There’s no denying how the urinary system consists of the kidneys, ureters, bladder, and urethra. The kidneys are two bean-shaped organs positioned under the ribs toward the center of the back. They also keep a stable balance of salts and other compounds in the bloodstream.
Narrow tubes called ureters carry urine from the kidneys to the bladder, an oval-shaped room in the lower abdomen. They inhale together when urine is emptied through the urethra to outside the body.
These inhibitors do not appear to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass from the body in the urine without being noticed. These compounds are part of a person’s normal diet and make up important areas of the body, such as muscles and bones.
This sort of rock is called a struvite or infection stone. A bit less common is that the uric acid stone.
By way of instance, a ureteral stone (or ureterolithiasis) is a kidney stone found in the ureter. To keep things simple, but the term”kidney stones” is used throughout this fact sheet.
Gallstones and kidney stones aren’t related. They form in different regions of the body. For those who have a gallstone, you’re not always more likely to develop kidney stones.
For unknown reasons, the amount of individuals in the United States with kidney stones has been increasing over the past 30 years. The incidence of stone-forming disease rose from 3.8 percent in the late 1970s to 5.2 percent in the late 1980s and early 1990s. Stones occur more often in men. The incidence of kidney stones rises dramatically as men enter their 40s and continues to grow in their 70s. For women, the incidence of kidney stones peaks in their 50s. When a person gets more than one stone, others are likely to grow. Doctors don’t always know what causes a stone to form. While certain foods may promote stone formation in people who are susceptible, scientists don’t believe that eating any specific food causes stones to form in people that are not susceptible. A individual who has a family history of kidney stones may be more likely to develop stones. Furthermore, over 70 percent of people with a rare hereditary disease called renal tubular acidosis develop kidney stones.
In cystinuria, a lot of the amino acid cystine, which doesn’t dissolve in urine, is voided. This may cause the formation of stones made of cystine. In patients with hyperoxaluria, the body produces a lot of the salt oxalate. Whenever there is more oxalate than can be dissolved in the urine, the crystals settle out and form stones.
It’s the cause of stones in over half of patients. Calcium is absorbed from food in surplus and is lost into the urine. This high degree of calcium in the urine causes crystals of calcium oxalate or calcium phosphate to form in the kidneys or urinary tract.
Other causes of kidney stones are hyperuricosuria that’s a disorder of uric acid metabolism, gout, excess intake of vitamin D, urinary tract infections, and blockage of the urinary tract. Certain diuretics that are generally referred to as water pills or calcium-based antacids may increase the risk of forming kidney stones by increasing the amount of calcium in the urine.
Calcium oxalate stones may also form in people who have a chronic inflammation of the gut or who have had an intestinal bypass surgery, or ostomy surgery. As stated earlier, struvite stones may form in people who have had a urinary tract infection. Individuals who take the protease inhibitor indinavir, a drug used to treat HIV infection, are at risk of developing kidney stones.
Kidney stones often don’t cause any symptoms. Typically, the first symptom of a kidney stone is extreme pain, which occurs when a stone acutely blocks the flow of urine. Typically, a person feels a sharp, cramping pain in the back and side in the region of the kidney or in the lower abdomen. If the stone is too large to pass easily, pain continues as the muscles in the walls of the tiny ureter try to squeeze the stone along into the bladder. As the stone moves down the ureter closer to the bladder, you may feel the need to urinate more frequently or feel a burning sensation during urination.
In cases like this, you should contact a physician immediately.
Sometimes”silent” stones-those which don’t cause symptoms-are discovered on x rays taken during a general health exam. If they’re small, these stones would likely pass from the body unnoticed.
More frequently, kidney stones are found on an x ray or sonogram taken on somebody who complains of blood in the urine or sudden pain.
The health care provider may choose to scan the urinary system with a special test called a CT (computed tomography) scan or an IVP (intravenous pyelogram). The outcomes of all of these tests help determine the appropriate treatment.
Fortunately, surgery isn’t usually needed. Frequently, you can stay home during this process, drinking fluids and taking pain medication as necessary. (You can catch it in a cup or tea strainer used only for this function.)
If you have had more than one kidney stone, you’re going to form another; so prevention is extremely important. To prevent stones from forming, your physician must determine their origin. They will order laboratory tests, including blood and urine tests. If a stone has been removed, or if you’ve passed a stone and saved it, the laboratory should analyze it since its makeup assists in planning treatment.
You could be asked to collect your urine for 24 hours after a stone has passed or been eliminated. Your doctor will use this information to find out the origin of the stone. Another 24-hour urine collection may be required to ascertain whether the prescribed treatment is working.
A simple and most important lifestyle change to prevent stones is to drink more liquids-water is greatest. If you have a tendency to form stones, then you should try to drink enough fluids throughout the day to produce at least two quarts of urine in each 24-hour period.
Individuals who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, such as dairy products, may help prevent calcium stones. Taking calcium in pill form, however, could increase the risk of developing stones.
