Urinary tract stones: medications, symptoms, causes, etc. & bull; hello healthy

Definition

What are urinary tract stones?

Urinary tract stones are stones stuck in the urinary tract, either in the kidneys, ureters, or urethra. This is a disease in the human urological system.

Urinary stones are made of salt and minerals in the urine that stick together and form stones. Most of the stones are small gravels and are usually painless when they remain in the kidneys.

However, if the stone is larger, it can cause pain and even block the flow of urine when the stone moves through a narrow channel, the ureter's urinary tract.

How common is this disease?

Urinary tract stones are a common disease. In fact, this disease ranks third in the field of urology after urinary tract infections and BPH (benign prostate enlargement).

Unfortunately, data on patients with urinary tract stones are not well recorded in Indonesia. However, it is estimated that around 0.6% of Indonesia's population suffer from kidney stones which may be related to this disease.

Urinary stones can affect patients of any age. This disease can be overcome by reducing your risk factors. Talk to your doctor for more information.

Characteristics and Symptoms

What are the signs and symptoms of this disease?

Symptoms that are commonly felt are as follows.

• Severe pain in the side and back, under the ribs.
• Pain that radiates to the lower abdomen and groin.
• Pain that comes in waves and fluctuates in intensity.
• Pain when urinating.
• Urine that is pink, red, or brown in color.
• Urine is cloudy or smells bad.
• Nausea and vomiting.
• Urinating more often than usual.
• Fever and chills if there is infection.
• Urinate a small amount.

Pain caused by kidney stones can change their location as the stone moves through the urinary tract. The intensity also varies depending on the location.

There may be signs and symptoms not listed above. If you have concerns about certain symptoms, consult your doctor.

When should I see a doctor?

You should contact your doctor immediately if you have experienced any of the following.

• Pain that is so severe that you cannot sit still or find a comfortable position.
• Pain is accompanied by nausea and vomiting.
• Pain accompanied by fever and chills.
• Blood in urine.
• Difficulty urinating

Cause

What causes urinary tract stones?

Urinary stones often don't have one definite cause, although several factors can increase your risk of developing urinary tract stones.

This disease is formed when urine contains more crystal-forming substances (such as calcium, oxalate, and uric acid) than the liquid in the urine that can dilute it.

At the same time, urine may lack a substance that prevents the crystals from sticking together. These conditions create an ideal environment for urinary tract stones to form.

Risk Factors

What increases a person's risk of developing urinary tract stones?

There are many factors that put a person at risk for this disease, such as:

• Personal or family history. If someone in your family has kidney stones, you are more likely to develop urinary tract stones as well. If you've also had one or more kidney stones, your risk is higher for recurring urinary tract stones.
• Dehydration. Not drinking enough water every day can increase a person's risk of developing urinary tract stones. People who live in warm climates and those who sweat a lot can be more at risk than others.
• Certain diets. Having a diet high in protein, sodium, and sugar can increase your risk of developing certain types of kidney stones (including urinary tract stones). The risk is even greater if you are on a high sodium diet. Too much sodium in the diet increases the amount of calcium the kidneys have to filter and significantly increases the risk of urinary tract stones.
  
• Obesity. Body mass index (BMI), aka high body mass index, large waist size, and weight gain have been linked to an increased risk of urinary tract stones.
  
• Digestive diseases and surgery. Operation bypass stomach, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process that affect calcium absorption and cancer, increasing the levels of stone-forming substances in the urine.
• Other medical conditions. Diseases and conditions that can increase your risk of urinary tract stones include renal tubular acidosis, systinuria, hyperparathyroidism, certain medications and some urinary tract infections.

Diagnosis

How is this disease diagnosed?

When you have felt the symptoms, the first thing to do is to see a doctor. First, the doctor will conduct a physical examination first and ask questions about your or your family's medical history.

If your doctor suspects that you have kidney stones in the urinary tract, you may undergo the following tests and procedures.

• Blood test. Blood tests can tell if there is too much calcium or uric acid in your blood. Blood test results help monitor kidney health and can allow doctors to check for other medical conditions.
• Urine test. A 24-hour urine collection test can show if the body is removing too many stone-forming minerals or too little stone-blocking agents. For this test, your doctor may ask you to undergo two urine collections on two consecutive days.
• Imaging. Imaging tests can show stones in your urinary tract. Options range from abdominal X-rays to computerized tomography High-speed or multiple-energy (CT) which can show the presence of very small stones.
• Other imaging procedures. Includes ultrasound, non-invasive tests, and intravenous urography (intravenous pyelogram), or CT imaging (CT urogram) by using a contrast media compound that can clarify the picture of your urinary tract.
• Analysis of removed stones. You will be asked to urinate through a colander that will catch the rock that comes out. The doctor will then examine the stone in the lab.

