Most but not all of the energy from the shock wave is delivered to the stone.

Stone size is the greatest predictor of ESWL success. Generally:

  • stones less than 10 mm in size can be successfully treated
  • for stones 10 to 20 mm in size, additional factors such as stone composition and stone location should be considered
  • stones larger than 20 mm are usually not successfully treated with ESWL.

Stones in the lower third of the kidney can also be problematic because, after fragmentation, the stone fragments may not be cleared from the kidney. Due to gravity, these fragments dont pass out of the kidney as easily as fragments from the middle and upper thirds of the kidney.

Obesity also influences whether ESWL treatment will be successful. The urologist will calculate the skin-to-stone distance to help determine whether this treatment is likely to be effective.

The possible complications of ESWL include:

Symptoms Of Kidney Stones

Many people with kidney stones have no symptoms. However, some people do get symptoms, which may include:

  • a gripping pain in the back usually just below the ribs on one side, radiating around to the front and sometimes towards the groin. The pain may be severe enough to cause nausea and vomiting
  • blood in the urine
  • cloudy or bad smelling urine
  • shivers, sweating and fever if the urine becomes infected
  • small stones, like gravel, passing out in the urine, often caused by uric acid stones
  • an urgent feeling of needing to urinate, due to a stone at the bladder outlet.

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When Should You Go For Treatment

Some kidney stones are asymptomatic. You can move and do your normal daily activities without noticing any discomfort or pain.

You will start getting the symptoms once the kidney stones start to move. They move around the kidney or the bladder. This is the time to ask for a doctors consultation.

Symptoms:

  • Renal colic. It causes severe pain between the ribs and the hip, side of the body, or lower abdomen. The pain can spread to the groin.
  • Severe intermittent pains.
  • The amount of urine is less during each urination.
  • Blood in the urine.

All About Kidney Stones

How are Kidney Stones Diagnosed And Treated?

Its the kidneys job to filter blood and remove extra waste and water, which gets passed as urine. Urine contains many waste chemicals, which can sometimes form crystals that clump together and these clumps are kidney stones. The stones are hard, rock-like crystals of varying sizes and shapes anywhere from as small as a grain of sand to a golf ball.

There are four main types of kidney stones:

  • Calcium stones combined with oxalate or phosphate are the most common.
  • Struvite stones are often horn-shaped and quite large, mostly caused by urine infections.
  • Uric acid stones are often softer than other forms of kidney stones.
  • Cystine stones are rare and hereditary. They look more like crystals than stones.
  • Dehydration is a common cause of kidney stones. Drinking inadequate amounts of water for prolonged periods of time greatly increases your risk. If you live in hot and dry climates, or sweat a lot, you are also at increased risk.

    Another common cause of kidney stones is an imbalance of substances in your urine, i.e. high levels of calcium, oxalate, cystine acid or uric acid. This can happen if you:

    • have an underlying medical condition
    • use certain medications to treat conditions such as kidney disease, cancer or HIV
    • eat foods high in salt .

    While its not common, kidney stones can potentially lead to acute kidney injury or chronic kidney disease. This can happen two ways:

    Some other symptoms of kidney stones include:

    • blood in your urine
    • nausea and vomiting

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    What Does It Feel Like To Have A Kidney Stone

    Everyone experiences kidney stones differently. Typically, kidney stones within the kidney do not cause pain.

    If a stone falls onto the opening where the kidney meets the ureter or passes into the ureter, this can prevent urine from draining out of the kidney. This backing up of urine can lead to back pain just below your ribs. Sometimes the pain can be severe enough to cause nausea and vomiting.

    As a stone moves, the blockage of urine may be relieved and symptoms may improve or go away. The pain may return if the stone begins to cause blockage of urine again. This changing of symptoms is called renal colic.

    Blood in the urine may be a sign of kidney stones. Sometimes the blood isnt visible to the naked eye and must be detected by a urine test.

