"One of the main reasons that minerals can start to deposit in the kidneys is a lack of water."
On today's episode with Dr. Keller Wortham, MD, we'll be talking about an extremely painful condition: kidney stones. We'll talk about what kidney stones are, discuss some of the risk factors and symptoms, as well as what we can do to prevent kidney stones, and what to do when they happen.
- 01:25: What is a Kidney Stone?
- 02:53: Symptoms of a Kidney Stone
- 04:40: What Causes Kidney Stones
- 06:21: Risk Categories
- 07:14: Diagnosing Kidney Stones
- 08:21: Treating Smaller Kidney Stones
- 09:30: Treating Larger Kidney Stones
- 11:20: Preventing Kidney Stones
- 13:51: Wrap-Up
It’s said that there’s no pain that compares to childbirth, and while it's pretty unlikely that any man will ever experience that particular pain, there is a condition so painful that it’s the next best (or worst) thing — passing a kidney stone. A kidney stone is a lot smaller than a baby, but due to the sensitivity of the nerves along the ureters that pass from thekidneys to thebladder, kidney stones are still an extremely extremely painful experience.
If you’ve ever had a kidney stone, you know it’s terrible — patients who visit their doctors complaining of this condition are often writhing in pain, they can't get comfortable, and they're begging for pain medications. So why do kidney stones cause so much pain, what can we do to prevent them, and if we end up with one, what can we do to take care of it?
What is a Kidney Stone?
First of all, the medical name for kidney stones isnephrolithiasis, which means basically stones in your kidneys. However, kidney stones are not really stones; technically they are crystals. These crystals form from minerals in your blood and urine, which begin to crystalize. They can be really tiny, or they can grow to the size of a golf ball. They are essentially a mineral deposit, and they can have different textures. There are different kinds of stones that you can get in the kidney. Most of them are calcium oxalate, but there are other minerals that can cause kidney stones as well. If they get too large, they can actually block the flow of urine out of the kidney, which is quite dangerous. It can lead to kidney damage, serious infections, and if not treated, to death. So, it's a painful condition but it's also a very serious one.
Symptoms of Kidney Stones
So, how do you know if you have a kidney stone? Well, the first symptom you will notice is pain in the abdomen that radiates down to the groin. You might also feel it in the back, if your kidneys are under pressure. It is a very intense pain, often described as colicky, meaning it comes and goes to some degree, and you may find it’s impossible to find a comfortable position. Any movement can hurt, and you may spend time trying to get the right position so the pain will go away, but it never happens, because the pain is internal, occurring in the ureter, which is the little tube that passes from your kidney to bladder.
Most of the time when a stone is in the renal pelvis, which is the end of the kidney, it doesn't cause any pain, but as it starts to move down the ureter, that's when the pain starts. It also begins to irritate the lining of your urinary tract, leading to other symptoms like blood in the urine. So you might see pink tint to your urine, or pus in the urine. Typically white blood cells, which is pus, and red blood cells are found on a urinalysis at your doctor’s office. You might also notice a decreased amount of urine coming out, or you might feel the urgency to urinate more frequently. There are also some more systemic symptoms, especially if you're getting a bad blockage or you get an infection, which can include fever, serious fatigue, and body aches.
What Causes Kidney Stones
One of the main reasons that minerals can start to deposit in the kidneys is alack of water. People who don't drink enough water can experience a higher risk of kidney stones, because one of the main components in our urine is something called uric acid. When we drink water, we dilute the uric acid that we're metabolizing and getting rid of. When that uric acid is more concentrated due to dehydration, it can acidify the urine, and acidic urine can lead to the formation of different kinds of kidney stones. So that’s one great reason to make sure you stay properly hydrated all the time.
Other reasons people might get kidney stones include:
- Certain medications, especially diuretics. Medications that are used to controlblood pressure can often increase your risk of certain kinds of stones.
- Gout, which is a metabolic condition involving higher uric acid levels.
- Certain medical conditions can lead to it, particularly Crohn's disease. Hyperparathyroidism, which involves the parathyroid glands firing off too frequently, is another condition that can lead to kidney stones.
- Chronic urinary tract infections.
There are some other categories that can increase your risk of stones. If you fall into one of these categories, pay attention and maybe increase your water intake. These categories include:
- Being male — men are at a greater risk for kidney stones than women.
