Everyone experiences kidney stones differently. Typically, kidney stones within the kidney do not cause pain. If a stone falls onto the opening where the kidney meets the ureter or passes into the ureter, this can prevent urine from draining out of the kidney. This backing up of urine can lead to back pain just below your ribs.
Sometimes the pain can be severe enough to cause nausea and vomiting. As a stone moves, the blockage of urine may be relieved and symptoms may improve or go away. The pain may return if the stone begins to cause blockage of urine again. This changing of symptoms is called renal colic. Blood in the urine may be a sign of kidney stones.
If a stone is able to pass down the ureter and close to the bladder, the pain may move to the front of the abdomen, near the pelvis.
Stones very close to the bladder can cause pain that is felt in the genitals. A stone that reaches the bladder can cause burning with urination or changes in how often or how urgently you need to urinate.
The best imaging currently available for kidney stone detection is a CT scan. If you have crystals in your urine, that does not mean that you have a kidney stone. Crystals in the urine are common. If you have crystals in your urine along with other symptoms of kidney stones, you should see a doctor for an exam and imaging.
You have multiple options for treating kidney stones. You and your physician will decide which option is best for you based on the location, size, hardness, and composition of your stones. Instead of treating the stones, you and your doctor wait to see if they grow or pass.
Small stones that do not cause discomfort may not require treatment. But if the stones grow larger or pass into the ureter and cause pain, they may require treatment later. In some circumstances such as uric acid stones , medication can be used to dissolve stones in the kidney, with no surgical procedure needed. Shockwave lithotripsy is the most common type of treatment for kidney stones. It does not work well for stones that are in the lower part of the kidney, because those stones have to travel upward to reach the ureter and thus pass out of the kidney.
It works much better for stones in the top part of the kidney, because those pieces can pass down and out by themselves. Some stones form in the kidney itself, while others may form in the ureter. Kidney stones that form in the upper part of the ureter are close to the kidney. Those that form in the lower part are close to the bladder. The best way to help speed up the process of passing a kidney stone is to drink plenty of water.
The excess fluid encourages urination, which helps move the stone along. A person can also take steps to prevent new stones from forming and to stop existing ones from growing larger. These steps include:. Passing kidney stones can be uncomfortable and even painful.
In some cases, taking over-the-counter medications such as ibuprofen may be enough to alleviate the pain. If a person is experiencing particularly painful kidney stones, they should talk to their doctor, who may be able to prescribe stronger pain relief medications. Smaller kidney stones may pass on their own, causing minimal discomfort. However, large stones can be painful and increase the risk of health complications.
Pain is an indicator that a person should see a doctor. They can determine whether or not the stone requires additional treatment to help it pass. These may be signs of a kidney infection , which requires prompt treatment to prevent more serious complications.
Surgery is rarely the first choice of treatment. However, kidney stones larger than 6 mm require immediate surgery. Stones this large can stick in the ureter, causing infections and kidney damage. There are two main surgical options for kidney stone removal: ureteroscopy and percutaneous nephrolithotomy. Ureteroscopy requires general anesthetic. During the procedure, the surgeon removes or breaks up the stone, using tiny instruments inserted through the urethra.
The surgeon may then place a stent inside the urethra to hold it open. This allows any small stone fragments to pass more easily. During percutaneous nephrolithotomy, the surgeon removes very large stones measuring 10 mm or more. It involves removing the stone directly from the kidney through a small incision in the back.
The procedure requires general anesthetic and a 1—2 day hospital stay. The amount of time it takes to recover from a kidney stone depends on how it passes. Most people have two kidneys, one on each side of the spine behind the liver, stomach, pancreas and intestines. Healthy kidneys clean waste from the blood and remove it in the urine.
They control the levels of sodium, potassium and calcium in the blood. The kidneys, ureters and bladder are part of your urinary tract. The urinary tract makes, transports, and stores urine in the body. The kidneys make urine from water and your body's waste. The urine then travels down the ureters into the bladder, where it is stored. Urine leaves your body through the urethra. Kidney stones form in the kidney. Some stones move from the kidney into the ureter. The ureters are tubes leading from the kidneys to the bladder.
If a stone leaves the kidney and gets stuck in the ureter, it is called a ureteral stone. Kidney stones come in many different types and colors.
How you treat them and stop new stones from forming depends on what type of stone you have. Calcium stones are the most common type of kidney stone. There are two types of calcium stones: calcium oxalate and calcium phosphate.
Calcium oxalate is by far the most common type of calcium stone. Some people have too much calcium in their urine, raising their risk of calcium stones. Even with normal amounts of calcium in the urine, calcium stones may form for other reasons. Uric acid is a waste product that comes from chemical changes in the body. Uric acid crystals do not dissolve well in acidic urine and instead will form a uric acid stone.
Having acidic urine may come from:. Struvite stones are not a common type of stone. These stones are related to chronic urinary tract infections UTIs. Some bacteria make the urine less acidic and more basic or alkaline. Magnesium ammonium phosphate struvite stones form in alkaline urine. These stones are often large, with branches, and they often grow very fast. People who get chronic UTIs, such as those with long-term tubes in their kidneys or bladders, or people with poor bladder emptying due to neurologic disorders paralysis, multiple sclerosis, and spina bifida are at the highest risk for developing these stones.
