Dont Get Derailed by Kidney Stones
Posted 8/18/2017 by UHBlog
Ask anyone who has ever suffered with kidney stones how much they hurt. In fact, women have rated kidney stones as more painful than labor and childbirth, says urologist Ehud Gnessin, MD.
While men may not be able to relate to that comparison, the point is sharply made – especially since men, on average, are at a slightly higher risk for developing kidney stones than women, who may benefit from their bodies’ production of the hormone estrogen.
“Simply having kidney stones themselves is not usually painful,” Dr. Gnessin says. “In fact, about 15 percent of the population will develop stones. What causes the intense pain, however, is when large stones, which form inside the kidneys, pass out of the kidneys and obstruct the path of urine to the bladder.”
Most kidney stones are tiny compared to the two- to three-millimeter-wide ureters that carry urine from the kidneys to the bladder.
“Small kidney stones pass out of your body without you ever knowing they were there,” Dr. Gnessin says. “Larger stones, however, create the risk of obstructing the ureters. Kidney stone obstructions can cause long-term damage even when the damage is not immediate.”
And they can be extremely painful.
“Kidney stone obstructions can cause a sharp, severe cramping pain that usually starts in the lower flank of the back and moves toward the lower abdomen or groin,” Dr. Gnessin says.
Other symptoms may include nausea and vomiting, fever and chills, blood in your urine and difficulty passing urine.
What exactly are kidney stones? According to Dr. Gnessin, kidney stones form from minerals or salts in a person’s urine.
“When the urine contains high levels of these salts and minerals, stones are formed,” he says. “Stones start small, but they can grow larger in size.”
The two most common types of kidney stones are calcium stones, which account for 75 to 80 percent of all kidney stones, and uric acid stones, which make up about 5 to 10 percent of the total.
More specifically, about 60 percent of calcium stones are called calcium oxalate stones. Ironically, Dr. Gnessin says, foods that are rich in calcium oxalate include some that are considered to be among the healthiest to eat: spinach, beets, okra, black tea, soy and chocolate.
“Calcium stones are exacerbated by salt, which draws calcium into a person’s urine,” he says. “You can reduce your risk of calcium stones by lowering the salt in your diet.”
Uric acid stones are made from the byproducts of animal proteins.
“If you eat a lot of animal protein, you have a higher risk of developing a uric acid kidney stone,” Dr. Gnessin says. “They tend to form in acidy urine, which is associated with obesity and diabetes.”
The best way to reduce your risk of developing kidney stones is to drink a lot of liquids, Dr. Gnessin says.
“Taking a lot of liquids will dilute the urine and help to prevent kidney stones,” he says. “The best drinks are citrus juices, like lemonade, orange juice and grapefruit juice.”
Losing weight is another way to reduce your risk of developing kidney stones.
“We have medications for people with recurrent stones to prevent them from forming,” Dr. Gnessin says. “People who produce a large volume of stones also may be helped with medication.”
Stones that exceed the diameter of the ureters have a good chance of getting stuck, and it can take time for them to work their way out of your body. That’s why pain medication is important. By the way, men needn’t worry about damaging their most cherished organ – the urethra is typically seven to nine millimeters in diameter – more than three times wider than your ureters.
“If you have symptoms of an obstruction, you may need to go to the emergency room,” Dr. Gnessin says. “They will give you pain medication and will do a CT scan to confirm that you have a kidney stone. They can also test for a kidney infection. From the ER, you may be admitted to the hospital or sent home to wait it out.”
For stubborn stones that don’t pass on their own, several interventions are available to break them up for easier passage. Interventions range from medication to dilate the ureters to the use of lasers and audio shockwaves to bust up the stone.
“A few decades ago some of this technology to remove kidney stones didn’t exist,” Dr. Gnessin says. “Technology is advancing very quickly.”
After the pain of a kidney stone obstruction subsides, Dr. Gnessin suggests a scan to be sure the stone is gone.
“The body gets used to everything,” he says. “Sometimes the stone is still there after the pain is gone, but the body gets used to the new situation.”
Ehud Gnessin, MD, is a urologist at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Gnessin or any other doctor online.