    If a stone is able to pass down the ureter and close to the bladder, the pain may move to the front of the abdomen, near the pelvis.

    Stones very close to the bladder can cause pain that is felt in the genitals. A stone that reaches the bladder can cause burning with urination or changes in how often or how urgently you need to urinate.

    Signs And Symptoms Of Kidney Stones

    Pain is a classic symptom of kidney stones, says Prakash N. Maniam, MD, a urologist at Oviedo Medical Center in Oviedo, Florida. The pain is usually sharp and felt along the sides of the torso. It may radiate around to the abdomen and into the groin area as the stone moves through the urinary tract system, he says.

    As the stone moves along the tract, it can block the natural flow of urine, which causes the kidney to swell, Dr. Maniam explains. The swelling activates nerves, which sends signals that are interpreted by the brain as an intense visceral pain, he says.

    More than half a million people go to the emergency room because of kidney stones every year.

    In addition to pain, blood in the urine and a burning sensation during urination are other common symptoms of kidney stones, says Maalouf. Sometimes with severe pain, patients develop nausea and vomiting, he adds.

    If stone pain and fever develop, go directly to the ER, advises Timothy F. Lesser, MD, a urologist at Torrance Memorial Medical Center in Torrance, California. Fever is a sign of infection. Notably, a kidney stone with a urinary tract infection may cause and must be treated immediately.

    Other symptoms of a kidney stone can include frequent urination, a strong need to urinate, what looks like gravel in the urine, urine that smells bad, and cloudy urine.

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    What Are The Most Common Types Of Kidney Stones

    The most common type of kidney stone is a calcium oxalate stone. This type happens when calcium and oxalate combine in your urine. It can happen when you have high quantities of oxalate, low amounts of calcium and arent drinking enough fluids.

    Stones caused by uric acid are also fairly common. These come from a natural substance called purine, which is a byproduct of animal proteins .

    What Are Risk Factors You Can Control

    What are kidney stones and how are they treated?

    Diet is a factor in some cases of kidney stones. A dietician can recommend foods to reduce the risk of kidney stones. Higher than recommended amounts of vitamin D, vitamin C, salt, protein, and foods containing high oxalates may increase the risk of stone formation. Eating a low-protein, low-sodium diet with adequate calcium decreases the chance of developing stones. A balanced vegetarian diet that includes dairy might offer your body the best protection against kidney stones.

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    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.

    Risk Factors For Kidney Stones

    The greatest risk factor for kidney stones is making less than 1 liter of urine per day. This is why kidney stones are common in premature infants who have kidney problems. However, kidney stones are most likely to occur in people between the ages of 20 and 50.

    Different factors can increase your risk of developing a stone. In the United States, white people are more likely to have kidney stones than black people.

    Sex also plays a role. More men than women develop kidney stones, according to the National Institute of Diabetes and Digestive and Kidney Diseases .

    A history of kidney stones can increase your risk. So does a family history of kidney stones.

    Other risk factors include:

    In the case of a small kidney stone, you may not have any pain or symptoms as the stone passes through your urinary tract.

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    Kidney Stone Causes Symptoms Treatments & Prevention

    Your kidneys remove waste and fluid from your blood to make urine. Sometimes, when you have too much of certain wastes and not enough fluid in your blood, these wastes can build up and stick together in your kidneys. These clumps of waste are called kidney stones.

    Favorite Kidney Stone Blogs

    Which Kidney Stone Treatment Method is Right for Me ...

    CareBlog is the blog of the Urology Care Foundation, an organization dedicated to supporting urologic research and providing urologic health information to the public. The blog features information on kidney stones, as well as information on general urologic health .

    Want to hear about kidney stones from people whove gone through the experience? Let this website, which was founded by Mike M. Nguyen, MD, MPH, an associate professor of urology at the Keck School of Medicine at the University of Southern California in Los Angeles, be your guide. You can read through essential information from experts, as well as patient accounts and contributor articles that answer questions you may be wondering about, such as: Do vegetarians get kidney stones? and Does drinking a lot of water help a stone pass faster?

