Kidney stones take time to pass

April 1, 2013 By

Q: I went to the hospital last week where I was told I had kidney stones. The doctor told me they should pass in two to seven days. I’ve had them now for 8 days and only feel mild discomfort. If I don’t pass it (the stone), should I worry? I haven’t taken any pain medication in four days and I drink plenty of water throughout the day.

A: Kidney stones are small, hard deposits of tiny crystals that form in the kidney or ureter. An individual may have one or more within the kidney or ureter (the tube that carries urine from the kidney to the bladder). There are four primary types of stones that form when urine contains an excess of certain substances. The most common form is calcium stone(s) that can combine with other substances such as carbonate, phosphate or most commonly, oxalate. This type of stone is more common in young men between the ages of 20 and 30. Uric acid stones occur with gout or in those on chemotherapy. Again, they are more common in men than they are in women. Struvite stones form in individuals with excessive amounts of an amino acid known as cystine in the urine. This type affects men and women alike and tends to have a genetic basis. High doses of vitamins C, D and antacids containing calcium such as Tums can put people at higher risk of forming stones. Lastly, specific medications to include acyclovir and indinavir (both anti-virals) and triamaterene (a diuretic) can can cause stone formation.

Risk factors for stones include dehydration, consuming a diet high in protein, sugar and sodium, obesity, and having a history of gastric bypass surgery.

Symptoms present when the stones move down into the ureter(s). Pain in the groin, abdomen, testicles in men, or side and back below the rib area may vary in intensity from mild to extremely severe. The individual may experience fever and chills if an infection is present, hematuria (blood in the urine), abnormally colored urine, vomiting and diarrhea. There may be pain on urination. When the pain is severe, strong prescription-strength pain relievers may be ordered, and the person may even require hospitalization. There are some medications available to reduce or eradicate the formation of stones. When a stone fails to pass on its own, there are several options available to retrieve it, either through scoping the bladder or ureter or through shock wave lithotripsy, an ultrasound procedure.

Testing for diagnosis might include urinalysis to determine if red blood cells are present in the urine, lab testing to check uric acid, calcium/phosphorous/electrolyte levels, and kidney function tests. Imaging might include abdominal films, ultrasound, CT, MRI, or an intravenous pyelogram.

Treatment will depend on the severity of symptoms present and the type of stone(s) found. An increase of water intake is helpful to prevent stone formation and a medication known as Flomax routinely used to relax the ureter may be prescribed. Several procedures are available to assist with their removal. If your physician has not determined what type stone(s) you have, you will likely be instructed to collect them once they pass so they can be analyzed.

I cannot tell you how long your symptoms will last. Some stones are as tiny as a grain of sand and can be flushed rather quickly. Others are the size of a pebble, or substantially larger and may take longer. Reduce your salt consumption, maintain a normal weight, limit your sugar intake and force those fluids.

Readers who would like related information can order Dr. Gott’s Health Report “Kidney Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Gott’s Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

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What causes blood in the urine?

March 27, 2013 By

Q: I have been having blood in my urine this week. What are the possible causes?
A: Blood in the urine is medically referred to as hematuria. There are two types – that which is visible to the naked eye such as in a toilet bowl or on tissue referred to as gross hematuria and that which isn’t visible and can only be detected by examination under a microscope. The microscopic form may not present with any symptoms, while gross hematuria will reveal abnormally colored urine – pink, brown, or red because of the presence of red blood cells. Before panic sets in, ask yourself if you recently consumed beets, blackberries or rhubarb or if you used a laxative containing senna, or the antibiotic Rifampin, all of which can color your urine.

Causes of blood in the urine can result from taking aspirin, infection of the urinary tract), inflammation of the kidney/ bladder/or prostate (in men), a clotting disorder, polycystic kidney disease, performing strenuous exercise, cancer, and more. Infection occurs when bacteria enter the body through the urethra. Symptoms can include pain, burning and a strong urge to urinate plus urine that has a strong odor. Kidney infection occurs when bacteria enter the kidneys from the bloodstream or move from the ureters to the kidneys. Symptoms resemble those of having a bladder infection and may include flank pain and fever. Bladder infections and stones are crystals on the walls of the kidney that may present with extreme pain. An enlarged prostate can place pressure on the urethra and block the flow of urine. Problems urinating and an annoying urge to urinate are common. Clotting disorders such as sickle cell anemia will cause both visible and microscopic hematuria. Polycystic kidney disease is an inherited disorder that can cause cysts to develop in the liver and other areas of the body. Hypertension and kidney failure are common. On the upside, some of the complications are preventable with medication and changes in lifestyle.

Diagnosis is accomplished through testing of urine collected in a sterile manner, blood analysis that may reveal the presence of high levels of creatinine (a waste product from normal muscle breakdown), kidney biopsy with examination under a microscope, cystoscopy that allows a physician to examine the inside of the bladder and urethra, or even a CT or MRI. Despite the various tests available, there are instances in which the true cause simply isn’t found and a physician or urologist may consider a course of antibiotics or other means to reduce or eliminate symptoms.

If you cannot readily pinpoint recent trauma, a period of stressful exercise or another possible cause, I recommend you make an appointment with your primary care physician who may, in turn, refer you to a urologist to help get to the underlying cause of your hematuria. In the interim, drink more fluids, add 100% cranberry juice to your daily regimen, wipe from front to back during voiding, reduce your salt intake, eat less spinach, and be sure to follow-up with a health care professional if the situation continues.

