A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:
- extracorporeal shock wave lithotripsy (eswl)
To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
- ureteroscopy
This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
- percutaneous nephrolithotomy (pcnl)
This surgery is performed under general anesthesia. It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 

- open surgery
Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone.

Kidney Stones- Should It Be Removed

Urinary Incontinence is the sudden urine loss that occurs involuntarily in women. Some of the factors which cause urinary incontinence are pregnancy, menopause and childbirth. It should be noted that urinary incontinence by itself is not a disease, but is a symptom of other underlying disorders such as diabetes, infections and other conditions.

Causes of temporary cases of urinary incontinence include:
1. Constipation
2. Urinary tract infections
3. Excess consumption of alcohol and caffeine
4. Consuming carbonated drinks
5. Use of artificial sweeteners
6. High doses of vitamin B and vitamin C
7. Being on sedatives, muscle relaxants, blood pressure and heart medications
8. Eatables which are too spicy, acidic or sugary

However, persistence of incontinence might be due to a more serious condition. Some of the causes are stated below:

Age: The bladder muscles tend to weaken with age. This affects the bladder s urine holding capacity.
Pregnancy: Hormonal changes and increase in weight during pregnancy can cause incontinence.
Menopause: Oestrogen is responsible for the healthy maintenance of the lining of the urethra and bladder. The onset of menopause causes the oestrogen hormone levels to drop. The gradual damage of the bladder tissues causes incontinence.
Childbirth: The bladder control muscles are weakened during normal vaginal delivery, thus leading to incontinence.
Obstruction: Occurrence of tumours in the urinary tract can block the normal flow of urine which can cause incontinence.
Hysterectomy: The same ligaments and muscles support both the bladder as well as the urethra. With removal of the uterus by hysterectomy, the pelvic floor muscles are deteriorated. This leads to urinary incontinence.
Neurological disorders: Conditions such as multiple sclerosis (autoimmune disorder in which the immune system destroys the protective sheath of the nerves), Parkinson s disease (disorder affecting motor functioning of the body), brain tumours, spinal injury or strokes are capable of causing incontinence.

Different forms of urinary incontinence are classified on the basis of their symptoms:

Urge incontinence: Urge or urgency incontinence occurs when there is a leak before the person reaches the toilet.
Stress incontinence: Small amounts of urine leak out during normal physical movements such as sneezing, coughing and exercising. This happens because of the minimum stress exerted on the body, and hence, the name.
Functional incontinence: Sudden leakage of urine occurs due to external deterrents or physical disabilities such as not being able to find a toilet.
Overactive Bladder: This is characterized by frequent and urgent urination.
Overflow incontinence: A full bladder, at times, leads to unexpected leakage.
Transient incontinence: If urine leakage occurs due to temporary situations such as infections, or new medications.

Did You Know - Constipation Can Also be a Sign of Urinary Incontinence

The presence of red blood cells in the urine is called hematuria. If there are sufficient red cells, the urine turns to a bright red, pink or cola shade. Frequently, the urine looks totally ordinary because there is insufficient blood to change the colour. In this situation, the condition is called 'microscopic' hematuria.

The most common causes of hematuria are given below:

    Urinary tract infection (UTI)
    Kidney stones
    Tumours in the kidney or bladder
    Exercise: In this case, the blood is produced in the urine after strenuous activity. It is more commonly experienced by male patients.
    Injury: Traumatic damage to any part of the urinary tract, from the kidneys to the urethral opening, can cause hematuria.

The symptoms of hematuria vary depending upon the condition. These are as follows:

    Glomerulonephritis: If the glomerulonephritis is not serious, it may not show any signs. If the symptoms do show up, they can cause swelling, particularly in the lower furthest points(the thighs, legs, feet, and toes), decreased urine, and hypertension.
    Kidney or bladder infection: Symptoms rely on the site of the diseaseand can even cause extreme pain on one side of the lower back, fever, chills, nausea with vomiting, and pain in the bladder.
    Prostate infection: There can be pain in the lower back or in the region between the scrotum and rearend. Pain with discharge, blood in the semen, andfever and chills can also occuronce in a while.
    Tumour in the kidney or bladder: Most kidney and bladder problems develop without bringing about any pain or uneasiness. At the point when side effects build up, abdomen pain may be persistent.
    Kidney stones: When a kidney stone gets attached to the ureters, it can bring about extreme pain in the back, side or crotch, with nausea and difficulties in urination.

