Urinary Tract Infections Chapter
2 of 3 (Kidney Stones)
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What I need to know about Kidney Stones:-
Pain in the shaded areas (see diagram above) may be caused by kidney stones.
If you have a kidney stone, you may already know how painful it can be. Most kidney
stones pass out of the body without help from a doctor. But sometimes a stone will not
just go away. It may even get larger. Your doctor can help.
You should call a doctor when you have:
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extreme pain in your back or side that will not go away
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blood in your urine
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fever and chills
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vomiting
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urine that smells bad or looks cloudy
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a burning feeling when you urinate
These may be signs of a kidney stone that needs a doctor's care.
What do my kidneys do? Your kidneys are bean-shaped organs, each about the size of your fist. They are located
near the middle of your back, just below the rib cage.
The kidneys are sophisticated trash
collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2
quarts of waste products and extra water. The waste and extra water become urine, which
flows to your bladder through tubes called ureters (YOOR-uh-turs). Your bladder
(BLAD-ur) stores urine until you go to the bathroom.
Your body uses the food for energy and self-repair. After your body has
taken what it needs from the food, waste is sent to the blood. If your kidneys did not
remove these wastes, the wastes would build up in the blood and damage your body.
In addition to removing wastes, your kidneys help control blood pressure.
They also help
to make red blood cells and keep your bones strong. What is a kidney stone?
A kidney stone is a solid piece of material that forms in the kidney out of substances in
the urine.A stone may stay in the kidney or break loose and travel down the urinary tract.
A small
stone may pass all the way out of the body without causing too much pain.
A larger stone may get stuck in a ureter, the bladder, or the urethra. A problem stone can
block the flow of urine and cause great pain. Are all kidney stones alike?
No. There are four major types of kidney stones. The most common type of stone contains calcium
(KAL-see-um).
Calcium is a normal
part of a healthy diet. Calcium that is not used by the bones and muscles goes to the
kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine.
People who have calcium stones keep the calcium in their kidneys.
The calcium that stays
behind joins with other waste products to form a stone. A struvite (STROO-vite) stone may form after an infection in the urinary system. These
stones contain the mineral magnesium (mag-NEE-zee-um) and the waste product
ammonia (uh-MOH-nyuh).
A uric
(YOOR- ik) acid stone may form when there is too much acid in the urine. If you
tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
Cystine (SIS-teen) stones are rare. Cystine is one of the building blocks that make up
muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a
stone.
The disease that causes cystine stones runs in families.
What do kidney stones look like? Kidney stones may be as small as a grain of sand or as large as a pearl. Some stones are
even as big as golf balls. Stones may be smooth or jagged.
They are usually yellow or
brown. Golf-ball-sized and brown Small and smooth Jagged and yellow Kidney stones vary in size and shape.
  
These are not actual size.
What can my doctor do about a problem stone?
If you have a stone that will not pass by itself, your doctor may need to take steps to get
rid of it. In the past, the only way to remove a problem stone was through surgery.
Now, doctors have new ways to remove problem stones. The following sections describe
a few of these methods. Shock Waves: Your doctor can use a machine to send shock waves directly to
the kidney stone. The shock waves break a large stone into small stones that will
pass through your urinary system with your urine. Two types of shock wave
machines exist.
With one machine, you sit in a tub of water. With the other type
of machine, you lie on a table. The full name for this method is extracorporeal
(EKS-truh-kor-POR-ee-ul) shockwave lithotripsy (LITH-oh-TRIP-see). Doctors
often call it ESWL for short. Lithotripsy is a Greek word that means stone
crushing.
Tunnel Surgery: In this method, the doctor makes a small cut into the patient's
back and makes a narrow tunnel through the skin to the stone inside the kidney.
With a special instrument that goes through the tunnel, the doctor can find the
stone and remove it.
The technical name for this method is percutaneous
(PERkyoo- TAY-nee-us) nephrolithotomy (NEF-roh-lih-THAH-tuh-mee).
Ureteroscope: A ureteroscope (yoo-REE-ter-uh-scope) looks like a long wire.
The doctor inserts it into the patient's urethra, passes it up through the bladder,
and directs it to the ureter where the stone is located.
The ureteroscope has a
camera that allows the doctor to see the stone. A cage is used to catch the stone
and pull it out, or the doctor may destroy it with a device inserted through the
ureteroscope. How will my doctor find out what kind of stone I have?
Try to catch a stone in a strainer.
The best way for your doctor
to find out what kind of stone you have is to test the stone itself. If you know that you are passing a
stone, try to catch it in a strainer. Your doctor may ask for a urine sample or take blood to find out what
is causing your stones.
You may need to collect your urine for a 24-hour period. These tests will help
your doctor find ways for you to avoid stones in the future. Why do I need to know the kind of stone?
The therapy your doctor gives you depends on the type of stone you have. For example, a
medicine that helps prevent calcium stones will not work if you have a struvite stone.
The
diet changes that help prevent uric acid stones may have no effect on calcium stones.
Therefore, careful analysis of the stone will help guide your treatment.
What can I do to avoid more stones? Drink more water.
Try to drink 12 full glasses of water a day. Drinking lots of water
helps to flush away the substances that form stones in the kidneys. You can also drink ginger ale, lemon- lime sodas, and fruit juices. But water is best. Limit
your coffee, tea, and cola to one or two cups a day because the caffeine may cause you to
lose fluid too quickly.
Your doctor may ask you to eat more of some foods and to cut back on other foods. For
example, if you have a uric acid stone, your doctor may ask you to eat less meat, because
meat breaks down to make uric acid. The doctor may give you medicines to prevent calcium and uric acid stones.
Try to drink 12 full glasses of water every day.
Points to Remember:
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Most stones will pass out of the body without a doctor's help.
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See your doctor if you have severe pain in your back or side that will not go away.
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See your doctor if you have blood in your urine (urine will appear pink).
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Drink lots of water to prevent more kidney stones from forming.
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When you pass a stone, try to catch it in a strainer to show to your doctor.
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Talk to your doctor about how to avoid more stones.
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