If you’re a man, the thought of passing a kidney stone is enough to make your eyes water. Mr Andy Symes, urology consultant at The Montefiore Hospital in Hove, offers reassuring advice.
“There are lots of myths surrounding kidney stones (a build-up of crystals in the urine). For one thing, passing them when you go to the toilet is rarely painful and often goes unnoticed.
The most painful part is if the stone becomes stuck in the kidney or lodged in the ureter. Patients describe excruciating pain in the lower back and stomach coupled with nausea Called renal colic, it isn’t life threatening and most patients will be given pain relief and sent home from their GP or hospital to pass the stone naturally. It is important to see a urologist to make sure it has passed, and for advice about prevention.
More men than women suffer with kidney stones, but it is becoming increasingly common across the board, with the blame squarely on poor diets high in protein, salt and sugar. In the Brighton area, we see about 15-20 new renal colic cases a week. But there is a lot you can do to prevent kidney stones appearing or reoccurring.”
- Drink plenty of water. If you have had a kidney stone in the past, aim to drink around 2 to 2.5 litres of water a day. If you have been sent home from hospital to pass the kidney stone, drink normally as too much water may spark the pain again.
- Reduce salt in your diet.
- It’s a myth that citrus fruit dissolves kidney stones. However, it can help with prevention. Try a squeeze of lemon in a glass of water daily.
- many stones containing oxalate, a naturally occurring substance which can combine with calcium in the body to form kidney stones. Foods high in oxalates are - rhubarb, beetroot, spinach, nuts, bran flakes and chips. These should be eaten in moderation.
Increasingly, kidney stones are discovered during a hospital scan for another condition. Very small stones will pass out naturally in the urine undetected. However, if the stone is stuck in the kidney or the ureter, symptoms can develop suddenly. These are:
- intense pain in the back or side of the abdomen, or occasionally in your groin.
- blood in your urine.
- men may have pain in the testicles or scrotum
What can be done
See your GP or attend A&E. Blood and urine tests will be carried out to check for infection and you will be prescribed painkillers. You will be referred to a urologist and be given a CT scan, although often as an outpatient.
Once the pain is under control, eight out of 10 people will be sent home to pass the stone naturally. You can use a small sieve or tea strainer so that you know when the stone has passed. However, patients will be given a follow up scan to check the kidney stone has gone.
Large kidney stones will need surgical intervention. A ureteroscopy is a small scope which allows the surgeon to examine the upper urinary tract and remove the stone. Or the stone will be broken down into smaller pieces by ultra sound waves (called lithotripsy). A large stone stuck in the kidney may need keyhole surgery. Procedures can be done in day surgery.
Mr Andy Symes is a consultant urologist and holds clinics at The Montefiore Hospital in Hove on Wednesday mornings. For more information call 01273 828 148.
First published in Brighton and Hove Independent on 15th June 2018.