Urinary stones are one of the diseases of affluence, the frequency of which has increased in recent years. They occur when the body is overloaded with the elimination of its toxins.
What are urinary stones?
According to Abbreviationfinder, urinary stones are mineral deposits in the body that have combined to form larger structures. They occur in the efferent urinary tract ( ureters, bladder and urethra ) and in the kidneys. The form and chemical composition can vary.
Urinary stones form when salts dissolved in the urine precipitate as crystals. Most are made of calcium oxalates, but stones made of cystine, uric acid, or phosphate are not uncommon. If the deposits cannot be flushed out naturally, they will grow into crystals over time. These can take on rounded or branched forms.
Depending on the localization, a size of up to several centimeters is possible before the first symptoms appear. Approximately every 20th German suffers from urinary stones in the course of his life, including twice as many men as women. Those affected usually receive their first diagnosis between the mid-20s and 60s.
Causes
Urinary stones often develop as a result of metabolic diseases or hormonal disorders that make it difficult for certain substances to be broken down. But basically everyone can get urinary stones. Any behavior that increases the salt and acid concentration in the urine encourages the formation of the crystals.
If the daily fluid intake is too low, the urinary tract is not flushed out sufficiently. Poor nutrition also plays a major role. Eating too much meat and coffee increases uric acid levels. Due to the resulting imbalance between water and the substances dissolved in it, the urine takes on a dark yellow color. If this is the case, even healthy people will develop deposits from which stones can develop.
Bladder stones are often the result of insufficient emptying of the bladder, which leaves residual urine. This particularly affects men with an enlarged prostate and people who suffer from urethral constriction, paraplegia or multiple sclerosis.
Symptoms, Ailments & Signs
Urinary stones cause sudden, colicky abdominal pain. The pain usually occurs in spurts and can radiate to the entire abdominal region and to the genitals. Accompanying this, the patient feels a strong urge to urinate and nausea. There are often difficulties in urinating and other symptoms that clearly indicate urinary stones.
The clearest sign of an illness is the red-colored urine. In the absence of treatment, complete urinary retention can occur, which is initially manifested by severe pain and increasing nausea. In the further course, the urethra can rupture, which is also associated with severe pain, blood in the urine and discomfort.
In less severe cases, the urinary stone merely wedges itself in the ureter and causes slight pressure pain. Burning pain occurs more quickly in women due to the shorter ureter. Externally, urinary stones are usually not visible. However, typical symptoms such as sweating and pale skin can occur.
External changes are also possible, particularly in the case of chronic complaints, for example an ailing appearance or inflammation. If the urinary stones are removed early, there are no serious symptoms or long-term effects.
Diagnosis & History
Urinary stones are most commonly recognized when they lodge in the ureter. They cause sudden, colicky pain that can be felt in the entire abdominal region up to the genitals. At the same time, the affected person feels a strong urge to urinate and nausea.
The pain associated with ureteral stones disappears as suddenly as it came, but returns at irregular intervals. Cramping pain, an increased urge to urinate and difficulty urinating indicate bladder stones. Stones with sharp edges can cause internal injuries if they move in the urinary tract. This manifests itself in red-colored urine and can lead to dangerous infections.
Kidney stones are often discovered by accident as they usually show no symptoms. Depending on their chemical composition, the stones can be located either on X-rays or with ultrasound scans. Urine and blood tests also help with the diagnosis. If nothing is done, it can lead to the formation of a so-called spill stone in severe cases. The entire urinary tract is “poured out” with deposited minerals
Complications
Urinary stones block the urinary tract, which can have serious consequences. In general, urinary stones cause very severe pain that radiates into the groin. This can severely limit the patient’s quality of life. On the one hand, the urine can build up so much that it is back in the kidneys.
As a result, the kidney can dilate (hydronephros) and become inflamed. The inflammation can go so far that the kidneys fail (renal insufficiency). As a result, the kidney can no longer perform as it used to. Less urine is expelled, leaving more volume in the body, leading to high blood pressure. Long-term high blood pressure can lead to occlusion of the vessels as part of an atherosclerotic process.
The increased blood volume ensures that more water is pressed into the tissue, resulting in edema. Furthermore, the kidneys can no longer produce enough hormones, which leads to a lack of vitamin D and anemia (due to EPO deficiency). The kidneys also experience disturbances in the electrolyte and acid-base balance.
It can no longer excrete enough protons, so that the pH value in the blood continues to drop. As a result, potassium also accumulates in the blood. An increased potassium concentration promotes the development of cardiac arrhythmias, which can be associated with sudden cardiac death.
When should you go to the doctor?
A doctor should be consulted in the event of unusual urinary behavior, blood in the urine or fever. Like any other type of stone, urinary stones require a comprehensive medical diagnosis. Larger stones need to be broken up using shock wave therapy, while developing small stones need medical supervision. In the case of urinary stones, comprehensive aftercare is always required. That is why you should go to your family doctor or urologist with urinary retention, pain in the kidney region and other complaints.
