- If you have a kidney stone, you may
already know how painful it can be. Most kidney stones pass out of the
body without help from a doctor. But sometimes a stone will not just go
away. It may even get larger. Your doctor can help.
You should call a doctor when you have
-extreme pain in your back or side that will not go away
-blood in your urine
-fever and chills
-vomiting
-urine that smells bad or looks cloudy
-a burning feeling when you urinate
What do my kidneys do?
Your kidneys are bean-shaped organs, each about the size of your fist.
They are located near the middle of your back, just below the rib cage.
The kidneys are sophisticated trash collectors. Every day, your kidneys
process about 200 quarts of blood to sift out about 2 quarts of waste
products and extra water. The waste and extra water become urine, which
flows to your bladder through tubes called ureters (YOOR-uh-turs). Your
bladder (BLAD-ur) stores urine until you go to the bathroom.
The wastes in your blood come from the normal breakdown of active muscle
and from the food you eat. Your body uses the food for energy and
self-repair. After your body has taken what it needs from the food, waste
is sent to the blood. If your kidneys did not remove these wastes, the
wastes would build up in the blood and damage your body.
In addition to removing wastes, your kidneys help control blood pressure.
They also help to make red blood cells and keep your bones strong.
What is a kidney stone?
A kidney stone is a solid piece of material that forms in the kidney out
of substances in the urine.
A stone may stay in the kidney or break loose and travel down the urinary
tract. A small stone may pass all the way out of the body without causing
too much pain.
A larger stone may get stuck in a ureter, the bladder, or the urethra. A
problem stone can block the flow of urine and cause great pain.
Are all kidney stones alike?
No. There are four major types of kidney stones.
-The most common type of stone contains calcium (KAL-see-um).
Calcium is a normal part of a healthy diet.
Calcium that is not used by the bones and muscles goes to the kidneys. In
most people, the kidneys flush out the extra calcium with the rest of the
urine. People who have calcium stones keep the calcium in their kidneys.
The calcium that stays behind joins with other waste products to form a
stone.
-A struvite (STROO-vite) stone may form after an infection in the
urinary system. These stones contain the mineral magnesium (mag-NEE-zee-um)
and the waste product ammonia (uh-MOH-nyuh).
-A uric (YOOR-ik) acid stone may form when there is too much acid
in the urine. If you tend to form uric acid stones, you may need to cut
back on the amount of meat you eat.
-Cystine (SIS-teen) stones are rare. Cystine is one of the building
blocks that make up muscles, nerves, and other parts of the body. Cystine
can build up in the urine to form a stone. The disease that causes cystine
stones runs in families.
What do kidney stones look like?
Kidney stones may be as small as a grain of sand or as large as a pearl.
Some stones are even as big as golf balls. Stones may be smooth or jagged.
They are usually yellow or brown.
What can my doctor do about a problem stone?
If you have a stone that will not pass by itself, your doctor may need to
take steps to get rid of it. In the past, the only way to remove a problem
stone was through surgery.
Now, doctors have new ways to remove problem stones. The following
sections describe a few of these methods.
Shock Waves
Your doctor can use a machine to send shock waves directly to the kidney
stone. The shock waves break a large stone into small stones that will
pass through your urinary system with your urine.
Two types of shock wave machines exist. With one machine, you sit
in a tub of water. With the other type of machine, you lie on a table.
The full name for this method is extracorporeal (EKS-truh-kor-POR-ee-ul)
shockwave lithotripsy (LITH-oh-TRIP-see). Doctors often call it
ESWL for short. Lithotripsy is a Greek word that means stone crushing.
Tunnel Surgery
In this method, the doctor makes a small cut into the patient's back and
makes a narrow tunnel through the skin to the stone inside the kidney.
With a special instrument that goes through the tunnel, the doctor can
find the stone and remove it. The technical name for this method is
percutaneous (PER-kyoo-TAY-nee-us) nephrolithotomy (NEF-roh-lih-THAH-tuh-mee).
Ureteroscope
A ureteroscope (yoo-REE-ter-uh-scope) looks like a long wire. The
doctor inserts it into the patient's urethra, passes it up through the
bladder, and directs it to the ureter where the stone is located. The
ureteroscope has a camera that allows the doctor to see the stone. A cage
is used to catch the stone and pull it out, or the doctor may destroy it
with a device inserted through the ureteroscope.
How will my doctor find out what kind of stone I
have?
The best way for your doctor to find out what kind of stone you have is to
test the stone itself. If you know that you are passing a stone, try to
catch it in a strainer.
Your doctor may ask for a urine sample or take blood to find out what is
causing your stones. You may need to collect your urine for a 24-hour
period. These tests will help your doctor find ways for you to avoid
stones in the future.
Why do I need to know the kind of stone?
The therapy your doctor gives you depends on the type of stone you have.
For example, a medicine that helps prevent calcium stones will not work if
you have a struvite stone. The diet changes that help prevent uric acid
stones may have no effect on calcium stones. Therefore, careful analysis
of the stone will help guide your treatment.
What can I do to avoid more stones?
Drink more water. Try to drink 12 full glasses of water a day.
Drinking lots of water helps to flush away the substances that form stones
in the kidneys.
You can also drink ginger ale, lemon-lime sodas, and fruit juices. But
water is best. Limit your coffee, tea, and cola to one or two cups a day
because the caffeine may cause you to lose fluid too quickly.
Your doctor may ask you to eat more of some foods and to cut back on other
foods. For example, if you have a uric acid stone, your doctor may
ask you to eat less meat, because meat breaks down to make uric acid.
The doctor may give you medicines to prevent calcium and uric acid stones.
Points to Remember
-Most stones will pass out of the body without a
doctor's help.
-See your doctor if you have severe pain in your back or side that will
not go away.
-See your doctor if you have blood in your urine (urine will appear pink).
-Drink lots of water to prevent more kidney stones from forming.
-When you pass a stone, try to catch it in a strainer to show to your
doctor.
-Talk to your doctor about how to avoid more stones.
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