Kidney stones; types, symptoms, and latest treatment methods
Kidney stones are solid lumps that are small in size, consisting of crystals resulting from the deposition of minerals and salts present in the urine in proportions higher than their typical rates.
Urine naturally contains dissolved salts and minerals, in certain proportions, when the levels of these minerals and salts in the urine rise, they become prone to the formation of kidney stones.
Kidney stones are mainly formed in the kidneys, but they can form in any other organ of the urinary system, such as the ureter, bladder, and urethra.
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| Kidney stones - Symptoms, causes, types, and treatment - Nutritionist |
Kidney stones begin to be small in size, but over time they may grow as salts and minerals are deposited on them.
Urine naturally contains dissolved salts and minerals, in certain proportions, when the levels of these minerals and salts in the urine rise, they become prone to the formation of kidney stones.
Kidney stones are solid lumps that are small in size, consisting of crystals resulting from the deposition of minerals and salts present in the urine in proportions higher than their normal rates.
Kidney stones are mainly formed in the kidneys, but they can form in any other organ of the urinary system, such as the ureter, bladder, and urethra.
Kidney stones begin to be small in size, but over time they may grow as salts and minerals are deposited on them.
What are the types of kidney stones?
Not all kidney stones are made up of the same crystals, there are different types of stones based on the components they crystal:
Calcium stones
Calcium stones are the most common, often consisting of calcium oxalate, a chemical found in many types of food, such as potato chips, nuts, chocolate, and some types of vegetables and fruits.
Calcium stones may sometimes consist of calcium phosphate.
Uric acid stones
This type of stone is more common in men, occurring when the urine is too acidic. Uric acid stones can occur in gout patients or patients undergoing chemotherapy.
Strophyte stones
This type of stone is often found in women who suffer from urinary tract infections. These stones can be large in size and lead to blockages in the urinary system.
Because these stones occur as a result of infections, treating infections will reduce the risk of them occurring.
cysteine stones
Cysteine stones are rare, occurring in patients with the hereditary disease Cystinostria.
What are the causes of kidney stones?
Usually, there is no single, obvious cause of kidney stone formation, but a combination of factors may raise the risk of kidney stones. Men are more likely to develop kidney stones than women.
Mainly kidney stones are related to one or more of these causes:
Low urine volume
One of the main factors that raise your risk of kidney stones is the low volume of urine excreted from your body, caused by dehydration.
This happens if you don't drink enough water and fluids a day or live in a relatively hot climate that makes you lose more fluids by sweating, without compensating for it by drinking more water, it may also happen due to intense exercise.
When the volume of urine decreases, this makes it more concentrated and dark-colored, which means less ability for urine to dissolve salts.
Drinking more water helps reduce the concentration of salts in your urine, reducing the likelihood of your kidney stones forming.
Diet
Your diet can affect the likelihood that your kidney stones will form. If you follow a diet rich in animal protein, sodium, and/or sugar, this will increase the likelihood that your kidney stones will form.
Diseases and surgeries of the intestines
If you have inflammatory bowel disease or chronic diarrhea, it may cause changes in your digestion, affecting the absorption of calcium and water, which will raise the risk of kidney stones forming.
If you've previously had stomach reduction surgery or other bowel surgery, it will also affect the formation of stones.
obesity
If you are obese, whether, with a high BMI, significant weight gain, or a high waist circumference, this increases the likelihood of kidney stones forming.
Taking certain medications
Take certain medications such as diuretics, and acids containing calcium.
Certain medical conditions
Polycystic kidney disease or any other form of polycystic kidney
Renal cannabin acidosis, cysteine uria, or hyperthyroidism
A health problem that causes high levels of cysteine, oxalate, uric acid, or calcium in the urine
A health problem that leads to swelling or irritation of your intestines or joints
Family history
If you've had kidney stones in the past or currently have kidney stones; this makes you more likely to form more stones, now and in the future, and if someone in your family has had kidney stones before, this raises your body's predisposition to form stones in your kidneys.
Symptoms of kidney stones
It is common that kidney stones to cause severe pain to the patient. Usually, kidney stones may not cause any symptoms and remain hidden until the stones begin to move inside your kidney or cross out of it to the ureter; the channel that connects the kidney to the bladder, where the stones may settle in the ureter, causing the symptoms and pains that indicate them.
Usually, kidney stone pain begins suddenly and then comes and goes in waves. Pain can come and go with the body's attempts to get rid of kidney stones.
Common symptoms caused by kidney stones include:
Sharp pains and cramps in the back and loin under the ribs of the rib cage, usually moving towards the lower abdomen and thighs area
• Feeling of urgency to urinate
• Heartburn during urination
• Urinate more often than usual
• urinate a small amount of urine at a time (decrease in the amount of urine excreted from the body)
• Dark or red color of urine as a result of blood coming down with urine (sometimes urine contains only a few red blood cells, which can be seen with the naked eye)
• Turbid urine with an unpleasant odor due to the presence of pus or white blood cells in it
• Vomiting and nausea
• Fever and tremors in case of inflammation
• Pain in the front of the penis in men
When do you talk to your doctor?
You should make an appointment with your doctor if you experience any symptoms or signs that call for anxiety and discomfort including:
• Feeling severe pain in various situations whether you are standing, sitting, or lying on your back
• The appearance of blood in the urine
• Feeling pain and not being able to pass urine easily
• Abdominal pain accompanied by vomiting and nausea
Be sure to tell your doctor in detail about all your symptoms including when they started, their persistence and frequency during the day as well as the list of medications, vitamins, and supplements you're taking.