    With additional reporting by Lauren Bedosky.

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    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

    History Of Kidney Stones

    The Ancients and Urinary Stones

    Urinary stones have afflicted humans since the dawn of history. The first known stones were discovered in Egyptian mummies. In 1901, the English Archeologist E. Smith found a bladder stone from a 4500-5000 year old mummy in El Amrah, Egypt. Treatments for stones were mentioned in ancient Egyptian medical writings from 1500 B.C.

    Surgery to treat stones was first described in the 8th century B.C. by an ancient Indian surgeon named Sushruta. He provided detailed information on urinary stones, urinary anatomy, and surgery for stones in his writings, compiled as the Sushruta Samhita.

    Hippocrates

    In the 4th century B.C., Hippocrates specifically mentioned stones in his Hipprocratic Oath, which is historically taken by newly trained physicians.

    In the oath, this is the line that refers to stones:I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

    Most historians feel that this statement was a warning that physicians should refrain from participating in surgery, which was considered dangerous. At that time, and for many subsequent centuries, surgery was instead performed by barber/surgeons who were not considered physicians.

    Urinary Stones in the Middle Ages

    Modern Urinary Stone Surgery

    Modern stone surgery was developed in the last half century. In 1976, the first percutaneous stone surgery was performed by Fernstrom and Johansson.

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    What If Kidney Stones Are Left Untreated

    The main function of the kidneys is the removal of wastes and excess fluids from the body in the form of urine. Sometimes, when there are too much waste material and not enough fluids, these waste products can crystallize and get collected inside the kidneys. Over time, these crystals can transform into hard stone-like lumps, known as kidney stones.

    Kidney stones are very common. It is estimated that 1 in every 20 people around the world develops kidney stones at some point in time in their life. Although people of any age can have kidney stones, kidney stones are more common in the age group of 30-60 years.

    What Will Happen After I Leave The Hospital

    How Do You Treat Kidney Stones?

    After treatment, you will have blood in your urine and possibly abdominal pain or aching for several days. Other people experience a severe cramping pain as shattered stone fragments make their way out of the body. Oral pain medication and drinking lots of water will help relieve symptoms.

    Sometimes, the stone is not completely broken up, or big pieces remain and additional treatments may be needed.

    Rarely, more serious problems occur, such as bleeding near the kidney that might require a blood transfusion, damage to the area around the stone, or pieces of the stone blocking the flow of urine.

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    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.

    • What food may cause a kidney stone?
    • Should l take vitamin and mineral supplements?
    • What beverages are good choices for me?

    How Large Kidney Stones Are Treated

    There are several methods for breaking down or removing large kidney stones, whether minimally invasive or surgically.

    Lithotripsy

    Extracorporeal shock wave lithotripsy is an outpatient procedure that requires either light sedation or anesthesia and usually lasts between 45 minutes and an hour. A lithotripsy uses shock waves that work to break up the kidney stone into much smaller pieces that will pass more easily through the urinary tract.

    A ureteroscopy is generally an outpatient procedure that is performed under anesthesia. During this procedure, the surgeon will insert an ureteroscope through the urethra and bladder to the ureters. The ureteroscope is a thin, lighted, tube-like instrument with an eyepiece that allows the urologist to see the kidney stone. Once located, it can be retrieved or broken into smaller pieces using laser energy.

    Sometimes, the surgeon will choose to place a stent in the ureter . If placed, it will be removed in approximately four to 10 days during an office visit.

    Surgical removal

    Depending on its size and location, the urologist may choose to perform a Percutaneous Nephrolithotomy . This procedure requires general anesthesia, and may require an overnight stay in the hospital.

    Contact Urology Austin to schedule an appointment at the location nearest you.

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