Kidney Stones

If you are having, or suspected to have, a ‘ Kidney stone’; Following is a FAQ fact sheet :

Bean shaped organ, one on each side of the spine, overlying the last few ribs. Main job is to filter impurities and waste from the blood, and regulate body fluid balance. It helps in blood and bone formation too.

A stone is formed when certain salts, normally in a dissolved state (like sugar in water), are above a limit and the excess is thrown out as crystals, which soon combine to form a stone.

As long as the stone is not blocking the flow of urine, you are fine, but since the tube draining each kidney ( the ureter ) is very small (inner diameter 2-3 mm at some points ) once it gets ’jammed’ , it causes urine to dam up in the kidney, leading to severe back pain. The ureter tries valiantly to clear the block by squeezing its muscles, and this leads to severe pain, called ‘colic’.

Any severe pain can make you feel like throwing up, including a severe heart attack. Sometimes the pain killers, which you have to take, make you nauseous.

About 10-15% stones are invisible on X-Ray, especially if composed of cystine or uric acid .

The stone blocks the tube from the kidney. Since there are two kidneys, other kidney continues to function and hence urine reaches the bladder.

Relief of pain is the first objective, assessing the cause, and most effective treatment strategy is the next. An Ultrasound scan, a urine examination , a simple X-Ray to look for stone may be the only tests. 90% of stones are passed by the patients themselves, generally within 2-4 weeks. If necessary, a special CT Scan, will be necessary to assess the problem.

Apart from these social reasons, persistent vomiting/pain/fever make us intervene on an emergency basis. ‘stenting’ a stone, means putting a thin plastic tube from bladder to the kidney, to by-pass the ‘jam’ created by the stone. It is done either from below with a telescope, or sometimes from the kiney side.

Most stones are less than 4-5 mm in size, and will pass spontaneously, treated or not. Credit is given to the last trick/treatment/temple/talisman…. pick your choice ! Seriously speaking, during acute colic, the blocked kidney is temporary shut down ( otherwise it would literally ‘blow up’ a leak ) and hence attempt at ‘flushing’ the stone should be done only after severe pain has subsided.

Not always. Pain disappears once urine can trickle past the stone, but it may come back again if stone wedges tightly again. In some cases, the body ‘gives up’ attempts at pushing the stone out, and hence there is no pain, but gradually the kidney loses its function. Thus, it is important to get confirmation that your kidney is OK if you have no pain, but have not passed the stone either.

Small stones will pass anyway. If you would like to try alternative treatment options, go ahead, most important thing to remember is that you must not assume that treatment is successful because you have no pain. You must get X-Ray or a scan to confirm that you do not have a blocked kidney.

If a stone remains in the body for longer than a month, chances of it coming out without any help is small, and the risk of permanent damage to kidney function also increases if stone remains stuck for more than a month.

Correct treatment for a stone depends upon the size, type, location of the stone and kidney configuration, function etc, apart from other existing illnesses, travel time etc. Most stones are suitable for SWL (Shock Wave Lithotripsy), commonly known as Laser treatment., but not all. Urologist will be able to help you with this issue.

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