It seems amazing that something so tiny can cause so much suffering. But while a small minority of people are genetically destined to develop a kidney stone, you can probably greatly reduce your odds of getting one with some simple lifestyle changes.
Doctors don't entirely understand all the physiological changes that lead to kidney stones (medically known as renal calculi), and they aren't certain why some people are more susceptible than others to the most common types of stones.Yet everyone agrees on one point; Kidney stones can hurt- a lot. In fact, the condition is commonly cited as one of the most painful in all of medicine. Stone s smaller than a grain of rice can cause misery and a trip to hospital. You're not alone, although this may not be much consolation. Five percent of Australians and 5 to 10 percent of New Zealanders suffer from kidney stones and men are four times more likely to be victims.
Usually, your kidneys efficiently flush microscopic particles of salts and minerals into the ureter-
-the long, narrow tube that leads to the bladder--and then they're expelled when you urinate. Trouble looms when chemical imbalances and other processes cause the tiny particles to bind together into crystals, which over time grow into a kidney stone. When the stone moves from the kidney into the delicate ureter, it produces anything from a nagging ache to excruciating pain, often accompained by nausea and vomiting. This blockage may trigger a urinary tract infection. Sometimes stones can get stuck in the kidney, initiating an infection but not usually causing immediate pain.
Suspected causes of kidney stone include high levels of urinary calcium and oxalate ( a chemical that enables stone formation); excessive absorption of calcium from the intestine; too much dietary sodium; chemical imbalances; diseases (such as gout, recurrent urinary tract infections and hyperparathyroidism); and even some medications. Kidney stones are categorised by their chemical composition. It' s good bet that yours is made of calicum and oxalate, a combination responsible for 70 to 80 percent of all stones. About 7 percent are formed from uric acid; and a fraction are either struvite stones (almost always caused by urinary tract infections) or cysteine stores, which result from a rare genetic disorder.'
LIKELY FIRST STEPS
If you think you're passing a kidney stone, call your doctor right way or go to hospital. You may be hospitalised if your pain severe to you have signs of complications such as an obstruction or infection. However, about 85 percent of kidney stones are small enough (4 mm or less in diameter) to move though the ureter and enter the bladder within about 72 hours after they're discovered by X-ray. And once the stone leaves the ureter, your pain leaves with it.
In the meantime, immediate pain relief will be at the top of your wish list. Anti-inflammatory medications and narcotics are very effective and work quickly. You'll also receive antibiotics if you've developed a urinary tract infection. Stones lodged in the kidney or ureter will need to be removed by surgical or nonsurgical procedures.
Treatment Options
If your doctor advises watchful waiting until the stone passes, you can help move it along by drinking water---3 to 4 litres a day. Going for a walk (if you're up to it) can also help speed the stone along. Be sure to strain your urine so the stone can be sent for analysis.
Of those who've had a kidney stone but take to precautions to prevent another, half will repeat the ordeal within five years. That needn't be the case, because you can reduce your risk considerably with the following measures:
Drinks lots of fluids--mostly water. Your goal is to keep diluting your urine enough to prevent crystals from forming.
Lower your salt intake. Too much salt can raise calcium levels in your urine. Aim to consume less than 2400 mg of sodium a day.
Eat less meat. Animal protein encourages the body to excrete calicum and uric acid. Eat more nonmeat protein sources such as soy.
Get more potassium in your diet. Foods rich in this mineral include orange juice, bananas and other fruit and vegetables. Although doctors typically recommend that patients reduce the oxalates in their diets (oxalate-rich foods range from spinach to cranberry juice), it's not at all clear if oxalate reduction really makes any difference. Doctors also routinely tell patients to cut back on calcium. Now, even the accuracy of that widely accepted piece of advice is under fire (see on shortly).
What is happening
Usually, your kidneys efficiently flush microscopic particles of salts and minerals into the ureter-
-the long, narrow tube that leads to the bladder--and then they're expelled when you urinate. Trouble looms when chemical imbalances and other processes cause the tiny particles to bind together into crystals, which over time grow into a kidney stone. When the stone moves from the kidney into the delicate ureter, it produces anything from a nagging ache to excruciating pain, often accompained by nausea and vomiting. This blockage may trigger a urinary tract infection. Sometimes stones can get stuck in the kidney, initiating an infection but not usually causing immediate pain.
Suspected causes of kidney stone include high levels of urinary calcium and oxalate ( a chemical that enables stone formation); excessive absorption of calcium from the intestine; too much dietary sodium; chemical imbalances; diseases (such as gout, recurrent urinary tract infections and hyperparathyroidism); and even some medications. Kidney stones are categorised by their chemical composition. It' s good bet that yours is made of calicum and oxalate, a combination responsible for 70 to 80 percent of all stones. About 7 percent are formed from uric acid; and a fraction are either struvite stones (almost always caused by urinary tract infections) or cysteine stores, which result from a rare genetic disorder.'
LIKELY FIRST STEPS
- Watchful waiting to see if a kidney store will pass on its own.