Doctors also use the information from the various tests above to determine what is causing the disease and plan the appropriate treatment to treat or reduce urinary tract stones.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor for more information.

What are the treatments for this disease?

Treatment for stones that travel to the urinary tract can vary, depending on the type of stone and its cause. Most kidney stones do not require invasive treatment. You can push out the small rock by:

• Drink water. Drinking 2-3 liters of water a day can help cleanse your urinary system. Unless your doctor advises otherwise, drink enough fluids (especially water) to produce clear or nearly clear urine.
• Pain relief. Passing kidney stones can cause discomfort. For mild pain relief, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve).
• Medical therapy. The doctor can give you medicine to help you get rid of kidney stones. This type of medication, known as an alpha blocker, relaxes the muscles in the urinary tract, helping you pass kidney stones more quickly and with less pain.

If a kidney stone cannot be treated with either of the steps above because the stone is too large to pass through the urine on its own, causing bleeding, kidney damage or ongoing urinary tract infection, here are some possible procedures.

Extracorporeal shock wave lithostripsy (ESWL)

ESWL uses sound waves to create strong vibrations (shock waves) that break stones into small pieces so they can pass through your urine.

This procedure takes about 45 - 60 minutes and can cause pain of moderate intensity. You may be given a light anesthetic to make you feel comfortable.

Surgical removal of kidney stones

Procedure called percutaneous nephrolithotomy involves the surgical removal of kidney stones using a small telescope and a device that is inserted through a small incision in the back.

You will receive general anesthesia during the operation. After that, you will need to stay in the hospital for one to two days until you recover. Your doctor can recommend this surgery if ESWL doesn't work.

Ureteroscopy

Ureteroscopy is a medical treatment to remove smaller stones in the urinary tract or kidneys, the doctor will insert a thin, lighted tube (uretoscope) which is equipped with a camera through your urethra and bladder to your ureter.

After the stone is traced, the stone will be snared and broken into pieces which will be excreted in the urine.

Then, the doctor inserts a small tube (stent) in the ureter to relieve swelling and promote healing. You may need local or general anesthesia during this procedure.

Percutaneous Nephrolithotomy (PCNL)

This procedure is performed for larger or irregularly shaped stones using scope who finds and removes stones. Scope is inserted directly into the kidney through a small incision in your back.

Parathyroid gland surgery

Some calcium phosphate stones form due to overactive parathyroid glands. This stone is located on the four corners of the thyroid gland just below the Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), calcium levels spike and kidney stones form as a result.

Hyperparathyroidism occurs when a small, benign tumor forms in one of your parathyroid glands. It can also occur when you have other conditions that cause these glands to produce more parathyroid hormone.

Removing the tumor from the gland will stop the formation of kidney stones. Doctors also administer medications to prevent the parathyroid glands from producing too much hormone.

Prevention

What lifestyle changes or home remedies can be made to prevent this disease?

Here are lifestyle changes and home remedies that can help you deal with urinary tract stones.

Drink water throughout the day

For people with a history of kidney stones, doctors usually recommend that you pass 2.5 liters of urine a day. You will be asked to measure the amount of urine passed to make sure that you are drinking enough water.

If you live in a hot, dry climate, or if you exercise a lot, you may need to drink more water to produce enough urine. If your urine is light and clear, this means you are probably drinking enough water.

Reduce consumption of foods containing oxalates

If you tend to form calcium oxalate stones, your doctor may recommend limiting foods rich in oxalate. Various foods are beets, spinach, chocolate, tea, and several types of nuts.

Choose a low salt diet

As already explained, foods that are high in sodium can trigger the formation of kidney stones that occur in the urinary tract. Try to reduce the amount of salt by consuming no more than 1500 mg per day.

Reduce your intake of animal protein

Too much consumption of animal protein such as red meat, poultry, eggs and seafood can reduce levels of citrate, a chemical in urine that can help prevent stone formation. A high protein diet can also increase uric acid levels.

Make sure calcium needs are met properly

Eating foods rich in calcium is allowed. In fact, too little calcium can cause an increase in oxalate levels which will lead to kidney stones. Calcium in food also has no effect on the risk of kidney stones.

However, you have to be careful if you want to get it from taking supplements. Calcium supplements have been linked to an increased risk of kidney stones, so their use is often unnecessary if the goal is to prevent kidney stones.

Regardless of which method you want to go for, talk to your doctor so you can find the right solution together.