Getting Past the Pain of Kidney Stones

Besides being painful, what are kidney stones?

They’re solid formations of minerals and salts that crystalize in urine in the kidneys when concentrations are high. They can be as tiny as a grain of sand to pebble-size and larger. 

Some stay in the kidneys. Others migrate down the ureter, the tube between the kidney and bladder. Small stones move into the bladder and out of the body with no to minimal symptoms.

Larger stones, though, can become lodged in the ureter, block urine flow and cause sharp pain in your back, side, lower abdomen or groin, and blood in your urine. Symptoms may also include burning urination, nausea and fever. Fever could indicate a serious infection, a reason to call to your doctor immediately.

Causes of Kidney Stones

You can lower your risk of developing kidney stones by drinking plenty of water to dilute the concentration of minerals in your urine. Recommended water consumption is about two liters — or half a gallon — of water (which works out to about eight 8-ounce glasses) a day. 

Other kidney stone risk factors include:

  • Too little or too much exercise
  • Being overweight
  • Eating food with excess salt, sugar and animal protein
  • Weight loss surgery
  • Kidney infections. Infections increase the risk of kidney stones by slowing urine flow or changing the acid balance of urine.
  • Family history of kidney stones

Types of Kidney Stones

Kidney stones vary in composition depending on the type of minerals in the urine:

  • Calcium forms about 80 percent of kidney stones – mostly calcium oxalate and in some cases, calcium phosphate.
  • Uric acid crystals tend to form stones in acidic urine. The following contribute to acidic urine: excess weight, chronic diarrhea, type 2 diabetes, gout and diets high in protein and low in fruits and vegetables.
  • Struvite (magnesium ammonia phosphate) forms in alkaline urine, often related to chronic urinary tract infections.
  • Cystine is an amino acid that forms stones when in high concentration, due to a rare inherited condition. This is the rarest form of kidney stones.
You can lower your risk of developing kidney stones by drinking plenty of water to dilute the concentration of minerals in your urine.

Diagnosis of Kidney Stones

Kidney Stones small

When you have kidney stone symptoms, as described above, see your health care provider. She’ll check your medical history, give you a physical examination and order imaging tests, as needed. 

Your doctor may ask you to drink extra fluid to help flush out the stone. By straining your urine, you may be able to save a piece of the stone. This will enable your doctor to determine the type of stone, what may be causing the condition and how to reduce your risk of recurring stones.

If your stone doesn’t flush out, your doctor may order a high-resolution CT scan from the kidneys to the bladder or a KUB (kidney-ureter-bladder) X-ray to determine the size and location of the stone.

Another test used for some patients is the intravenous pyelogram (lVP), an X-ray of the urinary tract taken after injecting dye.

Treatment of Kidney Stones

For smaller kidney stones, pain relievers may be the only treatment needed.

Larger stones that block urine flow or cause infection may require surgery, such as:  

  • Shock-wave lithotripsy, a noninvasive procedure using high-energy sound waves to break stones into fragments that pass out in the urine
  • Ureteroscopy, in which an endoscope is inserted through the ureter to retrieve or break up the stone 
  • Percutaneous nephrolithotomy or nephrolithotripsy, used for very large (2 centimeters or larger) or irregularly shaped stones. For both procedures, a small incision is made in the back to provide access for a nephroscope, a miniature fiberoptic camera, and other small instruments. Your doctor then either removes the stone (nephrolithotomy) or breaks up and removes the stone (nephrolithotripsy). 

For ongoing prevention of recurring kidney stones, your doctor may prescribe increasing fluid intake, changing diet, controlling weight and taking medication.

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