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"Last week I had severe abdominal pain,
nausea and vomiting; and then I was admitted to the nearby hospital
and had been treated with intravenous fluids and injections. After studying
my X-ray and scan reports the doctor said that, both of my kidneys have
stones and he advised me to undergo a surgery of the latest laser treatment.
Can I avoid surgery, Doctor?"
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Kidney
stones are the commonest universal complaint. Kidney stones modify the
victim’s behaviour with great fear of intense pain and threaten with failure
of the kidneys. The medical term for kidney stones is Nephrolithiasis
or Renal Calculi.
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| What are kidneys? | |||
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The
kidneys are the master chemists of your body. Normally, you have two kidneys,
one on either side of the spine under the lower ribs. They are pink in
colour and shaped like beans. Each kidney is about the size of your fist.
The urinary system is made up of the kidneys, the ureters, the bladder
and the urethra. Each plays an important role in helping your body to
eliminate waste products in the form of urine.
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The
main function of the kidneys is to remove the waste products from the
blood and return the cleaned blood back to the body. The ureters carry
the waste products,
as urine, from the kidneys to the bladder where it is stored until you
urinate. Urine passes out of the body through a tube called Urethra.
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| How does the stone form? | |||
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Kidney
stones usually are formed inside the kidney. The body creates kidney stones
from a wide variety of substances. It is very difficult to know exactly
what kind of stone a patient's body produces. The stones are formed from
a supersaturated solution of urine. “Promoters” are the components of
the various stones: calcium, oxalate, urate, cystine etc. “Inhibitors”
of stone formation include pyrophosphate and magnesium. The formation
of a renal calculus depends on the balance between stone promoters and
inhibitors. “Citrate” tends to prevent stones. The stones are formed as
small crystal which gradually increase in size. They travel through ureter
to reach the bladder. Sometimes the patient may void small stone with
mild irritation while urination. Larger ones block the urinary tract causing
pain, hydronephrosis and failure. A kidney stone can also develop
when certain chemicals in your urine form crystals that stick together.
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| What causes kidney stones to form? | |||
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There
are many potential causes of kidney stone formation. In general they are
the result of a superconcentration of chemicals in the urine that results
in crystals being formed. A disorder in your metabolism, dietary habits,
dehydration, recurrent urinary tract infections, blockage of the urinary
tract could alter your urine concentration.
" I have stones in my kidneys! What is the reason Doctor?" is an universal question of a patient to every practitioner after being confirmed with investigations. The most commonest answer to the patient could be ,“ You have metabolic disorder". Your body could not assimilate the minerals and salts such as calcium, uric acid or other salts in the blood, which is not assimilated by your body. Metabolism impairs commonly with the endocrine disorders as hyperparathyroidism, certain diseases like Ulcerative colitis and Regional enteritis. In Gouty arthritis the high level of uric acid in the urine can act as breeding ground for calcium oxalate stones. On the whole it is a complex process.
" I have food habits like others! Why does my kidneys develop stones?" the next common doubt of the patient. Diet contributes a part in the formation of stones and considered as maintaining causes. Clinically it is observed that being habitual for a particular food had promoted stones. A pregnant woman was advised to take plenty of “greens” to raise iron in the blood, and she had developed stones following an acute renal colic. Similarly a patient who had abnormal craving for “Tomato” is now on the treatment for Renal calculus. Habits like "betel chewing" with lime should also be considered. " Have you ever had burning micturation?"– to rule out infection a physician may put a leading question to you. Chronic infection may predispose stone formation. The slough and the crusts results following an infection, would combine with high level minerals and salts to form stones. This is considerably noted in the formation of vesical calculus after chronic cystitis. “ How is your urine stream?” |
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| What are the symptoms? | |||
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A
stone may quietly grow for years together and remains silent even for
many years. Very often it is an incidental finding in routine for
the other illness. A kidney stone can cause problems in two-ways:
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After
keeping silent for sometime, the stone may start to move downward
drawn by the urine and gravity. When the stone makes its run for freedom,
it hurts the patient with severe abdominal pain with or without nausea
and vomiting. Presence of blood in the urine which may look as pink or
orange confirm a ureteric calculus. The pain may be felt over back
or side, radiates to the groin, scrotum in men and the labia
in women. The severity of the pain is often described as the worst pain
a person has ever suffered, even by women who have given birth. It is
reported to be more painful than gunshots, surgery, fractured bones or
even burns.