You might be advised to avoid food with added vitamin D and certain types of antacids that have a calcium base. In case you have very acidic urine, you might want to eat less meat, fish, and poultry.
To prevent cystine stones, you should drink enough water every day to dilute the concentration of cystine that flows into the urine, which might be difficult. More than a gallon of water may be required every 24 hours, and a third of this has to be drunk during the night.
Individuals prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods if their urine Includes an excess of oxalate:
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People shouldn’t give up or avoid eating these foods without even speaking to their physician first. Generally, these foods can be eaten in limited quantities.
These drugs control the amount of acid or alkali in the urine, key elements in crystal formation. The drug allopurinol may also be helpful in some instances of hyperuricosuria.
Doctors usually try to control hypercalciuria, and therefore prevent calcium stones, by prescribing certain diuretics, such as hydrochlorothiazide. These drugs reduce the amount of calcium released by the kidneys into the urine by favoring calcium retention in bone. They function best when sodium intake is reduced.
Very rarely, patients with hypercalciuria can be given the medication sodium cellulose phosphate, which binds calcium in the intestines and prevents it from leaking into the urine.
If cystine stones can’t be controlled by drinking more fluids, your physician may prescribe drugs like Thiola and Cuprimine, which help decrease the amount of cystine in the urine. For struvite stones which have been completely removed, the first line of prevention is to keep the urine free of bacteria that could cause infection. Your urine will be tested regularly to make certain that no bacteria are found.
If struvite stones can’t be removed, your physician may prescribe a medication called acetohydroxamic acid (AHA). AHA is used with long-term antibiotic medication to prevent the infection that leads to stone growth.
People with hyperparathyroidism sometimes develop calcium stones. Treatment in these cases is usually surgery to remove the parathyroid glands (located in the neck). Generally, just one of these glands is enlarged. Removing the glands cures the patient’s difficulty with hyperparathyroidism and with kidney stones also.
Surgery should be reserved as an option for cases where other approaches have failed. Surgery may be needed to remove a kidney stone in it:
Doesn’t pass after a reasonable time period and causes constant pain
is too big to pass by itself or is caught in a challenging place
blocks the flow of urine
causes ongoing urinary tract infection
damages kidney tissue or causes constant bleeding
Has grown larger (as seen on followup x ray studies).
Until 20 years ago, surgery was necessary to remove a stone. It was quite painful and required a recovery period of 4 to 6 weeks. Today, treatment for these stones is greatly improved, and several choices do not require major surgery.
Extracorporeal Shockwave Lithotripsy
Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for treating kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into sand-like particles and are easily passed through the urinary tract in the urine.
Typically, ESWL can be done on an outpatient basis. Recovery time is short, and most people can resume normal activities in a day or two.
Complications may occur with ESWL. Most patients have blood in their urine for a couple of days after treatment. Bruising and minor discomfort in the back or abdomen from the shock waves are also typical. To decrease the possibility of complications, doctors usually tell patients to avoid taking aspirin and other medications that affect blood clotting for several weeks before treatment.
Another complication may occur if the shattered rock particles cause discomfort as they pass through the urinary tract. Sometimes, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone isn’t completely shattered with a single treatment, and other treatments may be required. ESWL isn’t ideal for very large stones.
Sometimes a procedure called percutaneous nephrolithotomy is suggested to remove a rock. This therapy can be used when the stone is quite large or in a place that doesn’t allow effective use of ESWL.
1 benefit of percutaneous nephrolithotomy over ESWL is that the surgeon removes the stone fragments rather than relying on their natural passage from the kidney.
Ureteroscopic Stone Removal
Even though some kidney stones at the ureters can be treated with ESWL, ureteroscopy may be required for mid- and – lower-ureter stones. No incision is made in this process. Instead, the surgeon passes a tiny fibrotic tool called an ureteroscope through the urethra and bladder into the ureter. The surgeon then locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a kind of shock wave. A small tube or stent may be left in the ureter for a few days to help the lining of the ureter heal. Before fiber optics produced ureteroscopy potential, doctors used a similar”blind basket” extraction technique. But this outdated technique shouldn’t be used because it might damage the ureters.
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Prevention Points to Keep in Mind
When you’ve got a family history of stones or have had more than 1 stone, you’re going to create more stones.
A excellent first step to thwart the creation of any sort of stone is to drink loads of liquids-water is greatest.
If you’re at risk for developing stones, your physician may perform certain blood and urine tests to ascertain which variables can best be changed to decrease that risk.
Some of us will need medicines to prevent stones from forming.
Individuals with chronic urinary tract infections and stones will frequently want the stone removed if the physician determines that the disease results from the rock’s existence.
In light of the above it’s evident that a physician has a burdened duty to serve the patients on humanitarian grounds. A physician needs a patient and as such the patients require support of the physician who’s found considerate in addition to dutiful personality. In the aforementioned difficulties and complicacy, the physicians have to be responsibility so as to look after the patients.