Based upon the suspected cause of hematuria, some of the treatments may include the following:

    Urine culture: In this test, a urine sample is extracted and examined to check whether bacteria has developed. This test is used to find a case of a kidney or bladder disease.
    Computed tomography (CT) of the kidneys, ureters and bladder: For most cases,a CT scan is conducted. This helps in viewing the internal organs and finding the areas that may have been affected by the condition. It also shows the extent of the damage and the spread of the disease so that a proper treatment plan may be laid out.
    Ultrasound: This test uses sound waves to create images that can show whether or not a kidney mass is a non cancerous. This method can also be used to find out whether or not there are any kidney stones, which may be causing hematuria.
    Cystoscopy: In this test, the specialist embeds an adaptable telescope into the urethra and passes it into the bladder to investigate the bladder lining for tumours or different issues.

Can Hematuria Be Treated?

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

As we all are aware that waste products in the blood are passed through urine. This filtering process is done by the kidneys as it separates the waste products including minerals and salts, which have to be passed out through urine. Many times, these minerals and salts get stuck in your urinary tract and over a long period, this forms kidney stones. They can vary in size from a ping pong ball to the size of a sugar crystal. They are not noticed till the time they cause a blockage. Sometimes, they cause immense pain if they start breaking or are pushed into the ureters (narrow ducts which lead to the bladder).

Symptoms of kidney stones:
1. Immense pain in the groin, belly and back.
2. Pain while urinating and urination occurring frequently.
3. Blood found in the urine (haematuria).
4. Vomiting and nausea.
5. Feeling extremely restless and not being able to lie still.

Kidney stones can also cause a kidney infection. Signs of kidney infection include:
Kidney stones can also cause infection in the kidneys as they block the passage of urine to the bladder by blocking the ureters. This leads to build up of the waste product which can result in an infection. Some of the symptoms of kidney infections could be:
1. Feeling chilly and shivering on your skin.
2. High temperature of 100.4 F (38C) or more.
3. A feeling of fatigue or weakness.
4. Immense diarrhea
5. Bad smelling and cloudy urine.

Types of Kidney stones:
1. Struvite stones: It contains ammonia and magnesium. It is usually quite large and horn- shaped.
2. Uric acid stones: Brown, smooth and softer than other kinds of kidney stones.
3. Cystine stones: They are yellow and don t look like stones. They usually resemble crystal.
4. Calcium stones: It is composed of calcium.

What causes kidney stones?
Kidney stones can occur due to several factors. It usually forms when urine generally contains crystal substances like uric acid, calcium and oxalate. Your urine might not be able to dilute these substances resulting in the perfect environment for the formation of kidney stones. In case you are showing any of the symptoms mentioned above, you should visit you doctor immediately before the problem can worsen.

Common Symptoms of Kidney Stones

Treatment for Kidney stones varies depending on the size and type of the stone or the symptoms caused by it. In case of small stones, medication and simple changes in lifestyle can be enough to treat it, but surgeries and extensive treatments are required if symptoms are severe. 

Following are treatment options for kidney stones:

Small stones with minimal symptoms 
1. Drinking water
Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones. 

2. Pain relievers
There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen. 

3. Medical therapy
In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy. 

Large stones with severe symptoms
 
1. Using sound waves to break up stones 
In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. 

2. Surgical removal of kidney stones 
Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails. 

3. Ureteric Calculi (Using a scope to remove stones) 
A thin illuminated tube called ureteroscope is used to remove a comparatively smaller stone in the kidney or ureter. The ureteroscope is equipped with a tiny camera which determines the location of the stone which is then broken into pieces with the help of other instruments. It may require general or regional anesthesia.

Treatments For Kidney Stones

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