Health – A weekly column prepared by Dr. Balwant Singh’s Hospital

By Dr Anirban Banerjee MS,MRCS (Consultant surgeon)
                                        
What is a kidney stone?

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, one on each side of the spine. 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 wastes and extra water become urine, which flows to your bladder through tubes called ureters.
If you have a kidney stone, you may already know how painful it can be! A kidney stone is a solid piece of material that forms in a 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. A problem stone can block the flow of urine and cause great pain.
Kidney stones have nothing to do with gall bladder stones (cholelithiasis).

Are all kidney stones alike?

No. Doctors have found four major types of kidney stones.
The most common type of stone contains calcium. The most common combination is called calcium oxalate.
A struvite stone may form after an infection in the urinary system. These stones contain the mineral magnesium and the waste product ammonia.
A uric acid stone may form when the urine contains too much acid. If you tend to form uric acid stones, you may need to cut down on the amount of meat you eat.
Cystine stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body.

Who gets stones?

Stones are more common in men. The first stone usually occurs in the 20 to 40 year age group. Once someone has had a stone, he/she is more likely to have a subsequent stone in the future. Stones are also more common in hot/tropical regions where either excessive sweating or a lack of good water intake leads to stone precipitation in the urinary tract.

What are the symptoms of stones?

 Pain in the shaded areas may be caused by a kidney stone.
The pain (colic) is usually severe, and consists of a gripping feeling, coming and going in waves. The movement of the stone causes irritation, and/or blockage to the drainage of urine. Typically the pain of a kidney is felt in the back and side of the abdomen, and may travel down to the groin (‘loin to groin’ pain).Blood in the urine may be seen when passing urine. Other symptoms include an urge to pass urine, or discomfort passing urine. Nausea and vomiting may also occur. Fever may suggest infection in the urine.

When should I call a doctor?
Your doctor can help. You should call a doctor if you have any of the following signs:
*  extreme pain in your back or side that does 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 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.

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.

Tunnel surgery
In tunnel surgery, the doctor makes a small cut on 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 nephrolithotomy.

What can I do to avoid more stones?

Drink plenty of 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 the best. Limit your coffee, tea, and cola to 1 or 2 cups a day because the caffeine may cause you to lose fluids too quickly.
Your doctor may ask you to eat more of some foods and to cut out 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.
If you are prone to forming calcium oxalate stones, you may need to limit foods that are high in oxalate. These foods include rhubarb, spinach, beets, soybean, crackers, peanuts, chocolate, black Indian tea, sweet potatoes.

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.

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