Other readers who are interested in learning more can order Dr. Gott’s Health Report “Kidney Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

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Does Home Remedy Help Kidney Stones?

March 28, 2009 By

DEAR DR. GOTT:
I am a 46-year-old male who recently found out I have kidney stones. While researching the problem on the internet, I found a site where others with this problem could share advice and tips about ways to relieve the discomfort and get the stones to pass quickly. Of all the remedies, there was one that was repeated time and again all over the site. It recommended drinking two ounces of virgin olive oil with two ounces of freshly squeezed lemon juice, wait five minutes and follow with eight ounces of water. It said to drink this twice a day and to keep drinking plenty of water throughout the day.

I would like to know if there is any research to support the use of either olive oil or lemon juice to help pass kidney stones. [Read more...]

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Daily Column

November 4, 2008 By

DEAR DR. GOTT:
I recently went on a trip that involved traveling 1100 miles. During that time I developed a blood clot in my right leg that moved into the bottom of both lungs. Because of this I had several tests done. One was a CT scan and during this they incidentally found what appeared to be a tumor on one of my kidneys. I was given the anticoagulant Coumadin to start immediately and told to check out the kidney problem when I got home.

When I returned home I saw my physician who was concerned about my kidney at first. I asked for a referral to a specialist who ordered another CT scan. Again, it showed I had a mass on my kidney. I was told that it was under 4 cm so it was caught quite early.

My urologist doesn’t want to do anything about the kidney right now despite the fact he feels it is cancer. [Read more...]

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Daily Column

May 8, 2008 By

DEAR DR. GOTT:
I believe I have damaged my kidneys with the excessive use of Excedrin over the last 30 years. My blood urea nitrogen level was flagged on my blood test with a level of 21.

I was diagnosed with irritable bowel syndrome several years ago and I frequently have to urinate.

I didn’t realize the use of Excedrin was so bad until recently. I have completely stopped using it but now wonder if the damage is reversible. Is there anything I can do to make my kidneys healthier?

DEAR READER:
Let me start by saying, a normal blood urea nitrogen (BUN) level ranges between 8 and 20. In my opinion, your level of 21, while technically abnormal, is insignificant. It is not abnormal enough to be diagnostic of kidney damage. This does not mean you do not have some degree of damage.

Over use of any medications can potentially lead to kidney damage because they are all processed within the kidney before being excreted in the urine. That is why most physicians urge patients to use medication only when and if needed, especially over-the-counters.

If you are still concerned, I recommend you make an appointment to speak with your primary physician who can explain the results and what they may mean. He or she may choose to order other tests, such as a kidney ultrasound, to determine if there is any damage and if so, the severity.

To give you related information, I am sending you a copy of my Health Report “Kidney Disorders”. Other readers who would like a copy should send a self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Daily Column

March 27, 2008 By

DEAR DR. GOTT:
As odd as this sounds, I promise this is not a joke. When my husband sneezes, the air he expels as an odor to it. I would associate it with the smell of marigolds or musty urine. We have noticed this over the course of the last month or so.

I offer the following information in case it has any bearing (but we believe not).

He has been diagnosed with colitis but it is under fair control with diet. (He has been fairly closely following your no flour, no sugar diet.) He does not smoke anymore, having quit four years ago. He is a mild/moderate social drinker. His lymph nodes swell up on occasion but I assume that is from fighting off infection. It does not seem to have any correlation with the smell. He also has heartburn and uses antacids a few times a week. He takes vitamin C regularly but no other multi-vitamin. We cannot think of any major dietary or lifestyle changes in the last month that might cause this bizarre occurrence.

We wonder if ammonia-smelling sneezes have an obvious cause and should they be something to be concerned about? Is this something you have ever heard of before?

DEAR READER:
Ammonia-smelling breath is a well-recognized consequence of diabetes, kidney disease and liver disorders. Don’t ignore your husband’s symptom. He needs to be checked. Although the ammonia odor may simply reflect inefficient digestion that is characteristic of colitis and other intestinal disorders, I worry that a more serious situation is developing. Get him to your family physician for testing and let me know the outcome.

To give you related information, I am sending you copies of my Health Reports “Living with Diabetes Mellitus” and “Kidney Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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Daily Column

March 14, 2008 By

DEAR DR. GOTT:
I am a 73-year-old male with heart and kidney failure. I am not on dialysis. I take Lasix. I was taking three 80 mg pills every day for quite some time. One day I suddenly could not urinate. The following day, the same thing so I went to the emergency room at my local hospital where I was catheterized. The doctor then told me I did not have a blockage and that he could find nothing wrong with my blood and urine tests. He told me upon release to reduce my Lasix to one and a half pills per day. A few days later, my ankles began to swell, so my kidney doctor put me back on two pills a day.

I am still unsure about what happened. Could taking three Lasix a day have caused this?

DEAR READER:
I do not believe that the Lasix was the cause of your unpleasant experience. More likely, you had bladder dysfunction due to urinary tract muscle contraction.

I assume that your “kidney doctor” is a nephrologist. You should review your problem with him or her. I would hope that the specialist can suggest ways of over coming the spasm if it occurs again.

To give you related information, I am sending you copies of my Health Reports “Bladder and Urinary Tract Infections” and “Kidney Disorders”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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