Could it be a Kidney Stone?

You’ve probably heard about how painful a kidney stone can be, but do you know much more about these pesky little pebbles? 

A kidney stone is a small, hard concretion that is formed in the kidney from minerals and acid salts found in the urine. Kidney stones are usually not painful until they obstruct the urinary tract.  If a kidney stone travels from the kidney into the ureter (the tube that connects the kidney to the urinary bladder), it often gets stuck and causes sudden onset, severe pain, usually on one side of the back, the side or the abdomen. 

Symptoms
In addition to sudden onset, severe pain, kidney stones can cause dark-colored or blood in the urine, nausea or vomiting.  As a stone travels further down toward the bladder, it can also cause burning with urination, the frequent need to urinate and an urgency to urinate.  Sometimes, these symptoms can be mistaken for something else.  Often, patients suspect a GI tract issue – constipation or a stomach virus.  Stones on the right may feel like appendicitis, and stones low in the urinary tract can cause symptoms similar to that of a urinary tract infection (UTI).

Causes
Kidney stones are caused by a combination of factors – there is a genetic correlation, and they can also result from diet and fluid intake.  Patients who don’t drink enough water or who eat a diet high in salt are at a greater risk.  Additionally, conditions such as intestinal disorders, ulcerative colitis, Crohn’s disease or a previous gastric bypass surgery can cause stones.  Metabolic disorders, certain medications and frequent UTIs can also be culprits.

Who Gets Kidney Stones?
In the United States, 8.8 percent of the population, or one in 11 people, have had a kidney stone. Anyone can get a kidney stone, but some people are at a greater risk.  Unfortunately, here in North Carolina, we live in the “stone belt.”  People in the south have a higher incidence of stone disease than elsewhere in the country.  Men are affected more often than women, and kidney stones are more common in non-Hispanic white people than in non-Hispanic black people and Mexican Americans. Overweight and obese people are more likely to get a kidney stone than people of normal weight.

Prevention
The most common type of stone is a calcium stone.  You can decrease your risk by drinking a lot of water – eight glasses per day – and by eating a low-sodium, normal calcium diet.  Contrary to popular belief, cranberry juice does NOT reduce the risk of kidney stones.

Treatment Options
A stone that is not causing symptoms can potentially be watched (or followed by your doctor instead of treated), depending on size.  However, if you have a stone that is causing pain, you should see a urologist.  There are three main medical interventions to treat kidney stones: 

  • ESWL or Shock-wave Lithotripsy – Under sedation in the hospital, a machine delivers shock waves to the kidney stone to break it up so the pieces can be passed.
  • Ureteroscopy – Under anesthesia in the hospital, a scope is passed into the urinary tract, and a laser fiber breaks up the stone into pieces that can be removed. 
  • Percutaneous Nephrolithotomy – This is the most invasive way to manage stones and is reserved for large stones bigger than one inch in diameter.  A scope is guided into the kidney through a small incision in the back, and the stone is broken up and removed through the tract. This procedure usually requires a one- to two-day hospital stay.

Once you’ve had a kidney stone, there is a 50 percent chance that you will get another one within the next five years.  So, take steps immediately to help prevent another occurrence. 

If you would like to schedule an appointment with a urologist, we invite you to learn more about the urologists at WakeMed Physician Practices – Urology.  However, if the pain is severe, you should go to the emergency room for an evaluation and help with controlling the pain. 

Dr. Ann Becker is a urologist with WakeMed Physician Practices – Urology.

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