Normally the patients choose all natural methods such as plenty of fluid intake, diuretics and even intravenous fluid administration to expel the stones. If they do not pass out through urine they choose the latest "Laser treatment" the Extra corporeal shock wave lithotripsy by which the kidney stones are focused by sonic waves to blast them into pieces. Stones in the ureter are crushed and removed by sonic waves or hydraulic instruments reaching them through ureteroscopy. Even open surgery is performed in some cases to tackle the acute crises, but the results are only temporary. The recurrent tendency for stones makes the physicians and surgeons puzzle as some kidneys just make stones. |
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| What are the types of stones? | |||
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There
are many varieties. Calcium oxalate is very common form found in many
patients and calcium phosphate is also found in few cases. Most patients
with this type have an inherited metabolic disorder that causes increased
presence of calcium in the urine. Certain drugs like diuretics, antacids
and steroids may cause an overload of calcium in urine. Over active
parathyroid gland hyperthyroidism,
too much of vitamin A or D and diet high in calcium and oxalates may result
in hypercalcinuria. Uric acid stones forms an another variety. Unlike
the other stones, these stones contain no calcium in pure form. For this
reason, they are not visible on X-rays. Patients with Gout
often develop these stones, but most patients who have these stones do
not have gout. Cysteine stones have a protein matrix due to excess amounts
of the amino acid cysteine in the urine. Cystinuria is an inherited condition
and uncommon. Some rare stones are silicate struvite
stones and xanthine.
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| How to find? | |||
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An
X-ray of the kidneys, ureters and bladder can reveal the presence of most stones.
Certain less common stones can be seen in intravenous pyelograms or ultrasound.
A complete diagnosis of kidney stones should include blood screens, 24-hour
urine samples, provocative calcium loading tests and stone analysis to
determine the type of stone, its underlying cause and proper course
of treatment.
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| How to eliminate the stone? | |||
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Unless
the kidney stone is larger than 3mm in diameter it is most likely to pass
out without medical intervention. Those between 5mm and 10mm in diameter
are less likely to pass on their own as they are larger. If the kidney
stone is larger than 10mm in diameter the sufferer may be advised to undergo a surgery
or Lithrotripsy. Stones have been known to become as large as the
size of golf ball. It is not necessary to remove a stone unless
it causes other problems.
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| How to prevent stone formation? | |||
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The easiest practical step to take is increasing hydration. This applies
to sufferers of all types of kidney stones. The hot climate causes increased
amount of perspiration and loss of body fluid. Drinking very large quantities
of water -- two or more quarts per day -- is probably the most important
step in reducing stone formation. When you sweat and dehydrate you should
consume more water and fluids. During acute attacks of uretric colic water
therapy had expelled stones.
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Whenever there is an urge to pass urine, do not postpone urination for a longer period. Sedentary life-style should be changed. |
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Dietary regulations are also an important
factor to be advised. Calcium, oxalate, urate cystine, phosphate and magnesium
rich foods should be minimised. Citrate foods may be increased.
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| Treatment. | |||
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To win over the kidney stones problem
one has to wage a two-staged war.
When a victim has the tendency to produce stones his basic metabolism have to be corrected. This is the reason why the stones recur after a surgery. A patient cannot adopt food habits for a long-time. Homoeopathic Medicines have the job here! I have treated many cases of renal calculus. I can say that the cure rate is very high. I have advised surgical measure for vesical calculus and renal stones those very large in size occupying the entire inner surface. The stones inside the pelvis dissolve gradually and further deposition is minimized with the dynamic remedies. The stones obstructing the ureteric lumen pass out during micturation. I remember a case of multiple bilateral renal calculi, one being of 2.5 cm on right kidney. He was hospitalized for acute pain in abdomen and had been treated with IV fluids. The nephrologist advised for immediate surgery as the patient had mild hydronephrosis. Meanwhile the patient happened to see my TV interview and consulted me with numerous doubts. He started taking Homoeopathic Medicines after little hesitation. After few days he voided some stones during urination. I asked him to undergo scan studies and those reported that the size of the large calculus had been greatly reduced to 1.2 cms and a few small calculi on both sides were present of 3-5 mm size. He took treatment for about a year. Now he is free from his complaints. I happened to meet him in train after five years and asked with curiosity, “ How are you? Do you have any complaints?” He replied, "No Doctor! Few months back I verified with scan. No problem Doctor. Thank you… " and so the talk continued. |
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