Kidney and Ureteral Stone

Understanding Kidney Stone Pain and Management

The intense cramping pain you’re experiencing in your lower back, along with feelings of nausea or vomiting, can be attributed to a small stone that has formed within your kidney. This stone is currently navigating a narrow tube called the ureter as it makes its way toward your bladder. As the stone reaches your bladder, the severity of the pain typically diminishes. However, the pain might recur as the stone continues its journey, exiting the bladder and passing through the urethra. The stone could either pass in one piece, with a size ranging from 1/16 inch to 1/4 inch (1 mm to 6 mm), or it could disintegrate into sand-like particles that might go unnoticed.

 

Potential for Future Kidney Stones: 

After experiencing a kidney stone episode, there’s a possibility of developing another stone in the future. There are four main types of kidney stones. Around 80% of kidney stones are calcium stones, primarily consisting of calcium oxalate, with some composed of calcium phosphate. The remaining three types include uric acid stones, struvite stones (resulting from previous infections), and the rare cystine stones.

 

Managing Kidney Stone Passing:

Most kidney stones will eventually pass on their own, a process that can take anywhere from a few hours to several days. If a stone is too large to pass naturally, alternative methods will be employed to remove it. These methods include:

Shock Wave Lithotripsy:

This noninvasive procedure employs high-energy sound waves to fragment the stone, facilitating its passage.

Ureteroscopy:

This procedure involves inserting a tool through the urethra and bladder into the ureter to extract the stone. Anesthesia is administered for this procedure.

Surgery:

In cases where a stone cannot be passed or removed using other methods, surgical intervention might be necessary.

 

Home Care Recommendations:

Ensuring ample fluid intake, equivalent to at least 12 eight-ounce glasses of predominantly water per day.

Collecting urine in a container each time you urinate and straining it through a sieve into the toilet. Continue this process until 24 hours after pain subsides. By then, if a kidney stone was present, it should have passed from the bladder. Sometimes, stones dissolve into particles resembling sand, which can be strained out, making the stone invisible.

Safeguarding any stone you find in the strainer and presenting it to your healthcare provider for a detailed examination. Understanding the type of stone is crucial, as it can influence preventive measures.

Maintaining activity to aid the stone’s passage, unless severe pain inhibits mobility. Urine might appear reddish, pink, or brown while passing a kidney stone, which is normal.

If pain emerges, ibuprofen or naproxen can be taken for relief, unless otherwise directed by your healthcare provider. Prior consultation is essential if you have chronic liver or kidney disease or a history of stomach ulcers or digestive bleeding.

 

Preventing Future Kidney Stones

Over the next 5 to 7 years, there’s a 50% risk of developing another kidney stone. This risk is higher if you have a family history of kidney stones or certain chronic conditions like high blood pressure, obesity, or diabetes. Lifestyle and dietary changes can mitigate this risk. For calcium stones, which constitute most kidney stones:

Adequate fluid intake remains paramount.

Consuming foods rich in phytates, such as wheat, rice, rye, barley, and beans, may lower the risk of stone formation.

Increasing consumption of potassium-rich fruits and vegetables is advised.

Foods naturally abundant in citrate, like fruit and low-sugar fruit juices (e.g., lemon juice), can help prevent stone formation by inhibiting crystal formation.

Ensuring a moderate calcium intake is important. Research shows that pairing calcium-rich and oxalate-rich foods can reduce stone risk by binding minerals in the stomach and intestines before reaching the kidneys.

Limiting salt intake to 2 grams (1 teaspoon) daily can help prevent excess calcium in urine. Processed and canned foods tend to be high in salt.

Moderating the consumption of high oxalate foods (e.g., spinach, rhubarb, nuts) and pairing them with calcium-rich foods.

Reducing animal meat, shellfish, high protein foods, and alcohol intake to lower the risk of uric acid stones.

Limiting sugar and fructose intake, and avoiding excessive vitamin C supplementation.

Consulting a dietitian or healthcare provider for personalized dietary recommendations to prevent kidney stone recurrence.

Follow-Up and Medical Care

Seek prompt medical attention if pain persists beyond 48 hours or if specific symptoms occur. Engage in conversations with your healthcare provider regarding urine and blood tests to determine the underlying cause of the stone. Diagnostic findings from X-rays, CT scans, or other tests will be shared to inform your ongoing care.

Urgent Situations and Medical Care:

Contact 911 if you experience:

  • Weakness, dizziness, or fainting.

When to Contact Your Healthcare Provider:

Get in touch with your healthcare provider immediately if any of the following occur:

  • Inadequate pain relief from prescribed medication.
  • Recurrent vomiting or inability to retain fluids.
  • Fever of 100.4°F (38°C) or higher, as advised by your provider.
  • Passage of solid red or brown urine (impenetrable to light) or urine containing numerous blood clots.
  • Foul-smelling or cloudy urine.
  • Inability to urinate for 8 hours with escalating bladder pressure.
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