Stones, Begone

Reduce your risk of kidney stones by following these tips.
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Each year in the U.S., kidney stones cause more than half a million people to visit the emergency room. You’ve probably heard that kidney stones can be very painful, which is true, but there’s good news too: You can take steps to reduce your risk. Kidney stones are formed when minerals crystallize and harden in the kidney. Some stay there, and others travel through the urinary tract. Tiny stones are sometimes eliminated in the urine with only mild discomfort. But larger stones can force urine to back up behind them, causing aches between the ribs and pelvis, or pain on either side of the lower back, in the stomach or groin.

Treatment Options 

Most stones are eventually excreted in urine, and they can be treated by drinking more fluids and taking over-the-counter pain relievers. Some, however, need to be either broken down or removed during an outpatient procedure. In rare cases, surgery that requires hospitalization is the best option.

The impact of a kidney stone can vary greatly from individual to individual. “You can have wide variation in terms of what happens with a stone, depending on the size and where it is,” says Timothy J. Mackey, M.D., director of urology at The Valley Hospital in Ridgewood and in private practice at Urology Group in Midland Park.

See your Doctor Promptly 

To determine the best treatment, doctors need to know the size and location of the stone or stones. Typically, ultrasound imaging is used todetermine this. Doctors also need to understand the role your personal history may be playing. Kidney stones have many causes, including inherited conditions, dietary factors and infection. Risk factors include obesity; diets high in salt, sugar or animal protein; weight-loss surgery (gastric bypass); and certain medications and medical conditions. A personal history of kidney stones is itself a risk factor: One episode brings a 50 percent chance of recurrence within 10 years.

How Stones are Removed 

For stones that must be removed, the two options most commonly used are noninvasive shockwave treatment (lithotripsy) or ureteroscopy. Shockwave therapy works well for most stones, and is often used for those in the kidney. Administered in an outpatient setting, shockwaves are aimed directly at the stone, blasting it into bits that then pass through the urinary system. It creates a level of discomfort that’s similar to a colonoscopy.

Ureteroscopy, a more complex procedure, is often the treatment of choice for large stones located in the ureter (the duct through which urine passes between kidney and bladder). A short, flexible lighted tube called an endoscope is inserted through the bladder into the ureter. This scope allows the surgeon to see the stone and either remove it using a tiny wire basket or break the stone into small pieces using a laser. “These procedures are generally effective, well-tolerated and safe,” says Dr. Mackey, who notes that neither procedure is likely to have side effects and most patients return to normal activities quickly.

Best Practices for Prevention

Fortunately, there are steps you can take to reduce your risk of getting kidney stones.

1. Drink plenty of fluids. Timothy J. Mackey, M.D., director of urology at The Valley Hospital in Ridgewood, recommends drinking at least eight 8-ounce glasses (a total of 64 ounces or 2 quarts) of liquid daily. Water is best. If you perform strenuous outdoor work, you’ll need to drink close to a gallon daily.

2. Stick to a diet that’s low in salt, sugar and animal protein.

3. Reach or maintain a healthy weight.

4. Drink lemonade. Both lemonade and limeade are rich in potassium citrate, a substance that helps to prevent kidney stone formation. Just avoid versions with sugar, which can increase kidney stone risk. Make your own sugar-free lemonade by adding a tablespoon of lemon concentrate per quart of water. To help mask the tart taste, try using stevia, a natural sweetener extracted from the leaves of the stevia plant.

5. Don’t avoid calcium-rich foods. Though most kidney stones are made up primarily of calcium, calcium in food is not linked to an increased risk of kidney stones. However, calcium supplements may be. Ask your doctor what preventive steps are important for you.

Symptoms to Watch For:

Some patients with a kidney stone experience dull aches between the ribs and pelvis. Others develop severe pain (often in waves) in the side, abdomen, lower back or groin. Urine may look cloudy or smell bad.

Emergency symptoms include:  

  • Pain that makes it difficult to find a comfortable position
  • Pain with nausea and vomiting
  • Pain with fever and chills Blood in the urine
  • Difficulty passing urine
Categories: Bergen Health & Life