Kidney Stones Health Feed

There are diseases which affect us in spite of us trying to keep them away as far as possible and then there are lifestyle diseases, for which we are largely to blame. It can be said that lifestyle diseases are those, which occur on account of the decisions we make and the actions we commit. Having said that, would it not be interesting to know more about lifestyle diseases?

There are various kinds of lifestyle diseases, which affect various parts of the body. For instance, if a person drinks a significant amount of alcohol, more than what he or she should, then he may soon be affected by a lifestyle disease in the form of liver cirrhosis. Apart from just the alcohol, this condition can also be caused on account of chronic hepatitis.

1. Stroke: A lot of people are of the opinion that a stroke is something, which only strikes old people. However, this is not correct. In fact, there is quite a bit of trouble can be caused if this opinion is held and people allow themselves to not care enough about their health using this as justification. Statistically, up to 15% of the cases of stroke in a country such as India occur to people who have not even reached the age of 40. Surprising and scary at the same time, isn’t it?
2. Kidney problems: When people think of lifestyle diseases, they most likely think of problems, which are related to the heart. While it can be said that a heart attack on account of bad lifestyle choices has the highest visibility, even parts of the body, which are rarely thought of like the kidneys, can kick up trouble in the form of nephritis. So, what exactly happens when a person has nephritis? Simply put, the kidneys swell up and this causes a lot of pain, which could have been avoided with a reasonable amount of foresight and effort. When this occurs, kidneys create trouble when they need to perform their primary function of purifying blood and complications related to the kidneys can really have a magnified impact on other parts of the body.
3. Heart disease: Finally, addressing the elephant in the room, when it comes to lifestyle diseases - heart disease. Around 31% of people who die every year worldwide fall prey to it and the main culprits behind heart failures include smoking, diabetes, and very high cholesterol levels.

Kidneys stones are a common condition. They are quite different from Gallstones which are formed in the Gall bladder. Gall stones are from bile concentration in the gall bladder. "Silent" Gallstones which are detected on an ultrasound done for another cause, can be left alone.

However, silent kidney stones should never be left alone. These can silently grow to a large size and cause kidney failure without the patient ever experiencing pain. Every patient of stone needs to be evaluated by blood tests, ultrasound and possibly CT-scan. Small stones 5 mm or less may pass out naturally, but should be monitored on Ultrasound to confirm clearance. Larger stones are cleared by a variety of Endoscopic Operations like Ureterorenorenoscopy, PCNL or ESWL. These need 1-2 days hospitalisation and have quick recovery. The stone removed should be analysed for contents so that appropriate preventive measure in diet and medicines can be started as soon as possible. 

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

1. Most stones which are lying in calyces of kidney are asymptomatic 
2. Nausea & vomiting 
3. Frequent urinary tract infections 
4. Fever with chills 
5. Foul smelling urine 
6. Hesitency, frequency and burning in urination 
7. Blood in urine (urine with a reddish, pink or brownish hue) 
8. Passage of small stones in urine 

Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

1. Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
2. Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
3. Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
4. RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
5. Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.