- High volume of water to help flush the stone out of the urinary tract.
- Narcotic analgesics and anti-inflammatory medications to control pain.
- Antibiotics if a urinary tract infection occurs.'
- Nonsurgical or surgical procedures, if needed to eliminate a stone.
QUESTIONS TO ASK
- If my pain is under control but the stone hasn't passed yet, do I need to restrict my activities?
- Is it advisable for me to take a vitamin or mineral supplement? And what about calcium?
- Could I have an undiagnosed condition that is making me form kidney stones?
Treatments
If you think you're passing a kidney stone, call your doctor right way or go to hospital. You may be hospitalised if your pain severe to you have signs of complications such as an obstruction or infection. However, about 85 percent of kidney stones are small enough (4 mm or less in diameter) to move though the ureter and enter the bladder within about 72 hours after they're discovered by X-ray. And once the stone leaves the ureter, your pain leaves with it.
In the meantime, immediate pain relief will be at the top of your wish list. Anti-inflammatory medications and narcotics are very effective and work quickly. You'll also receive antibiotics if you've developed a urinary tract infection. Stones lodged in the kidney or ureter will need to be removed by surgical or nonsurgical procedures.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Lots of fluids Help move and prevent stones.
----------------------------------------------------------------------------------------------------------------------------------------------
Low-salt, low-protein diet Keeps stones from forming.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Painkillers Needed while a stone is passing.
------------------------------------------------------------------------------------------------------------------------------------------
Preventive drugs Vary based on type of stone.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Lithotripsy Uses shock waves to shatter stones.
---------------------------------------------------------------------------------------------------------------------------------------------
Ureteroscopy For stones in the low or middle ureter.
----------------------------------------------------------------------------------------------------------------------------------------------
Percutaneous surgery Therapy for larger or cystine stones.
----------------------------------------------------------------------------------------------------------------------------------------------
Chemolysis Dissolves rarer types of stones.
TAKING CONTROL
PROMISING DEVELOPMENTS---------------------------------------------------------------------------------------------------------------------------------------------
Lots of fluids Help move and prevent stones.
----------------------------------------------------------------------------------------------------------------------------------------------
Low-salt, low-protein diet Keeps stones from forming.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Painkillers Needed while a stone is passing.
------------------------------------------------------------------------------------------------------------------------------------------
Preventive drugs Vary based on type of stone.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Lithotripsy Uses shock waves to shatter stones.
---------------------------------------------------------------------------------------------------------------------------------------------
Ureteroscopy For stones in the low or middle ureter.
----------------------------------------------------------------------------------------------------------------------------------------------
Percutaneous surgery Therapy for larger or cystine stones.
----------------------------------------------------------------------------------------------------------------------------------------------
Chemolysis Dissolves rarer types of stones.
TAKING CONTROL
- Treat a urinary tract infection promptly. Struvite stones form only in infected urine. If you have an infection (see Urinary tract infection, see on later, and Prostatitits, see on later), call your doctor.
- Rehydrate after sweating.
- If you live in a warm climate or you participate in strenuous physical activities, drink more than the recommended 3 to 4 litres of water a day--enough to keep your urine almost colourless. Carry a water bottle with you as a reminder.
- Maintain a healthy weight. Kidney stones seem to be more common seem to be more common among over weight people. But if you need to lose some kilos, don't go on a crash diet; this can make you produce more uric acid, which then promotes kidney stones. Lose weight gradually.
- In a study in Finland, men reduced their risk of kidney stones by 40% for every bottle of beer they drank per day. According to researchers, this is not only because the alcohol and water in the drink dilute your urine, but possibly because certain substances in brewer's hops decrease the excretion of calcium. Of course, too many beers increase the risk of heart and liver disease, so experts advise that men limit their intake to two beers a day.
If your doctor advises watchful waiting until the stone passes, you can help move it along by drinking water---3 to 4 litres a day. Going for a walk (if you're up to it) can also help speed the stone along. Be sure to strain your urine so the stone can be sent for analysis.
Of those who've had a kidney stone but take to precautions to prevent another, half will repeat the ordeal within five years. That needn't be the case, because you can reduce your risk considerably with the following measures:
Drinks lots of fluids--mostly water. Your goal is to keep diluting your urine enough to prevent crystals from forming.
Lower your salt intake. Too much salt can raise calcium levels in your urine. Aim to consume less than 2400 mg of sodium a day.
Eat less meat. Animal protein encourages the body to excrete calicum and uric acid. Eat more nonmeat protein sources such as soy.
Get more potassium in your diet. Foods rich in this mineral include orange juice, bananas and other fruit and vegetables. Although doctors typically recommend that patients reduce the oxalates in their diets (oxalate-rich foods range from spinach to cranberry juice), it's not at all clear if oxalate reduction really makes any difference. Doctors also routinely tell patients to cut back on calcium. Now, even the accuracy of that widely accepted piece of advice is under fire (see on shortly).
No comments:
Post a Comment