Diagnosis of kidney stones
Based on a physical exam, health assessment, and knowledge of your medical and family history, your doctor may ask you to perform certain laboratory tests and tests that include:
• Blood test to check the level of calcium, phosphorus, uric acid, urea nitrogen in the blood (BUN), and blood creatinine level. These tests help assess your kidney function and enable your doctor to find out why your stones form.
• Urine test to detect the presence of bacteria or white blood cells, which are often a sign of a urinary tract infection, or the presence of any deposits that caused the formation of stones in you. This test requires you to collect a urine sample over the course of a day or two.
• Examining the kidney stones that you pass through the urine, your doctor may provide you with special equipment to collect kidney stones that you excrete during urination, this helps your doctor to find out exactly why these stones form and thus determine the best treatment method for you.
• Imaging procedures; are performed by several methods to enable the doctor to look inside your body and see what is happening, in emergency cases usually resort to the procedure of computed tomography which is based on the use of a special type of X-ray to give three-dimensional CT images of the internal organs of the body taken from several angles so that they are more detailed and clear compared to the use of regular X-rays which enables the doctor to determine the location and size of stones formed even small ones. Computed tomography (CT) scan can be used with or without injection of dye into a vein.
• Ultrasound, this technique is characterized by providing high-resolution images, used to detect complications associated with kidney stones including a change in the size or shape of the kidneys. Ultrasound is recommended when diagnosing pregnant women and children under 16 years of age
Treatment of kidney stones
There are many options available for treating kidney stones, ranging from following healthy lifestyles to taking drug treatments and possibly even resorting to surgery; it depends on the size, location, type of stones formed, the severity of the pain, and the symptoms you experience, and the accompanying complications such as a blockage in the urinary tract or a malfunction of the kidneys.
First, wait
Most often, the kidney stones formed are small enough for your body alone to get rid of them by passing them through the urine. Your doctor may suggest that you wait for 2-4 weeks with monitoring to get rid of kidney stones naturally.
During this period you should drink plenty of water up to about 3 liters a day, and make it a daily habit that continues until after recovery to prevent the formation of new stones.
The use of drugs to treat kidney stones
Sometimes, despite the small size of the stones you have, their presence can cause you pain, discomfort, and more. Depending on your situation, your doctor may recommend any of the following:
• Pain relievers such as NSAIDs and paracetamol
Drugs belonging to the group of calcium channel blockers (such as Nifedipine) and the group of alpha-blockers (such as Tamsulosin) that relax the muscles lining the ureter and thus expand the stream through it (a cylindrical tube that transports urine from the kidney to the bladder) making it easier for stones to pass through and exit on their own.
• Cases of acute pain necessitate the need to go to the emergency to take opioid analgesics and anti-inflammatories intravenously and follow up the case with the doctor closely.
Surgery to treat kidney stones
Sometimes kidney stones formed are stuck inside the urinary tract or are too large to be allowed to exit normally on their own, such stones may cause a blockage in the urinary tract so that you lose your ability or have extreme difficulty while urinating, or recurrence of a urinary tract infection forcing your doctor to resort to using one of the minimally invasive surgical procedures to break up and remove kidney stones.
There are three basic techniques approved for kidney stone surgery, the benefits and risks of each of which are explained by your doctor, to reach the choice of the most appropriate method for your condition taking into account several factors including the size and location of your stones, the medications you take, and your health status and preferences.
The use of shock sound waves to treat kidney stones
From simple treatment options made on an outpatient basis without any surgical procedure, you can go home the same day and resume your daily activities within two to three days.
It takes about 45-60 minutes and may need mild anesthesia. It is considered an effective way to break up small and medium-sized kidney stones (kidney stones less than 20 mm in size).
This technique directs high-energy sound waves from outside the body through the skin towards large stones to break them up during a collision into smaller pieces that are discarded by passing them through the urine.
Shock sound waves are one of the widely used and safe options for breaking up kidney stones, however, they may be accompanied by some side effects such as blood in the urine, especially in the first days after treatment.
If you have large or hard kidney stones, especially those made up of calcium oxalate, calcium phosphate, or cysteine, shock sound waves aren't effective options for you.
Use advanced laparoscopic and laser surgery to treat kidney stones
Ureteroscopy is one of the latest therapeutic procedures used to break up kidney stones, performed under general anesthesia without causing any wound or incision in the body, and you can leave on the same day.
During endoscopic ureteroscopy, a thin tube at the end of which a small camera is attached to the end of which the doctor can detect the internal organs and see and locate the stones, the doctor inserts it through the urethra to the bladder and then into the ureter to get rid of kidney stones and ureters.
If the stones are of small size, the doctor collects them inside a medical basket and removes them, but if they are too large to be disposed of as a single piece, the doctor here resorts to directing laser beams or shock waves toward these stones to break them up so that they can easily exit through the urine.
Depending on the course of the operation and your health situation, you may need to temporarily place a small and hard plastic stent for 4-10 days inside the ureter in a way that allows urine to pass through the ureter until the ureter returns to normal.
Percutaneous kidney stone extraction
It is the best option for removing large kidney stones especially after other treatment options fail to break them up, they are done under general anesthesia, and require a stay in the hospital for a day or two until they fully recover.
During the procedure, the doctor makes a small incision in the back to pass the endoscope through it into the kidney where the stones are located to see the stones and determine their exact location and then direct a source of energy such as a laser or ultrasound to break up the stones into small parts that are suctioned directly through an external tube.