If you know someone who has had kidney stones, or you have experienced the agony yourself, you know that the pain can be unbearable. Kidney stones are one of the most painful experiences a person can have, sometimes even surpassing the pain of childbirth. What exactly are kidney stones, how are they diagnosed, and what can be done about them? Read on to find out more information, and how Servant Medical Imaging can help you diagnose kidney stones.
Importance of the Kidneys
Most people have two kidneys, each about the size of a fist, located in the back area behind the ribs. The kidneys filter the blood and produce urine, which flows through the ureters (long tubes) to be stored in the bladder. The bladder fills and then empties through a short tube, the urethra. The kidneys help keep the body’s blood in the right composition by eliminating waste in the body. Every day the kidneys filter 120 to 150 quarts of blood and produce 1 to 2 quarts of urine. The kidneys are incredibly important for overall health, including keeping bones healthy, blood pressure stable, and pH levels balanced.
Kidney Stone Formation
Kidney stones form when the urine contains more crystal-forming substances than can be diluted by the urine. These substances form tiny “stones” inside the kidneys which may or may not deposit permanently in the kidney. Some of these stones are not even as big as a grain of rice, but they can wreak havoc on the kidneys and cause massive pain when they are loose and begin to pass down the ureter. There are several types of kidney stones:
- Uric Acid Stones: These stones can result when someone is dehydrated, and the urine becomes too concentrated. Genetic factors, a high-protein diet, and gout are all associated with uric acid stones.
- Cystine Stones: These stones are hereditary and are caused by the kidneys producing too many of certain amino acids.
- Struvite Stones: These stones are formed as a response to an infection, such as a urinary tract infection.
- Calcium Stones: This is the most common type of kidney stone, and form when too much calcium oxalate is present in the body. Nuts, chocolate, dark leafy greens, and some other fruits and vegetables are high in oxalate. These types of stones are also common during pregnancy.
Whatever the stone is made of, it can block urine from exiting the kidneys and being cleared from the body. The urine backs up in the kidney and causes severe pain but the worst pain is when the stone travels through the ureters to the bladder. Even though they are tiny, they have extremely rough, jagged edges that can cause incredible pain.
Many people who have a kidney stone for the first time have no idea what is going on, but know that they are in excruciating pain. If a kidney stone is not moving or is not blocking the exit of urine from the kidneys, you might not know it is even there. The symptoms that commonly present in patients with kidney stones include:
- Sudden severe pain in the low back, side, groin, or abdomen.
- Pain does not change with position.
- Pain that comes in waves.
- Urine that is pink, red, or brown (fresh or old blood)
- Nausea or vomiting.
- Fever and chills.
- Pain on urination; inability to urinate much liquid.
The pain that comes with a kidney stone can cause a patient to be unable to sit down, sleep, or concentrate on anything but the pain.The pain is so severe that most patients find themselves at an Urgent Care Center or ER to be examined.
Kidney stones should be suspected in patients who present with the symptoms listed above, although other disorders which may be even more serious, such as dissecting aortic aneurysm, can mimic ureteral stone pain. There are several ways that a conclusive diagnosis will be made, including blood and urine testing and imaging. Urine testing can be useful for quickly showing blood in the urine and both urine and blood testing can determine the underlying cause of the stones. But these may take hours or days to get results. By then, the stone has passed or surgical or other intervention has occurred. To arrive at a faster diagnosis, medical imaging is used which can show stones that are in the kidneys or ureters.
Abdominal x-rays are rarely used to diagnose kidney stones as they are less helpful than other imaging and may miss smaller stones or be difficult to see in gaseous patients They can detect larger calcified stones and may be the only option a patient has in less traveled regions.
This test involves x-rays and injected dye to see how the kidneys, ureters, and bladder are functioning. Intravenous Pyelogram (IVP) may result in contrast (dye) reactions in some patients and, like x-rays, still involve radiation.
A CT scan with computer processed thin x-ray images of the body, can quickly reveal whether kidney or ureteral stones are present. A CT scan gives a more detailed picture than a plain x-ray and is the preferred imaging study to evaluate for stones, although recent studies have suggested that ultrasound should be considered first. CT usually is done without contrast dye injection.
An ultrasound uses sound waves to look at the kidneys and bladder. There is no radiation with an ultrasound and is preferable for pregnant women early in a pregnancy.
Both CT scans and ultrasounds find most kidney stones, and choosing either one will not affect your pain level, complications from kidney stones or your treatment plan.
Many kidney stones will pass out of the body within 48 hours, and drinking a lot of fluids will help with this process. Anti-inflammatory drugs or pain medications may be prescribed by your doctor to deal with the pain. Some stones will be too large to pass through the ureter, and stones larger than 9 or 10 mm rarely can pass on their own. If stones will not pass naturally, a process called lithotripsy may be recommended. Lithotripsy uses shock waves to break the stones into smaller pieces that can more easily exit the body. Older methods of kidney stone removal used surgery to manually remove the blockage, but this is not as common today. If you are able to pass the stone, it is helpful to save it so your physician can analyze what type of kidney stone it is and develop a treatment plan.
Prevention is the best medicine when it comes to kidney stones. Drinking enough water every day, especially if you live in a dry climate, can help to keep your urine diluted and prevent stone formation. If you find that you are prone to forming calcium oxalate stones your physician might advise you to modify your diet to avoid foods high in oxalate. Pregnancy can predispose women to kidney stones, so staying well hydrated is especially important when you are pregnant. And even though many stones are calcium-based, making sure your diet has enough calcium is important to prevent kidney stone formation. Avoid excessive Vitamin D if you are prone to kidney stones. Also, studies have also shown that lemonade, limeade and juices high in natural citric acid can help prevent stones from forming or becoming larger. If you have passed a kidney stone in the past, you need to be even more careful to prevent new stones in the future. Stones can form again and recurring kidney stones could indicate a larger problem, such as kidney disease.
Hopefully you will never have to experience the pain that comes with kidney stones. But if you do, you will be thankful that medical imaging can quickly diagnose the problem and help get you started on the appropriate treatment. If your physician suspects a kidney stone and you need imaging done, turn to Servant Medical Imaging. We have convenient medical imaging contact us around Oklahoma City, Tulsa, Stillwater and Broken Arrow—contact us today!