Kidney stones are a bit of a mystery.
The tiny black crystals, which are no bigger than a few millimeters, can cause excruciating pain, according to Larry Sellers.
Sellers, a physician at Mercy’s Internal Medicine Clinic, said he has seen patients sweating and riving in pain with their knees tucked into their chest due to kidney stones.
According to Sellers, 13 percent of men and 7 percent of women in the United States will develop urinary tract stones at some point during their life. Over the past two decades, he said, the prevalence of stones has increased by 37 percent.
The majority of kidney stones, Sellers said, pass spontaneously, but those that don't engage the smooth involuntary muscles of the collecting system. Those muscles contract to push the stone along. The process isn't pleasant.
People are also reading…
"It's just like a woman having a baby when labor starts. They know they're trying to push something out," he said. "It's just a little black speck and they can't believe that that little black speck had them rolling around on the floor."
Men are more likely to develop kidney stones than women, according to Sellers. They usually appear after age 40, although he said he recently treated a 21-year-old man for them.
A person whose bowel has been damaged by inflammatory bowel disease or removed during surgery, Sellers said, often wind up with kidney stones.
Most of his patients, he said, don't have any symptoms associated with kidney stones for many years. Then all of sudden back pain sets in. It comes and goes, migrating from the lower back to the side of the pelvic region.
"It's a colicky-type of pain that builds in intensity and then it eases off and then builds in intensity again," he said.
Sellers said most patients are diagnosed with stone disease after a CT scan.
If the patient doesn't pass the stone on their own, he said the method of intervention used will depend on the size and placement of the stone or stones.
A kidney stone stent, a plastic tube placed between the kidney and bladder, he said can be used to help a kidney stone pass.
A stone that cannot be removed via a stent, he said may be broken into smaller pieces with ultrasound.
A recent patient who had several stones and a kidney infection, Sellers said, was treated with a laser.
"Now even if you fail those and you have to have surgery, it's not the big incision and exposing the kidney like it used to be," he said. "They can use a laproscope or a robot, which is a variation of laproscopic technique."
PREVENTING KIDNEY STONES
Diet, Sellers said, doesn't have much to do with preventing kidney stones.
Most kidney stones, he said, consist of calcium oxalate, a chemical compound that forms envelope-shaped crystals. Kidney stones can also be composed of calcium phosphate. Phosphate, he said, is a common chemical found in cola soft drinks.
"We think of calcium deposits in our plumbing, and we know that calcium substances like gravel we put on the roads is a hard, rock-like substance, but the situation -- as far as stones forming in the kidney -- requires the concentration of the substance to exceed the solubility," he said.
Restricting calcium intake, Sellers said will not benefit a patient with kidney stones. Calcium, he said, actually combines with chemicals that don't get absorbed. The chemicals then pass on through the intestines.
When there isn't enough calcium in the body, he said those chemicals don't combine with calcium until they reach the kidneys.
"When they're in the kidney, then they start to form crystals and you can get stone formation," he said. "If you had adequate calcium going into the intestine it can bind with oxalate in our foods so that we don't have to absorb it and we don't have to excrete it."
Sellers said think of a glass of iced tea with sugar. The sugar mixes with the liquid and you don't see it. If you keep adding sugar, however, crystals will form, just like they do in the kidney.
"Crystal formation is an important factor in terms of subsequently developing something that's bigger," he said. "If you get a lot of crystals that coalesce together, that's what forms the stone."
Patients who suffer from kidney stones, Sellers said should drink adequate amounts of fluid, especially water.
Being exposed to a hot environment, where adequate fluids aren't present, he said can actually initiate crystal formation in the kidney.
The more fluids you drink, he said the greater the chance that calcium phosphate and calcium oxalate will remain in solution form and pass through the kidney.
"Sometimes if there's caffeine in the liquid, it may actually act as a diuretic on the kidney and pull water out of the body, so you want people to be reasonable in terms of what beverages they're drinking," he said.