Cystine is an amino acid that is in certain foods; it is one of the building blocks of protein. Cystinuria too much cystine in the urine is a rare, inherited metabolic disorder. It is when the kidneys do not reabsorb cystine from the urine. When high amounts of cystine are in the urine, it causes stones to form. Cystine stones often start to form in childhood.
Common symptoms of kidney stones include a sharp, cramping pain in the back and side. This feeling often moves to the lower abdomen or groin. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone. A major risk factor for kidney stones is constant low urine volume. Low urine volume may come from dehydration loss of body fluids from hard exercise, working or living in a hot place, or not drinking enough fluids.
When urine volume is low, urine is concentrated and dark in color. Concentrated urine means there is less fluid to keep salts dissolved. Increasing fluid intake will dilute the salts in your urine. By doing this, you may reduce your risk of stones forming.
Adults who form stones should drink enough fluid to make at least 2. On average, this will take about 3 liters ounces of fluid intake per day. While water is likely the best fluid to drink, what matters most is getting enough fluid.
Diet can also affect the chance of forming a stone. One of the more common causes of calcium kidney stones is high levels of calcium in the urine. High urine calcium levels may be due to the way your body handles calcium. It is not always due to how much calcium you eat. Lowering the amount of calcium in your diet rarely stops stones from forming.
Studies have shown that restricting dietary calcium can be bad for bone health and may increase kidney stone risk. Health care providers usually do not tell people to limit dietary calcium in order to lower urine calcium.
But calcium intake should not be too high. Instead of lowering dietary calcium intake, your health care provider may try to reduce your urine calcium level by decreasing your sodium salt intake. Too much salt in the diet is a risk factor for calcium stones. This is because too much salt is passing into the urine, keeping calcium from being reabsorbed from the urine and into the blood.
Reducing salt in the diet lowers urine calcium, making it less likely for calcium stones to form. Because oxalate is a component of the most common type of kidney stone calcium oxalate , eating foods rich in oxalate can raise your risk of forming these stones. A diet high in animal protein, such as beef, fish, chicken and pork, can raise the acid levels in the body and in the urine.
High acid levels make it easier for calcium oxalate and uric acid stones to form. The breakdown of meat into uric acid also raises the chance that both calcium and uric acid stones will form. Certain bowel conditions that cause diarrhea such as Crohn's Disease or ulcerative colitis or surgeries such as gastric bypass surgery can raise the risk of forming calcium oxalate kidney stones. Diarrhea may result in loss of large amounts of fluid from the body, lowering urine volume.
Your body may also absorb excessive oxalate from the intestine, resulting in more oxalate in your urine. Both low urine volume and high levels of urine oxalate can help to cause calcium oxalate kidney stone formation. Obesity is a risk factor for stones. Obesity may change the acid levels in the urine, leading to stone formation. Some medical conditions have an increased risk of kidney stones.
Abnormal growth of one or more of the parathyroid glands, which control calcium metabolism, can cause high calcium levels in the blood and urine. This can lead to kidney stones. Another condition called distal renal tubular acidosis, in which there is acid build-up in the body, can raise the risk of calcium phosphate kidney stones. Some rare, inherited disorders can also make certain types of stones more likely. Examples include cystinuria, which is too much of the amino acid cystine in the urine, and primary hyperoxaluria, in which the liver makes too much oxalate.
Some medications, and calcium and vitamin C supplements, may increase your risk of forming stones. Be sure to tell your health care provider all the medications and supplements you take, as these could affect your risk of stone formation.
Do not stop taking any of these unless your health care provider tells you to do so. The chance of having kidney stones is much higher if you have a family history of stones, such as a parent or sibling. Other people have their stones diagnosed when sudden pain occurs while the stone is passing, and medical attention is needed.
When a person has blood in the urine hematuria or sudden abdominal or side pain, tests like an ultrasound or a CT scan may diagnose a stone. These imaging tests tell the health care provider how big the stone is and where it is located. A CT scan is often used in the ER when a stone is suspected. It is used because it can make a quick and exact diagnosis.
Treatment depends on the type of stone, how bad it is and the length of time you have had symptoms. There are different treatments to choose from. It is important to talk to your health care provider about what is best for you. Often you can simply wait for the stone to pass. Smaller stones are more likely than larger stones to pass on their own. Waiting up to four to six weeks for the stone to pass is safe as long as the pain is bearable, there are no signs of infection, the kidney is not completely blocked and the stone is small enough that it is likely to pass.
While waiting for the stone to pass, you should drink normal amounts of water. You may need pain medication when there is discomfort. Certain medications have been shown to improve the chance that a stone will pass.
The most common medication prescribed for this reason is tamsulosin. Tamsulosin Flomax relaxes the ureter, making it easier for the stone to pass. You may also need pain and anti-nausea medicine as you wait to pass the stone.
Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney. Today, surgery usually involves small or no incisions cuts , minor pain and minimal time off work.
Shock waves are focused on the stone using X-rays or ultrasound to pinpoint the stone. Repeated firing of shock waves on the stone usually causes the stone to break into small pieces. These smaller pieces of stones pass out in the urine over a few weeks. Because of possible discomfort caused by the shock waves and the need to control breathing during the procedure, some form of anesthesia is often needed. SWL does not work well on hard stones, such as cystine, some types of calcium oxalate and calcium phosphate stones, or very large stones.
With SWL, you may go home the same day as the procedure.
0コメント