- Age — if you're between 30 and 50, that’s the most likely time for kidney stones to happen.
- A family history of kidney stones.
- High doses of certain medications.
Diagnosing Kidney Stones
If you think you may have a kidney stone, and are experiencing some of the symptoms that we just mentioned, you need to get to your doctor right away. As previously mentioned, there are some serious complications that could occur, including infection and kidney damage, if kidney stones are left untreated. Also, your doctor can prescribe medication to alleviate the pain, as well as additional medications that can help your urine flow better and help get the stone out.
The doctor will diagnose the kidney stone by a urinalysis, which means they test your urine to see if it contains red blood cells and white blood cells. If it does, that's an indication that the kidney stone might be passing. Next, they may do some sort of imaging. Typically, that's an X-ray of your kidneys and bladder, or a CAT scan. A CAT scan is a series of X-rays that can provide more detail on the situation. Once that is determined, they can see where the stone is and more importantly, how big it is, which will determine the course of action.
Treating Smaller Kidney Stones
If a stone is small enough, it can pass spontaneously. Unfortunately, while the word “spontaneously” makes it sound like a quick process, it can actually take 48 to 72 hours to pass a kidney stone. Your doctor may prescribe you certain medications to help with that pain if they think the stone is small enough to pass, as well as the previously mentioned medications to increase urine flow, and medications that can relax the muscles of the ureter to make it a little wider, allowing things to flow through it more easily. Those medications include calcium channel blockers, and something called Flomax which is an alpha-blocker. In other words, if you've got a stone that’s small enough to pass, they can help speed up that process with these various medications, andyou can help speed it up by staying constantly hydrated.
Treating Larger Kidney Stones
The cut-off for whether a stone will pass or not is thought to be about 4 mm, which is about the size of the head of a match. If the stone is bigger than that, there are a couple of things that you can do.
The first thing that's very common is a sound wave technique calledlithotripsy. This means the doctor essentially fires shock waves at the stone to try to break it into smaller pieces, which can then pass in the urine without so much pain and without blockage. Often if you're passing a kidney stone or you're getting a shockwave therapy, your physician will give you a screen to pee into so that they can catch any of those stones and analyze their content, to figure out what kind of stone you might be passing. That can help them determine what kind of metabolic disorder or other condition might be responsible for the formation of the kidney stone.
If the shockwave therapy doesn't work, or you live in a location where it’s not offered, or if the stone is too big or it's starting to block passage of the kidney and they're becoming concerned, then you can have surgery. This would involve opening up the renal pelvis to take the stone out. Hopefully it doesn't come to that, but that is certainly an option to get a stone out.
Preventing Kidney Stones
We talked a little bit about prevention already, but let’s take a closer look at some natural things you can do to help prevent kidney stones.
- Water. Of course, the primary thing you want to do isdrink plenty of water.
- Lemon Juice. Improve your chances even more by adding lemon juice to your water. It's best to use fresh lemons. Lemons contain citric acid, and citrate helps break down stone. So lemon water can help break down kidney stones that are already forming, or help prevent them.
- Basil. Fresh basil contains a compound that stabilizes uric acid and prevents it from crystallizing. You can eat it fresh, or add it to recipes when you cook, or flavor your water with it.
- Apple cider vinegar. Pour about two tablespoons ofapple cider vinegar into an eight-ounce glass of water, and mix it up. ACV also contains citric acid, and it will help prevent kidney stones, as well as absorb some of the calcium deposits that can lead to stones.
- Celery and wheatgrass can increase your urine flow. They almost serve as a diuretic, and that can be helpful in keeping urine flowing and preventing stones from forming.
- Pomegranate juice. Any time you're getting juice of any kind, try to find a natural one without added sugar. You can even press your own pomegranates to make your ownjuice, although that’s a lot of work. Pomegranate juice helps increase the urine flow, helps acidify the urine, and helps prevent the stones from forming.
Above all, just try to stay hydrated, especially if you're in one of those higher risk categories. If you start to experience any of the symptoms that might indicate a kidney stone, get to your doctor, because they can diagnose how big that stone might be, and help prevent some of the dangerous complications that could occur, like an infection or a blockage.
We hope you found this talk on kidney stones helpful. We hope you never have to experience one!