Diagnosing and Treating Kidney Stones

Treating Kidney StonesMost people who have had kidney stones can recall only one thing about their experience: pain. In fact, the pain the stone causes as it passes through the urinary tract has been likened to the pain of childbirth.

Pain is usually the first symptom the doctor looks for in diagnosing kidney stones. The pain is usually sharp and sudden. It may go away for a few hours and then return with a vengeance as the stone moves around your urinary tract system. Often, the pain is located in the lower back or flank and shoots down toward the groin.

If you have a kidney stone, it will probably be hard for you to find a comfortable position. You may feel the need to get up and pace or twist from side to side on your bed.

There are other symptoms of kidney stones as well. Many people with kidney stones report feeling nauseated. They may feel cold and clammy or hot and sweaty. Passing urine may be painful. There may even be blood in the urine if the kidney stone lacerates the urinary tract.

Kidney stones occur when crystals drop out of urine and form hard “pebbles.” Some kidney stones are round and smooth, but the majority are jagged. Larger stones may cause blockages as they move through the urinary tract.

There are several types of kidney stones. Some are caused by medication, others may be related to too much calcium in your diet or certain types of meat and fish. Still others may be the fault of the body’s metabolism. Your doctor may want to analyze kidney stones that have passed to find out what type they are.

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As a general rule, kidney stones occur more frequently in men than in women, and more frequently in people who are less active during the day than in people whose jobs require them to move around a lot.

If this is your first kidney stone, your doctor will probably want to perform several tests to make sure he or she is diagnosing the problem properly. Several other diseases which require immediate treatment, such as appendicitis, a failing liver, or a large tumor, may mimic the pain of kidney stones, so getting the correct diagnosis is imperative. Tests may include urinalysis, blood work, ultrasounds, and CT scans.

In spite of the pain, which can be formidable, most kidney stones (70% to 80%) can safely be treated at home. Your doctor will ask you to strain your urine and bring the stone in for testing once you have passed it. While waiting for the stone to pass, drink plenty of fluids. You may take over the counter pain (OTC) medication for discomfort. If OTC pain medication proves not strong enough, your doctor may prescribe another pain medication such as Toradol or a narcotic-based medication like Vicodin or Percocet.

Although most people can pass the stone with help, about 20% to 30% of sufferers will require medical intervention. Doctors have three basic techniques for removing stones. The first is called extracorporeal shock wave lithotripsy, or ESWL. The patient is placed in a warm bath, and shock waves are directed at the kidney in order to break larger stones into smaller pieces that can pass more readily. For patients who are anxious or in severe pain, this procedure can be done under sedation or under strong pain medication (e.g., morphine).

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Another technique, called the ureteroscope, is usually done under sedation. A long, thin tube is passed through the bladder. Ultrasound and laser energy are used to break up stones. The ureteroscope can also be used to simply remove large stones.

Finally, tunnel surgery may be used to remove stones in the kidneys. Tunnel surgery requires a small cut in the back. The surgeon then “tunnels” through the skin to the site of the stone and removes it. This procedure, too, requires sedation and may be done under general anesthetic.

Most people who are treated for kidney stones do not spend any time in the hospital. They go home as soon as any sedation they have been given wear off.

Unfortunately, that may not be the end of the story. Up to 75% of people who suffer from kidney stones will develop kidney stones again sometime in their lifetime. Many people who are prone to kidney stones and are aware of the symptoms do not seek medical advice for each flare up. Doctors suggest you be seen if you are running a fever, if the pain becomes unbearable, if you cannot keep food or liquids down, if the stone doesn’t pass on its own in a few days, or if you have only one functioning kidney.

Kidney stones are far from pleasant, but with the proper treatment, you’ll soon find yourself back on your feet and ready to face the world again.