KIDNEY STONES: Diagnosis, Treatment, Prevention
The ability to urinate without pain is a blessing taken for granted; that is, until you can’t.
In some people, the kidney has a tendency to accumulate crystals that form what we call “stones” or, in medicalese, “nephrolithiasis” or “renal calculi”. Many kidney stones are as small as grains of sand; some are bigger, but any size can cause excruciating pain known as “renal colic” and, sometimes, blood in the urine. Your chances of experiencing a kidney stone is about 1 in 20 over your lifetime.
Once formed in the kidney, stones usually don’t cause symptoms until they begin to move down the tubes (called the ureters) which connect the kidneys to the bladder. When this happens, the stones, if big enough, can block the flow of urine. This may cause swelling of the affected kidney as well as significant pain. Kidney stones as small as grains of sand may have no problem passing through the ureter to the bladder, but then cause pain as they attempt to pass through the tube that goes from the bladder to the outside (also known as the “urethra”). Ouch.
Renal colic pain often comes in waves. These waves can last from 20 to 60 minutes, and may include nausea and vomiting and an urgent need to urinate. Your urine may have a foul odor, and be red or brown in color due to the presence of blood.
Although the symptoms of kidney stones are pretty uniform, there are actually several different types:
Calcium stones: Calcium stones are the most common. Calcium combines with other substances, such as oxalate, phosphate, or carbonate to form a stone. They occur more often in men than in women, and usually in those 20 to 40 years old.
Cysteine stones: These form in people who have an excess of a substance called cysteine in the urine, a condition that tends to run in families.
Struvite stones: This variety is mostly found in women and can grow quite large; they can cause blockages at any point in the urinary tract. Although not an infection in itself, a history of frequent and chronic infections is a risk factor.
Uric acid stones: More common in men than in women, these stones are associated with conditions such as gouty arthritis, something we’ve talked about before.
To diagnose a kidney stone, look for pain that starts suddenly and comes and goes. Pain is commonly felt on the side of your back (also known as your “flank”). Lightly pounding on the right and left flank at the level of the lowest rib will cause significant pain in patients with kidney stones causing inflammation, as well as kidney infections. As the stone moves, so will the pain; the discomfort will travel down to lower the abdomen and could settle in the groin or even the urethral area.
You can tell the difference between a kidney stone and a kidney infection by whether there is a fever associated with the pain. Most kidney infections present with a fever as well as flank pain, I guess it’s possible to have a fever with a kidney stone, but it’s much less common.
Your treatment goal is to assist the stone to pass through the system quickly. Staying well-hydrated is one way to help. Drink at least 8 glasses of water per day to produce a large amount of urine. The flow will help move the stone along. Drinking lots of water may serve to prevent stones as well.
Some have used water pills, also called “diuretics”, or cranberry juice for the same purpose. Pain relievers may help, with ibuprofen the most available treatment of choice for pain relief in survival settings. Stronger pain medications, if you can get them, may be needed in severe cases.
Although there are drugs available to decrease the frequency of developing certain stones, some dietary changes may prevent the formation of kidney stones. Avoid foods that have a lot of calcium, such as:
Also, decreasing dairy intake will restrict the amount of calcium available for stone formation. This will keep them as small as possible and, therefore, easier to pass.
Sodium bicarbonate or sodium citrate increases the alkalinity of the urine and may decrease the likelihood of formation of uric acid stones.
It should be noted that, other than pain control, different types of stones may respond differently to treatment based on their composition. A strainer is sometimes used to catch the stone as it passes for evaluation by the lab (if one is available).
Other natural substances that may help (again, dependent on what kind of stones you have) are:
- Horsetail tea (a natural diuretic)
- Pomegranate juice
- Dandelion root tea
- Celery tea
- Basil tea
As for supplements, there are a lot of them on the market like “Stone Breaker”, a hydrangea, celery seed, and other herbs in a combination extract that you’ll find on Amazon. I can’t vouch for its effectiveness due to the lack of hard data, but given the severe symptoms, it may be worth trying.
Joe Alton MD
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