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.