Kidney Stones: The Ultimate Beginner’s Guide
Did you know that kidney stones and ureteral stones affect 1 in 11 people and account for 1% of hospital admissions in the United States? Over the last several decades, more and more individuals in the United States alone are beginning to suffer through the experience of passing kidney stones. These stones originate from the kidney but pass into one of the tubes that connect the kidneys to the bladder. Sometimes, they can continue to grow in the ureter.
Pain from kidney stones is one of the most uncomfortable events a person can experience. For some, it can feel even worse than childbirth, gunshot wounds, burns, and painful results from other unfortunate incidents. In extreme cases, kidney stones can cause kidney failure, especially if an underlying disease exists in the patient, such as diabetes.
What are Kidney Stones?
In short, kidney stones are literal stones that result from a mineral buildup in the kidneys. There are multiple ways that these stones can form and can take anywhere from months to years. These stones end up traveling with the urine in the kidneys down the ureters (the tubes that connect your kidneys to your bladder). Along the way, they can get stuck and not only cause pressure and pain in the ureter but can also lead to immense kidney pressure and eventually excruciating pain.
Formation of stones
Kidney stones are formed by two processes. The first is an ample amount of substances in the urine that promote the creation of kidney stones, such as calcium, oxalate, and uric acid. High amounts of these substances can stem from a number of initial causes, such as what one eats or drinks to genetic history. Following the oversaturation of these compounds in the urine, they can clump together, forming a stone. This is very similar to how an oyster’s pearl can form from a grain of sand. In the end, the resulting stone can cause symptoms when it becomes too big for the ureter and end up stuck in it as they pass into the bladder.
The second phenomenon, apparently responsible for calcium oxalate stones, is the formation of Randall plaque, stone material that settles on microscopic calcium phosphate crystals. In addition, Calcium oxalate also binds to calcium phosphate, resulting in a mass of Randall plaque, calcium phosphate, and calcium oxalate that becomes the kidney stone.
Signs and symptoms
There are many ways to tell if you have a kidney stone. One of the most noticeable signs and/ or symptoms is the sudden feeling of severe pain, either around the genital area or in the lower back. Eventually, this pain could travel to your bladder and will linger there. Unfortunately, this pathway of pain tends to be common in individuals with kidney stones. But, it is also possible to not feel the kidney stone attempt to pass, as it may be small enough to not cause any significant pain. About 50% of patients tend to experience nausea and vomiting. However, a slow-growing stone may produce milder symptoms.
The location of the stone characterizes the symptoms in the following way:
- Stones blocking the ureter as it enters the lower pelvis results in mild to severe flank pain, a throbbing pain over the bladder, and bowel pain
- Objects in the ureter produce a sudden, severe, sharp pain in the flank and lower abdomen with shooting pain to the testicles or vulva. Nausea is fairly common when the kidney stone is in the ureter
- Upper ureteral stones lead to pain more concentrated towards the flank and lower back.
- Mid Ureteral stones lead to pain around the abdomen
- Lower ureteral stones send pain impulses to the groin or testicle (men) or labia majora (women)
- Stones that pass to the bladder may cause no symptoms and can possibly result in urinary retention.
Kidney Stone Treatment
In rare scenarios, the pain and positioning of the kidney stone can become so severe, surgery may be needed. However, if there is ever significant pain, it is always advised to go to your physician or the hospital, as they can provide you with the necessary treatment to increase hydration, correctly provide antibiotics, prevent scarring, and reduce the risk of permanent kidney damage.
Most small stones in patients with small collections of fluid around the kidneys can be treated with acetaminophen (Tylenol).
More serious cases with relentless pain may require drainage with a ureteral stent (percutaneous nephrostomy). IV hydration is preferred to aid in removing the stones. Urine should be strained to collect the stones so that they can be sent for analysis.
In order to treat the larger and more persistent kidney stones, lithotripsy –or shock wave therapy– can be done to break up the stone into smaller sections so that they can pass on their own.
Stents can be placed in the ureter via the bladder to open up the blockage and protect both the kidneys and ureter. During this procedure, the kidney stone can occasionally be taken out by the surgeon.
Are Catheters part of Kidney Stone Treatment?
Catheters are used in a variety of ways for kidney stone treatment. They measure the amount of urine and can be attached to a bag for collection. When there are symptoms of retention, they can relieve that pressure.
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Kidney Stone Pain Relief
Pain relief is usually in the form of acetaminophen (Tylenol), ibuprofen (Advil), naproxen (Aleve), and meperidine. In addition, opioid narcotics might become necessary short-term. Oral narcotics such as codeine, oxycodone, hydrocodone –usually in combination with acetaminophen– and drugs for nausea. Heating pads may also provide some comfort when dealing with kidney stones.
However, pain levels and needs vary per person, so consult with your medical professional before purchasing or using any medication.
How to Prevent Stones
Of course, no one wants to have kidney stones. So, it is very important that if you just got over passing kidney stones, you take preventative measures to ensure you have a very low risk of getting them in the future. That means limiting protein from meats, salt, taking medicines that slow down or entirely prevent stone formation and drinking plenty of fluids (water).
Patients with high urine calcium levels and recurrent calcium stones may benefit from thiazide diuretics (drugs and/ or medicines that make you urinate more). This allows for the kidneys to flush out clusters of calcium, preventing the creation of those bigger stones. Another widely recommended medicine is Potassium citrate, another chemical compound that de-acidifies your urine, damaging the environment in which kidney stones form. Potassium citrate can also be used with those thiazides or by itself. However, please consult your physician or medical specialist, as they will know how to cater to your needs via these medicines.
A majority of the ingredients needed for kidney stones to form are most commonly found in food. In order to aid patients in their kidney stone battles, doctors and physicians have agreed on the following food tips:
Make sure you…
- Eat more calcium-rich foods
- Ease up on the sodium (Provide some examples)
- Processed foods, like chips and crackers
- Canned soup
- Canned vegetables
- Avoid Oxalate-rich foods, such as:
- Sweet Potatoes
- Also, reduce meat consumption, so watch how much you eat of:
More importantly, please make sure to always consult your medical professional when it comes to treating, diagnosing, or preventing kidney stones!
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