When it comes to urinary tract problems, kidney stones are among the most common.
Over 300,000 patients go to the emergency room in the United States every year for diagnosis and treatment related to kidney stones.
- Kidney stones can cause intense pain, making them impossible for patients to ignore.
- It is important to seek prompt treatment to alleviate the immense discomfort and reduce the risk of potential complications.
There is not a single cause of kidney stones, but a number of risk factors that might contribute. When there are high levels of crystal-forming substances in the urine that the fluid is able to dilute, a stone can develop. These substances include oxalate, calcium, and uric acid. The risk factors for this condition can include:
- Personal or family history
- A diet high in sodium, protein or salt
- Digestive system surgeries or diseases
- Being obese
- Certain medical condition, such as renal tubular acidosis, hyperparathyroidism, or cystinuria
Some patients might not experience symptoms right away. However, once the stone gets into the ureter, which is a tube connecting the bladder and kidneys, symptoms are common. They might include:
- Flank pain
- Fluctuating pain
- Urine that is red, brown, or pink
- Vomiting and nausea
- Frequent urination
- Radiating pain to the groin and lower abdomen
- Painful urination
- Foul-smelling urine and cloudy urine
- Feeling the need to urinate often
- Small amounts of urine
- Chills and fever with infection
Doctors will begin treatment by putting patients through a complete diagnostic process. This not only confirms kidney stones, but it ensures that the doctor chooses an appropriate treatment for the patient. Diagnosis generally involves a patient history, physical examination, 24-hour urine collection, blood testing for uric acid and calcium levels, and imaging tests, such as a CT scan, to visualize the urinary tract and kidneys.
When symptoms are minimal due to the stones being small, doctors might recommend that patients drink approximately two to three quarts of water per day to help flush the urinary system. Pain relievers might be suggested for minor discomfort, such as ibuprofen, naproxen sodium, or acetaminophen. Doctors might also prescribe an alpha blocker medication. These may help stones to pass easier due to relaxing the ureter muscles.
When stones are larger, more involved medical intervention might be needed. Extracorporeal shock wave lithotripsy is a procedure that works to break up stones through the use of sound waves. Patients might receive light anesthesia or sedation for this procedure since it may cause moderate pain. Bleeding and bruising are possible side effects.
A scope might be used to either break up a stone or remove it completely if it is small enough. The tube is lighted and referred to as a ureteroscope. Patients might be given anesthesia for this procedure to alleviate potential discomfort. If stones are especially large, percutaneous nephrolithotomy might be recommended. This is a surgical procedure that involves a small incision in the back to access the affected kidney and remove the stone.