A visit to the doctor is indicated at the latest if the symptoms persist for more than five days or increase in intensity over time. If the symptoms occur together with fever or circulatory problems, it is best to call the emergency doctor.
Patients with urinary tract infections, children, pregnant women, the elderly and people who regularly consume alcohol or coffee are among the typical risk groups. Likewise, people with congenital narrowing of the urinary tract or chronic kidney disease. If the symptoms are mentioned, they should speak to a doctor as soon as possible to avoid serious complications.
Treatment & Therapy
In the case of acute colic, the patient is given antispasmodic drugs in addition to painkillers and anti- inflammatory drugs. In most cases, the urinary stones then slide on by themselves and are passed out after a short time. However, a lot of drinking without antispasmodic measures is useless.
At this point, because of the pain, the patient’s interior is so cramped that the urinary tract narrows and the stones get stuck. From a certain size, urinary stones can no longer be excreted. In these cases, surgery may be necessary.
Shattering with shock waves is also possible. Here the stones are bombarded with energy waves from the outside after their exact localization, whereby they shatter into small parts. They are crushed until they can be flushed out.
In the case of uric acid stones, the patient is given drugs that chemically dissolve the stone. When all gentler methods have been exhausted, crushing is done with forceps or lasers. The risk of developing urinary stones again is very high for the people affected. A quarter of patients need to be treated at least four times in their lifetime. With the appropriate measures, the renewed formation of urinary stones can be slowed down or completely prevented.
Outlook & Forecast
People who have urinary stones have a favorable prognosis in most cases. If treated early, there are good therapeutic options, so that the symptoms can be alleviated and the disease cured at the same time.
In the case of small urinary stones that cause only a few symptoms, drug treatment is often sufficient. In the best case, the urinary stones are removed from the body via the natural excretions due to the active ingredients and recovery occurs. In the case of larger urinary stones, the foreign bodies are crushed or surgically removed.
The shattered small parts are then also transported out of the body via the excretions. A recovery is given after a few weeks. In a control examination, imaging procedures are used to finally check whether all foreign bodies have been removed.
Due to social developments, an increase in diseases caused by urinary stones has been documented in recent years. It is not uncommon for the stones to reappear in the course of life. If the foreign bodies are recognized and diagnosed in good time, the prognosis remains favorable even in the event of a recurrence.
If no medical treatment is sought, a deterioration in health is to be expected. In severe cases, there is a risk of an acute condition that requires emergency medical care. Otherwise, there is a risk of the person concerned dying prematurely.
Prevention
Drinking at least two liters of water a day dilutes the urine so that fewer deposits form. Existing deposits and smaller stones can be washed out naturally. Physical activity supports this process.
A change in diet makes sense if the person concerned has already had problems with urinary stones. Which foods he has to avoid depends on the composition of the stones that have been removed from him. The patient should check his urine at home with test strips and adjust his drinking and eating habits accordingly.
Aftercare
In order to prevent a recurrence, proper follow-up care after treatment is essential. The amount of liquid consumed should be increased to such an extent that the amount of urine produced is more than two liters per day. This leads to dilution of the urine and an overall reduction in stone formation.
A change in diet adapted to the individual case can also prevent the formation of new stones through targeted changes in the pH value. Ideally, a urinary stone analysis could be carried out by the doctor treating you as part of the treatment. The majority of those affected have calcium oxalate stones, the formation of which is favored by foods containing oxalate.
Examples include rhubarb, celery, parsley, soy, beetroot, spinach, cocoa, nuts and black tea. Oxalates, which cannot be adequately diluted and excreted due to insufficient fluid intake, adhere to calcium and form urinary stones. Follow-up care would consist of drinking more and ideally not eating these foods.
Uric acid stones develop when the urine becomes too acidic, which is caused by a diet rich in protein and purines. Avoiding purine-rich foods such as meat, sausages, offal, alcohol, legumes and certain fish, and a low-protein diet reduce the acidity in the urine. In consultation with the doctor, this effect can be enhanced by the targeted intake of alkalizing foods.
You can do that yourself
Those affected can take some measures themselves against urinary stones. Warmth, movement (especially jumping and climbing stairs) and plenty of fluids are particularly important. In addition, there are dietary steps: a low- purine diet and avoiding milk and milk products as well as chocolate, nuts, beans, spinach and luxury foods such as alcohol and caffeine.
Beer in particular should be avoided due to its high purine content and negative effects on uric acid levels. Strict diets are not recommended, however, as this can lead to the development of further urinary stones.
Dragees or herbal drops with birch leaves, rest harrow or horsetail can help. Effective remedies from herbal medicine are also teas made from bedstraw, dandelion roots or Orthosiphon. With lemon juice, apple cider vinegar and celery juice, there are also some household remedies that help against the pain and promote the passage of urinary stones.
Once the stones have been washed out, vitamin A can support the regeneration of the damaged tissue. In order to avoid new complaints, the cause of the kidney gravel must also be determined and eliminated in the long term. If you have severe pain, cramps or urinary retention, you should see a doctor if you have urinary stones.
