1. A kidney stone, what is it?
Kidney stones are crystal-like formations which are found in the ureters, bladder and kidneys which forms the body’s urinary tract. Kidney stones can be the cause of infections, severe pain as well as serious kidney damage. The size of the stones can vary from tiny 1-mm to substantially large stones which can fill up the kidney completely.
- Can I possibly have kidney stones?
Patients, who experience their first occurrence of kidney stones, can have such extreme pain that they can become immobilized. Individuals can experience such a kidney stone incidence the first time as both frightening and confusing, due to the severe amount of pain, if they don’t have the knowledge to know what was happening to them. This type of pain is in general described as one of the worst kinds ever experienced. It will be necessary to get to the emergency room to get diagnosed and received treatment. X-rays, generally a CT scan will be used to determine whether it is a stone.
- Which symptoms are experienced when a kidney stone passes?
Pain caused by a stone is frequently described as agonizing and excruciating. According to women it is even worst than childbirth. It is possible that the pain may start in the flank or upper back and then spread to the groin and abdomen. Changing your position won’t relieve this pain. Discomfort and pain caused by kidney stones are predominantly due to an obstruction in the flow of urine passing down the ureter, a narrow tube which link up the kidney and the bladder.
It is assumed that the intensified pressure extending the ureter and kidney is the cause of this pain. For this reason stone pain comes in ripples with a weaker and stronger intensity. This is due to the ureter (drainage tube) which is occasionally obstructed as the stone tries making its way through. With the passing of the stone downwards in the tube, the experienced pain moves down the patient’s body. Further symptoms regularly during a kidney stone incidence include nausea, blood present in urine (hematuria), the urge for urination and vomiting. As soon as the stone passes through the ureter into the bladder, patients usually experience a relief as the pressure and obstruction is relieved. However, it can take stones days or weeks to pass through.
- Is pain experienced by the passing of all types of kidney stones?
According to the majority of doctors kidney stones just cause pain when they block the ureter as it makes its way downwards to the bladder. Stones which do not obstruct like the type positioned in the calyxes of the kidney, are usually considered not painful. This is an explanation why certain patients may have exceptionally large stones which fill up the complete kidney, but experience a minimum amount or no pain.
Notwithstanding, it can occur that certain non-blocking kidney stones may cause pain due to either an obstruction of the collecting tubules (tiny tubular formations) within the kidney or maybe due to other unknown reasons.
Recently an article published in a medical journal upholds this view and suggested that treating papillary, tiny non-obstructing kidney stones may alleviate pain.
Testimonials from a lot of kidney stone sufferers, which include an urologist, who had a kidney stone-history suggested that certain non-blocking stones can also cause pain.
- What are the causes for developing kidney stones?
One from every ten people will be affected by kidney stones in their lifetime. Actually, this is a more common condition than realized by the majority of people. Several factors determine if an individual will develop this condition. Whilst some factors can be within an individual’s control, others unfortunately are not.
- Gender: Men have a much greater risk developing stones
- Age: Generally kidney stones occur between the age-brackets of 20 – 50
- Race: White people are at the highest risk in comparison with other races
- Seasonal climate: During summer the development of kidney stones are more common. This is because the high temperatures in summer time can cause dehydration. However, it is also possible due to increased exposure to the sun, which may result in higher calcium-concentrations as a result of the production of Vitamin D.
- Geography: People residing in dry and hot environments have an elevated risk. The people who live in the United State’s South-Eastern regions are more likely to develop stones, in comparison with the other states.
- Body weight: Individuals who are overweight or with a high BMI (body mass index) are likely to have a higher rate that stones are formed.
- Occupation: Individuals, who work outdoors, are more likely to develop stones because of exposure to the sun as well as dehydration.
- Infections: Chronic infections of the urinary tract can result in the forming of stones, linked to infection, also called struvite stones.
- Genetics & Medical disorders:People who have a history of certain disorders, like renal tubular-acidosis or medullary sponge kidney have a higher risk to form stones. Individuals who have a family history linked to kidney stones have an elevated risk of developing stones.
- What can I drink for dissolving the kidney stone?
Patients frequently ask if they can drink something for dissolving kidney stones. Regrettably, calcium phosphate and calcium oxalate account for approximately 80-percent of all types of kidney stones, which medication can’t dissolve.
However, patients suffering from uric acid kidney stones, accounting for 5-7 percent of kidney stones, potassium citrate medication can be administered successfully for dissolving such stones, assisting the stones to pass through and for the prevention of re-development.
Patients suffering from cystine stones, which are less common at just 1-3 percent will be benefiting too from the intake of water and potassium to assist in dissolving the stones. People who suffer from cystine kidney stones can in addition receive treatment with amercaptopropionly-glycine or D-penicillamine which can both bind and help dissolving the kidney stones.
Patients who have infection (struvite) kidney stones were treated in the past with a solution of hemiacidrin irrigation. During this procedure the substance was directly dripped on these stones by using a tube which was directly put into the affected kidney. However, due to the potential hazardous side effects of this drug as well as the difficulty administering it, it became uncommon.
- How are kidney stones formed?
Elements called soluble salts are responsible for the forming of kidney stones. The calcium oxalate kind of kidney stone is the most prevalent one. However, it can be either in crystalline or a dissolved form.
During a precipitation process stones will start to form to become solid crystals. Sodium chloride which is present in seawater is such a soluble salt. However, urine contains such chemical substances which in combination, form soluble salts. Normally these chemicals prevail in urine in a liquid form.
