Kidney Stones

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Kidney stones usually form in the centre of the kidney, where urine collects before flowing into the ureter, the tube that leads to the bladder. They are created when certain substances in urine—including calcium and uric acid—crystallize and the crystals clump together. Small stones are able to pass out of the body in the urine and often go completely unnoticed. But larger stones irritate and stretch the ureter as they move toward the bladder, causing excruciating pain and blocking the flow of urine. Sometimes a stone can be as large as a golf ball, in which case it remains lodged in the kidney, creating a more serious condition.

Kidney stones are more common in young and middle-aged adults than in the elderly, and they are much more prevalent in men than in women. People living in hot climates are sometimes prone to kidney stones because their bodies become dehydrated, concentrating the minerals in their urine.

If you've had a kidney stone once, you are likely to get one again. So it's important to determine as best you can what caused the stone to form and to take steps to prevent a recurrence.

Causes

Why some people form kidney stones and others do not is not always clear. In 90 per cent of cases, the cause remains unknown. The condition appears to run in families, and people who suffer from gout, inflammatory bowel diseases, and chronic urinary tract infections also seem to be predisposed to it. Medical evidence suggests that drinking too few fluids can cause stones, as can prolonged bed rest.

Chronic use of antacids containing calcium has also been linked to kidney stones. Dietary deficiencies, especially of Bitamin Be and magnesium, and excessive amounts of Vitamin D also may be factors in the formation of stones. An imbalance of these vitamins and minerals can increase the amount of calcium oxalate in the urine; when the levels become too high, the calcium oxalate does not dissolve, and crystals may begin to form. In genetically susceptible people, eating foods that are themselves rich in calcium oxalate-such as chocolate, grapes, spinach, and strawberries-may also promote stones.

Diagnostic and Test Procedures

Because many of the symptoms of kidney stones also indicate other disorders, a doctor must confirm the presence of a stone. An evaluation will include blood and urine tests and probably an intravenous pyelogram (IVP), a special X-ray technique for viewing the kidneys, or an ultrasound scan to reveal the stone's size and location.

Treatment

Conventional Medicine

Because 90 per cent of kidney stones pass out of the body on their own within three to six weeks, your doctor will most likely at first prescribe only plenty of water-at least 3 qt a day-and a pain medication, such as aspirin or acetaminophen with oxycodone. A hot-water bottle can also help ease the inevitable discomfort. Yomay be asked to urinate through a strainer so the stone can be recovered and analyzed. Once the stone's composition is known, your doctor can prescribe drugs or suggest dietary changes to prevent your developing another one. The vast majority of kidney stones consist of calcium oxalate, so doctors often prescribe a thiazide diuretic to prevent recurrences.

If complications develop, such as an infection or total blockage of the ureter, the stone must be surgically removed. Depending on its size, type, and location, the stone is taken out either by conventional surgery or, more commonly, with a thin telescopic instrument called an endoscope. The surgeon passes the endoscope through the urethra into the bladder or ureter and then either pulls the stone out or bombards it with sound waves or laser beams, breaking it up into tiny pieces. If the stone is lodged in the kidney, the instrument is inserted into the kidney through an incision in the patient's side. A new method, known as extracorporeal shock wave lithotripsy, uses high-energy shock waves to break up kidney stones without surgery.

Alternative Choices

In addition to the Chinese herbal remedy below, you might want to consider acupuncture or homeopathy; both therapies may help ease pain, and acupuncture may help facilitate the passing of a stone. In all cases, advocates stress that you should be monitored by a health professional.

Chinese Herbs

Practitioners of Chinese medicine sometimes prescribe star fruit (Averrhoa carambola) to help relieve pain and promote urination. Place three fresh star fruit in a pan with 2 tsp of honey. Boil the fruit until it is soft, then eat the fruit and its juice. Repeat every day until the stone has passed and yoare pain free.

Prevention

You can do many things, mainly dietary, to prevent a recurrence of stones. But always check with your doctor first; the stone's composition will determine which preventive steps you should take.

Drink at least 3 qt of liquid every day, more in hot weather.

Avoid or eat sparingly foods containing calcium oxalate (chocolate, celery, grapes, bell peppers, beans, strawberries, spinach, asparagus, beets, black tea). You may need to limit your overall intake of calcium, but do not do so without your doctor's advice.

Take daily supplements of Vitamin Be (10 mg) and magnesium (300 mg), both of which reduce the formation of oxalates.

Avoid Foods That Raise Uric Acid Levels:

anchovies, sardines, organ meats, brewer's yeast.
Reduce uric acid by eating a low-protein diet.
Avoid antacids; they are often high in calcium.
Reduce salt to no more than 3 grams per day; higher amounts may raise the level of calcium oxalate in your urine.
Avoid vitamin D supplements, which can increase calcium oxalate levels.

Symptoms

waves of sharp pain that start in the side and move toward the groin.
nausea and vomiting
profuse sweating
blood in urine.

Sometimes an infection is Present and May Cause These Additional Symptoms :

fever and chills.
frequent urge to urinate.
painful or excruciating urination.
cloudy or foul-smelling urine.

Call Your Doctor If:

you think you have kidney stones; a medical evaluation is essential to diagnosis and treatment.

you are experiencing waves of sharp pain in your side or abdomen; such pain may also be a sign of another serious condition, such as gallstones, pelvic inflammatory disease, or an intestinal obstruction. Seek immediate medical help.

you are experiencing any pain or difficulty with urination; this could also be a sign of a bladder infection, a sexually transmitted disease, a vaginal problem such as vaginitis, an enlargement of the prostate, or a bladder or prostate tumor, see your doctor without delay.

you notice blood in your urine; it may also indicate kidney disease, a bladder or kidney disease, a bladder or kidney tumor, or a urinary or prostate infection. See your doctor without delay.

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