symptom of kidney stones

Kidney stones are made of salts and minerals in the urine that stick together to form small solid pebbles that form in the urinary tract that can cause one of the most painful ailments. In many cases they are very small and can pass out of the body without any problems. But if a stone even small when becomes lodged and blocks the flow of urine, excruciating pain may result and prompt medical intervention may be needed.

Occasionally crystals form in urine from various salts that build up on the inner surfaces of the kidney. Eventually these crystals become large enough to form stones in the kidney, a condition called nephrolithiasis. Not all kidney stones cause symptoms. They're often discovered when you have X-rays for an unrelated condition or when you seek medical care for other problems, such as blood in your urine or recurring urinary tract infections. The pain becomes agonizing only when a kidney stone breaks loose and begins to work its way down from your kidneys to your bladder through the connecting tube.

The symptoms of kidney stones may vary from person to person. Some may feel a dull pain in the lower back or pelvis. This is a clear indication that something is wrong with your body. The level of pain may go up and down, or it may be continuous. Kidney stones often make walking and bending a difficult task. Along with this, if one feels that his or her energy level has come down drastically, that could be another symptom of kidney stones.

This disorder is popularly known as development of kidney stones called Urinary calculi thats build up over a period of time. These kidney stones are made up of the minerals and the crystallized salts that remain in the urine. Urinary calculi disorder of the kidney is usually accompanied by acute pain. The pain is caused when the kidney stones block the paths carrying urine. Generally, these stones move within and out of the urinary tract on their own accord. But if they fail to pass out of the body, they are surgically removed. At times, the urologists use the ultrasound technique called lithotripsy to break down the kidney stones non-surgically.



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Shock wave treatment for kidney stone

Nowadays, extracorporeal shockwave lithotripsy (ESWL) is a frequent alternative to surgery of kidney stone. With this method, shockwaves are generated which travel through the body until they reach the denser material of the stones, where they shatter them into fine particles, which can easily be flushed out of the body

Shock wave treatment can be used directly on a stone lodged in the ureter. This is achieved by passing a small fiberoptic device, called a ureterscope, through the urethra and bladder and on into the ureter. Here the stone can either be shattered at close quarters by a shock wave or captured and pulled down the ureter and out of the body.

At times when the stone is too large, neither of these methods are selected and the surgical removal option is used. This involves a tiny incision in the back, creating access to the kidney. Then, using a device called a nephroscope, the surgeon locates the stone and grabs the stone with the device. This allows removal of the stone. If the stone is particularly large shock, wave treatment might also be used.

symptom of kidney stones : Prevention in patients with recurrent stones

Prevention in patients with recurrent stones — A more extensive work-up is generally recommended for a patient who has had previous stones or who is at higher risk for developing recurrent stones. Special tests are performed to analyze the patient's urine and blood and determine whether underlying conditions may be contributing to stone formation. Examples include too much calcium or uric acid in the urine, which can be treated with specific medications to reduce the incidence of new stone formation.

Radiologic studies, such as an IVP or CT scan, may be performed to search for asymptomatic stones within the urinary tract and to identify anatomic abnormalities that may be responsible for stone formation. If available, the most recently passed stone is analyzed. Depending on its make-up, medications may be prescribed to inhibit the formation of similar stones. Patients with recurrent stones may also benefit from increasing their fluid intake.

SUMMARY

A kidney stone can form when certain substances in the urine are at higher than normal concentrations, although stones can form even if these substance are at normal levels. The substances can form crystals that become attached to the kidney and gradually increase in size, forming a stone.
Eventually, the stone may move down the urinary tract to be expelled in the urine. Or, the stone can remain in the urinary tract, blocking the urine flow and causing pain.
Certain diseases and habits can affect a person's risk for developing kidney stones. These include a past history or family history of kidney stones, certain dietary habits, underlying medical problems, certain medications, and dehydration.
Symptoms are usually produced as a stone passes from the kidney into the ureter (the tube that leads from the kidney to the bladder) (show figure 1). The most common symptom of a kidney stone is pain; other symptoms can include hematuria (blood in the urine), passing small stones, nausea, vomiting, pain with urination, and an urgent feeling of needing to urinate. Many patients with kidney stones have no symptoms.
Clinical symptoms, laboratory tests, and diagnostic x-ray studies may all be used to diagnose a kidney stone. Computed tomography (CT scan) is the preferred diagnostic test in most patients.
During initial treatment, many patients require only pain medication and fluids until the stone is passed. Nonsteroidal antiinflammatory drugs (NSAIDs) may be prescribed for pain and can be given in a vein (IV) or by pill. If the pain is not controlled by an NSAID, narcotics may be prescribed.
Patients are typically instructed to increase their fluid intake to three liters per day, including drinking at night. A severe restriction of dietary calcium intake is not recommended, even for patients with a calcium-based stone, because this can increase the risk of kidney stones.
Stones smaller than 5 mm, and even those up to 7 mm, often pass on their own. Larger stones rarely pass on their own and usually require treatment. Several procedures are available for the treatment, including shockwave lithotripsy, percutaneous nephrolithotomy, and ureterorenoscopy.
Patients with stones that cause no symptoms may be treated, depending upon the size and location of the stone. Other factors are considered in deciding whether to treat the stone, including the patient's occupation (eg, pilot, frequent traveler, local worker) and access to a treatment facility.
Further testing is recommended for patients who have recurrent kidney stones or who is at higher risk for developing recurrent stones. Tests may be performed to determine whether underlying medical conditions are causing the stone formation. Medications may be prescribed to prevent the formation of stones. Patients with recurrent stones also benefit from increasing their fluid intake.

by Glenn M Preminger, MD

symptom of kidney stones :History of kidney stones

History of kidney stones — Patients who have had a kidney stone in the past have the highest risk of future stone formation. It has been estimated that for patients who have already had a stone, the likelihood of forming a second stone is about 15 percent at one year, 35 to 40 percent at 5 years, and 80 percent at 10 years.

Family history of stones — Persons with a positive family history of kidney stones are at increased risk for developing stones.

Dietary habits — Regular ingestion of certain liquids appears to affect a person's risk for stone formation. An increased risk of stones may be associated with the intake of tea in some individuals. On the other hand, drinking large amounts of water or other liquids, particularly citrus juices, has been linked to a reduced risk of stone formation.

Interestingly, higher levels of dietary calcium intake appear to protect against rather than cause stone formation in some patients. This finding is probably due to the combination of some of the extra dietary calcium with dietary oxalate, which prevents oxalate entry into the blood and subsequent excretion. Stone formation falls because the percentage fall in oxalate excretion exceeds the percentage rise in calcium excretion. These changes are reversed and stone formation may be enhanced with a low calcium diet. However, certain individuals who absorb excess calcium from their diet may experience additional stone problems with a high calcium intake. The best recommendation regarding dietary calcium is to avoid excessive intake of calcium, as well as low calcium diets.

Other medical conditions — Some medical conditions can increase an individual's risk for stone formation, including conditions that increase the absorption of oxalate from the gastrointestinal tract (like short bowel syndrome, chronic diarrhea, or previous bowel surgery), or conditions that increase the chance of urinary tract infection. Patients with hyperparathyroidism and sarcoidosis may have an increased risk for stone formation. The risk of kidney stones is also increased in patients with gout or with high concentrations of uric acid in their urine. Cystinuria (increased levels of cystine in the urine) is caused by an inherited condition and increases the risk of cystine stone formation.

by Glenn M Preminger, MD