Keep your fingers crossed and hope you never develop kidney stones! Why? Because they create one of the worst pains known to man or woman. It is difficult to see someone in the agony and distress caused by kidney stones.

Symptoms

Stones may cause no symptoms, but if a stone becomes stuck or in a ureter (one of a pair of tubes carrying urine from the kidney to the bladder), the muscle of the ureter tries to move the stone down the ureter. Although the ureter is a small tube the pain caused by the muscle trying to move the stone is excruciating. The pain is described as 'colicky'. This means that the pain builds to a crescendo then fades for a short time then returns. This is reckoned to be one of the worst pains anyone can experience. The person cannot sit still and writhes around in agony trying to find a comfortable position.

The pain may spread to the lower abdomen and into the groin (referred pain).

Blood in the urine is a common sign of kidney stones. Sometimes the patient may not see this, but a dipstick check of urine will reveal lots blood.

The closer the stone to the bladder the more likely the person is to feel the symptom of wanting to urinate more frequently.

Causes

Doctors do not always know what causes a stone to form. While certain foods may promote stone formation in people who are susceptible, scientists do not believe that eating any specific food causes stones to form in people who are not susceptible.

A person with a family history of kidney stones may be more likely to develop stones. Urinary tract infections, kidney disorders such as cystic kidney diseases, and metabolic disorders such as hyperparathyroidism are also linked to stone formation.

Dehydration, alone, is unlikely to cause stones to form and there is always some other factor such as kidney disease, infection, or some body disturbance that alters the amount or type of substances dissolved in the urine.

Other possible causes are gout and excessive intake of vitamin D.

Treatment

Fortunately, surgery is not usually necessary. Most kidney stones can pass through the urinary system with plenty of water (2 to 3 litres a day) to help move the stone along. Often, you can stay home during this process, drinking fluids and taking pain medication as needed.

You may be asked to collect your urine for 24 hours after a stone has passed or been removed. The sample is used to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate, and creatinine (a product of muscle metabolism). Your doctor will use this information to determine the cause of the stone. A second 24-hour urine collection may be needed to determine whether the prescribed treatment is working.

Prevention

If you've had more than one kidney stone, you are likely to form another; so prevention is very important. To prevent stones from forming, your doctor must determine their cause. He or she will order laboratory tests, including urine and blood tests. Your doctor will also ask about your medical history, occupation, and eating habits. If a stone has been removed, or if you've passed a stone and saved it, the laboratory should analyze it because its composition helps in planning treatment. Many of the stones contain calcium oxalate.

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Kidney stones