It is rather surprising that such salts’ concentration in the urine are generally much higher in comparison with that which could prevail when it is liquefied in water. Due to inhibitors present in the urine, such an uncommon situation can happen, which make it even more troublesome for the soluble salts to develop into crystals.
Certain inhibitors of kidney stones are elements, like citrate which comes from our nutrition, whilst proteins are further inhibitors which are produced by the body to assist to prevent the forming of kidney stones. Nephrocalcin and Tamm-Horsfall are examples of protein-inhibitors produced by the body.
Initially kidney stones are formed in the nucleation-process. This occurs when the elements which encourage the salt-crystals to develop, are more than the elements inhibiting the development of salt-crystals. With time such crystals will grow larger and can lead to a noticeable kidney stone, should favourable circumstances remain in the urine for the development of stones.
More significant elements which have and effect on the forming of stones:
- The quantity of urine an individual produce. Lower volumes result in a higher concentrate of urine and when slowed drainage is present, it becomes easier for such crystals to combine and gather. When a binding site is present the forming of stones also becomes easier as such a site can act as a base for the development of the crystals. A normal considered binding site may be the small-scale crystallisation which can form in the tissue of the kidneys, termed Randall’s plaques.
- Were the stones formed because I drank or ate something?
It was found that in the majority of patients, diet was not the key reason why stones were initially formed. Other significant factors play a part to determine if an individual is more likely to the forming of kidney stones. An individual in who stones don’t develop can follow the same eating plan as an individual in who stones do develop, but never would get stones.
However, it is true that your diet may play a principal role when it comes to preventing any kidney stones to develop in the future. The three predominant dietary features for the majority of individuals prone to stone-forming to decrease their risk include: reducing sodium intake, increasing their total intake of fluids and to curb a high intake of protein, especially meat.
Some foods which were considered to promote the developing of kidney stones include: coffee, tea, cola and consumption of calcium. However, according to research it was actually suggested that calcium intake, tea and coffee can assist in decreasing the risk of developing stones, whilst cola did not play an important role. (“Curhan et al, Am J of Epidemiology, 1996”).
- Is it possible to prevent a further kidney stone?
The answer is yes, as there are a lot of efficient methods to assist in the prevention of a further kidney stone. Basic changes to your eating regimen can decrease your chances to develop a further stone by 50%, whilst sophisticated medical treatment may decrease it even more. While such changes are not warranty that further stones won’t be formed, it can lessen the risk or a further painful kidney stone occurrence.
- What are the treatment choices available for a kidney stone?
To allow a kidney stone to pass through by itself is an option, by taking medication to assist the passing of a stone, or surgery for the removal of a stone.
- Which signs will point out an emergency situation with the occurrence of a stone?
If you suspect that a kidney stone is passing, the indicating signs that you need prompt medical care include:
- Continuous vomiting & nausea
- Having a fever, higher than 101.5-degrees F.
- Further symptoms of an infection of the urinary tract with a kidney stone, include: cloudy urine, urine with a foul smell and a burning sensation when urinating
- Excruciating pain
- Some medical disorders may complicate a kidney stone’s passing which could be hazardous. These disorders include: diabetic patients, individuals with just one kidney or who have a reduced kidney-function
- How long is the period during which a kidney stone is formed?
Kidney stones can develop in a period of less than 3-months. Research was conducted regarding soldiers who were deployed in Iraq and Kuwait, a desert environment. It became clear from this research that a kidney stone with symptoms could develop in 93-days. (“Evans and Costabile, J Urol, 2005”).
- My Risk to form a further kidney stone?
There is a 40-50 percent chance to develop a further stone, during a period of 5-years. Furthermore, one from every two individuals who developed kidney stones may experience the development of a further stone during the future 5-years. However, with simple changes to your eating plan, the recurrence of stones can be reduced.
- Will I be successful in passing my kidney stone?
The location, the period you tried passing the stone and of course the size, will be the determining factors.
- Which type of surgery should I opt for?
Three common types of surgeries exist to remove kidney stones. The three options are: percutaneous nephrolithotripsy, an uretersoscopy and shock-wave lithotripsy.
- A ureteral stent: what is it?
A stent consists of a hollow, flexible tube which is positioned inside the ureter. The stent allows the flowing of urine around the kidney stone as well as assisting with the healing of the ureter after an operation. As stents are positioned inside the body it can’t be seen from the outside. Stents can have following effects: cause pain, a feeling to urinate frequently and minor bleeding.
- How is such a ureteral stent inserted?
A medical professional will normally insert ureteral stents in a surgical room. First a pliable wire is put upwards into the ureter, after which the stent is slipped over this wire. However, the stent remains in tact after which the wire will be removed. Loops on the stent’s two ends will keep it positioned until it must be exchanged or removed.
- How is the stent taken out?
There are two methods to remove a ureteral stent. Usually your healthcare professional will take out the stent by inserting a small camera through the urethra into your bladder. By using an instrument the doctor will grip the stent and remove it. During the second process a string is connected to a stent which can be seen where it exits the urethra. Then the string is simply pulled out.
- After the removal of the stent why am I experiencing pain?
After the stent is removed, a patient can expect a moderate feeling of discomfort. Furthermore, certain individuals experience extreme pain for some hours following the removal of the stent. It is considered that this may be because of the swelling of the ureter, or spasms and an impermanent obstruction which can develop after the stent’s removal. However, according to a new study, researchers suggested that this may be happening in 50 percent of patients. During this study one dosage which contains an anti-inflammatory and non-steroidal drug was administered, 15 minutes prior to the stent’s removal. This proved to be very efficient to prevent the extreme pain to develop.