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Kicking Kidney Stones:
Why Austinites are at risk and what can be
done
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It’s a common condition that can
cause uncommon pain. Kidney stones can be as small as a grain of
sand, the size of a pearl or even, for an unlucky few, larger
than a golf ball. No matter what their size, kidney stones are
considered to be one of the most uncomfortable of urological
disorders—just ask someone who’s passed one. But research
advances are teaching us how to prevent them from forming, and
allowing for quicker and easier treatment than ever before.
Signs of a Stone
If you’ve had a kidney stone, you’re not alone. Every year, more
than three million visits are made to health care providers and
more than half a million men and women end up in the emergency
room for problems related to kidney stones, according to the
National Kidney and Urologic Diseases Information Clearinghouse.
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Kidney stones are more prevalent
in certain parts of the United States—including Central Texas.
“There is an area sometimes called the “stone belt” that
stretches from coast to coast along the mid- and lower south
states where kidney stone rates are higher,” says Dr. Koushik
Shaw, a board certified urologist with The Austin Diagnostic
Clinic. “There are many theories on why that is, including
higher temperatures or the possibility of higher mineral content
in the water supply.”
No matter where you live, kidney stones develop when waste
materials in the urine don’t completely dissolve. “Sometimes a
stone will stay in the kidney and you won’t even know it’s
there,” says Dr. Shaw. “Other times, it will travel from the
kidney and travel down the ureter, the tube that carries urine
from the kidney to the bladder. Eventually, it may come out when
you urinate.”
But a stone can cause intense pain as it moves into the bladder.
Sometimes it can get stuck as it travels. “The most common
symptom of a kidney stone is sharp pain in the back, side or in
the lower abdomen,” explains Dr. Shaw. “Other signs of a stone
include nausea and vomiting, blood in the urine, cloudy urine,
the need to urinate more often, and fever and chills.”
Despite the discomfort—for which doctors can prescribe pain
medication—many stones can pass through your body if you stay
adequately hydrated. If the stone doesn’t pass promptly, or
causes severe pain or an infection, your doctor may recommend
medical treatment.
Treatment Advances
“Not too long ago, open surgery was a major option for removing
kidney stones,” says Dr. Shaw. “Today, there are new, less
invasive methods that can be performed in an outpatient
setting.”
Extracorporeal shock wave lithotripsy (ESWL) is a procedure that
uses a machine to send shock waves into a kidney stone to break
the stone into tiny fragments so that they can be passed. The
procedure may be done as an outpatient procedure under
anesthesia in approximately one hour.
Another outpatient procedure is called ureteroscopy. “If the
stone is lodged in the ureter, a long, thin instrument is
inserted into the urethra, the tube that drains urine from the
body, and passed through the bladder, until it reaches the
stone,” explains Dr. Shaw. “The stone is then broken up with
ultrasound or laser energy and the patient passes the fragments.
Or the stone may be removed with a small basket-like device.”
If the stone is very large, another option is percutaneous
nephrostolithotomy (PCN). Performed under anesthesia, the doctor
removes the kidney stone by making a small incision in the back
and using a needle and guide wire to fragment the stone and
remove the pieces. Although hospitalization may be needed, most
patients return to normal activities in about two weeks’ time.
“Your doctor will choose a treatment after considering the size
of your stone, the stone’s location and any medical conditions
you might have,” explains Dr. Shaw.
Kinds and Causes
No matter which method your doctor recommends, whether it’s
passing the stone naturally or removing it through a medical
treatment, your doctor will analyze the stone or stone fragments
to determine what kind of stone you have.
“There are four major kinds of kidney stones, all caused by
chemical imbalances in the urine,” explains Dr. Shaw. “Knowing
what your stone is made of helps your doctor figure out what
caused the stone to form in the first place. Then, steps can be
taken to prevent future stones.”
Approximately four out of five stones are made up of calcium.
Usually the stone also contains oxalate, a compound found in
some fruits and vegetables, including rhubarb, spinach, beets,
grapes and red raspberries. These stones can be caused by taking
too much calcium in pill form, medical conditions that regulate
how your body uses calcium, being inactive and a diet high in
oxalate, which is also found in nuts, chocolate and tea.
Struvite stones, which are found more often in women than men,
are usually caused by urinary tract infections. Uric acid stones
form when the urine contains too much uric acid, made by your
body when it metabolizes protein sources like meat, fish and
chicken. High-protein diets can you put you at risk for these
stones. Cystine stones are rare and usually hereditary.
“Other risk factors for stones include certain medical
conditions such as congenital kidney defects, high blood
pressure, arthritis, colitis and Crohn’s disease,” says Dr.
Shaw. “Certain medications, like diuretics, can cause stones,
and a diet high in salt, fat, meat and sugar, and low in fiber
also increases your risk.”
Prevention is Painless
If you’ve had a kidney stone, you may develop them again. Know
your family history as well; if someone in your family has had
stones, you’re more likely to form them and should take steps
toward prevention.
“If you want to avoid any type of kidney stone, the best thing
you can do is drink water and lots of it,” says Dr. Shaw. “Drink
six to eight full glasses each day. Drinking lemonade can also
be helpful because it has high levels of citrate, which is a
powerful reducer of stone formation. Stay as active as possible
and eat a healthy, balanced diet as well. If you are prone to
certain types of stones, such as calcium or uric acid stones,
your doctor can give you medication that can help prevent them.”
Research continues on how to prevent kidney stones, which have
been shown to afflict people since the time of the ancient
Egyptians. “If you’re unlucky enough to develop a stone, rest
assured that treatment options have come a long way since then,”
says Dr. Shaw. “If you think you have a stone, talk to your
doctor about the many options that can provide you with relief.”
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Koushik Shaw,
M.D., is a board certified urologist at The Austin Diagnostic
Clinic, a multi-specialty clinic with more than 120 physicians
representing 24 medical specialties at six locations throughout
Austin and Central Texas. Visit www.adclinic.com or call
512-901-1111. |
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