Warm weather is upon us. And since we have a tendency to get dehydrated while working or playing outside, those of us in medicine will start to see more kidney stones. But what are they, and why do we see more in summer?
Kidney stones occur in some people when certain chemicals, most commonly calcium oxalate, come out of solution in our blood and become deposited and concentrated in our kidneys. This happens more in summer because we lose fluids due to sweating and because we often don’t drink enough water to keep those chemicals dissolved.
Once they are in our kidneys, they can grow bigger over time. Some of them stay put and are discovered incidentally on X-rays or CT scans. Others decide to take a journey out of the kidney and pass into the ureter that leads to the bladder. Along the way, they cause spasm and irritation of the ureter. The result is pain in the flank or abdomen, blood in the urine, an urge to urinate, and sometimes difficulty urinating.
Having experienced the kidney stone demon, I can say that stones are really, really painful. We treat them with hydration, anti-inflammatory drugs, nausea medicine, anti-spasm medications and sometimes with narcotic pain medications as well. Some stones pass quickly, on their own, and may respond to over-the-counter pain medications like acetaminophen or naproxen.
However, some stones get into the ureter and get stuck. How do we help them pass?
Urologists, who specialize in the urinary tract, sometimes pass a tube up the urethra. That tube has a device used to remove the stone. Sometimes lasers are used to burn the stones. Some stones are removed using lithotripsy, in which high energy sound waves break the stones into pieces. After the stones are removed, a “stent” may be placed to keep the ureter open.
All of this is especially important, because sometimes those stones cause more than pain and stop the outflow of urine, allowing the urine to become infected. When the urine can’t drain and is full of bacteria, the bacteria can spread to the blood stream and cause dangerous, and sometimes deadly, sepsis. In other instances, especially in those with poor kidney function, the stones can cause kidney failure.
Kidney stone symptoms, such as pain and vomiting — coupled with symptoms of infection symptoms like burning on urination, fever and flank pain — constitute a medical emergency that should not be ignored or delayed.
These little monsters are manageable, but please take them seriously. And especially in the summer, remember to drink plenty of fluids!