Which is harder: passing kidney stones or a bowling ball through a straw?

In a funny episode of Modern Family, Phil wakes his entire family in the middle of the night when he tries to pass painful kidney stones.  “There’s an alien inside of me,” he cries out in melodramatic anguish. His wife, Claire, not nearly as sympathetic as Phil thinks she should be, makes the mistake of telling him rather matter-of-factly, “It’s just a kidney stone.”


“Just a kidney stone,” he bellows indignantly. “Someone get your mom a glass of water and a piece of gravel from the driveway and let’s see how she likes it!”

If you’ve ever experienced the symptoms of kidney stones (excruciating pain in the groin or side, blood in the urine, vomiting and nausea, and a burning sensation during urination) you can probably identify with good ol’ Phil—especially if you are male. While women suffer from kidney stones, too, men are more prone to form stones. “About one in 10 guys at some time will get a kidney stone,” says Harrison Mitchell Abrahams, M.D., director of kidney surgery at Urology Associates of North Texas and USMD Cancer Center in Arlington, Texas.

Texans—especially those who either work outdoors or spend a lot of time outside gardening, exercising or playing sports—are at particular risk because hot temperatures contribute to dehydration—one of the major causes for kidney stones. “We call this the stone belt,” Dr. Abrahams says.

During his informative free lecture, Leave No Kidney Stone Unturned—part of September Man Series at USMD Hospital at Arlington—Dr. Abrahams explained why USMD is one of the busiest stone hospitals in the nation. “The rate of kidney stones is going up—even in kids, due to obesity or because they’re drinking soda and caffeinated drinks at a younger age.”

While there are different types of kidney stones (calcium oxalate, calcium phosphate, uric acid, struvite and cystine), they are all the result of crystal formations in the kidney and urinary tract. Most are hard and calcified, but some can have a mushy consistency similar to peanut butter or bubblegum. “We know a lot about why people make crystals—not stones,” Dr. Abrahams says. “For stones to form, people have to make crystals in their urine. The crystals have to clump together. And the clumps have to stick to the kidney. All three of those things have to come together.”

Scientists don’t know exactly why some people are more prone to form crystals than others, but they know the body’s pH balance plays a role. When the body’s normally alkaline balance of 7.4 becomes more acidic because the kidneys or lungs aren’t functioning as well as they should, urine becomes more acidic and makes conditions right for the formation of crystals. Oxalate-rich foods—chocolate, spinach, tea, pepper, peanuts, cocoa and wheat germ—can also contribute to crystal formations. Older people, individuals who are overweight and folks who suffer from certain chronic illnesses (Crohns disease, gout and parathyroid disease) are more likely to form kidney stones, too.   

When the stones begin moving and get stuck where the ureter meets the bladder, urine backs up in the kidneys and you begin to feel the painful symptoms of kidney stones. Twenty years ago, the treatment for kidney stones often involved open surgery. Large incisions meant patients had to endure a long recovery period. Today, Dr. Abrahams and his colleagues use a variety of minimally invasive procedures to remove kidney stones quickly and help patients feel better much faster. Depending on the type of kidney stones you have and their location, you may need a stent or nephrostomy tube, shock wave lithotripsy, ureteroscopy with laser lithotripsy or percutaneous nephrostolithotripsy. (You can see a detailed description of each procedure at http://www.uant.com/general_urology/kidney-stones.php)

Prescription alpha blockers and potassium citrate also offer effective treatment for kidney stones. But one of the best ways to help prevent kidney stones and the painful symptoms of kidney stones is something simple you can do every day.  “Drink lots of fluids. You want to drink enough fluids—about 80 ounces—to generate 2.5 liters of urine output in 24 hours,” Dr. Abrahams says. “It’s best to drink fluids that don’t have caffeine because caffeine is a diuretic that fools the kidney. Also restrict your salt intake to about 3,000 mg a day.”

If you have a history of kidney stones or are experiencing any of the painful symptoms of kidney stones, Dr. Abrahams and the board-certified urologists with Urology Associates of North Texas and USMD Hospital at Arlington can help. Call (817)417-1100 to schedule a consultation.


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