symptom of kidney stones ; How kidney stones are diagnosed

Doctors can usually diagnose kidney stones by asking about symptoms and doing a physical examination. Further tests may be done to confirm the diagnosis, reveal the size, location and identity of the stone. These include:

Blood tests: to identify excess amounts of certain chemicals related to the formation of stones.
Urine analysis: patients are asked to give a urine sample for testing, and may be asked to collect urine over 24 hours to analyse it for the chemicals that cause stones.
X-rays: stones that contain calcium show up white on the X-ray.
Intravenous urogram (IVU): an X-ray involving an injection of special dye to show up stones that can't be seen with X-rays alone.
Ultrasound scan: this uses high frequency sound waves to produce an image of the internal organs.
Treatment
Treatment depends on the type and cause of the stone. Most stones can be treated without surgery. Drinking lots of water (two and a half to three litres per day) and staying physically active are often enough to move a stone out of the body.

However, if there is infection, blockage, or a risk of kidney damage, a stone should always be removed. Any infection is treated with antibiotics first. Stones that are too large to pass can be removed in several ways:

Extracorporeal shock wave lithotripsy (ESWL)
This is the most common method and does not involve a surgical operation. Instead, shock waves are used to break the stones into crystals small enough to be passed in the urine. The shock waves do not hurt, although some people feel some discomfort at the time of the procedure and shortly afterwards.

Ureteroscopic stone removal
If a stone is lodged in the ureter, a flexible narrow instrument called a cystoscope can be passed up through the urethra and bladder. The stone is "caught" and removed, or shattered into tiny pieces with a shock wave. This procedure is usually done under a general anaesthetic.

Percutaneous nephrolithotomy (PCNL)
If ESWL doesn't work or a stone is particularly large, it may be surgically removed under general anaesthetic. The surgeon makes a small cut in the back and uses a telescopic instrument called a nephroscope to pull the stone out or break it up with shock waves.

Parathyroid surgery
A small benign tumour in the parathyroid glands (in the neck) can be the cause of the chemical imbalance resulting in kidney stones. If this is the case, the tumour can be surgically removed.

Prevention
Knowing the exact cause and type of stone enables people to make changes that can help prevent further stones.

To help prevent any type of stone, fluid intake should be two to three litres per day - water is best.

People who get calcium stones should cut down on foods that have high levels of calcium (dairy products and leafy green vegetables), and oxalate (chocolate, tea, rhubarb, cooked spinach and asparagus). It's important to discuss dietary changes with a doctor – not everyone finds them helpful.

People who get uric acid stones should eat less meat, fish and poultry. Also to help prevent uric acid stones, medicine may be prescribed to control the level of uric acid in the urine.

People who get struvite or "infection" stones need to keep the urine free of bacteria that can cause infection. This may mean taking long-term antibiotics.

National Kidney Federation (UK)
0845 6010209