What one simple habit will prevent what’s been called the worst pain ever? We’re talking roll-on-the-floor, get-me-to-the-ER type of pain.
Drink up. Yep, that’s it. Drink more fluid. That’s what Dr. James Reynolds calls the main practice to prevent kidney stones.
“Poor fluid intake is the No. 1 cause of kidney stones,” the urologist said.
If you think about the mechanics, it makes sense. The more you drink, the more you urinate and flush out your kidneys. It’s the “concentrated” urine that results in stones.
But if you get a kidney stone, professionals like Dr.Reynolds can guide you through the jungle. First, what causes kidney stones? “That’s the million dollar question,” says Dr. Reynolds.He emphasizes, however, that stones are not caused by too much soda pop. Dr. Reynolds describes as “absolute nonsense” this common belief that dark colas somehow induce kidney stones.
Instead, the many kinds of kidney stones are caused by so many different factors that “it’s a chapter in the urology book that’s about a hundred pages long,” he says.
All share some commonalities, though. The vast majority of kidney stones — 80 percent — include calcium, most often mixed with oxalate, a naturally occurring substance found in plants that binds with the calcium and crystallizes.
The other commonality is pain. And more pain. Regardless of what they’re made of, kidney stones can hurt. A victim of a kidney stone himself, Dr. Reynolds often hears “that it’s the worst kind of pain you can get.” He adds, “I’d have to agree.”
The composition of the stone won’t be determined until it’s extracted and analyzed.
A long, painful journey
First up, an exam by Dr. Reynolds. If a stone is identified, and if it’s small enough, say 5mm or less, he’ll recommend the patient wait for it to pass. Kidney stones proceed from the kidneys through the ureter, a long tube that carries urine to the bladder. The stone has to then make its way through the urethra and into the toilet bowl.
If the stone is too large to make that journey, then surgery is in order. Dr. Reynolds usually begins with what is called extracorporeal shock wave lithotripsy therapy, or ESWT, a procedure that resonates shock waves through the abdomen. The shock waves seek to blast the stone into fragments that are small enough to pass in urine.
This process can also be painful, he said, depending on how the crumbs end up. “Some people are pain free afterwards and pass them quickly. Some people have a lot of pain passing the fragments. It depends on how well they break,” he said. “Our goal is to get it in small enough pieces, but it’s hard to predict.”
The lithotripsy is successful in most cases — about 90 percent, says Dr. Reynolds. But when that doesn’t work, the next step is to go after the stone ureteroscopically — using a scope to inspect the ureter. The stone is broken up with a laser, he said, “unless it’s small enough that we can just pull it out.”
Recovery is usually uncomplicated for this outpatient procedure.
Difficult to overdose on calcium
While there are many factors behind the causes of kidney stones (most involving calcium), your diet is usually not one of them. Don’t worry about taking calcium supplements or drinking a lot of milk.
In fact, said Dr. Reynolds, calcium is sometimes prescribed, an issue that has to do “with the chemistry of calcium oxalate formation.”
Also recommended in some cases is potassium citrate, which helps decrease the acidity of the urine.