Kidney stones are one of the most painful health experiences, as they cause severe pain that may hinder a person's ability to lead a normal life.

Treatment of kidney stones

The treatment approach for kidney stones depends on the size, location, and type of stone, as well as the severity of the patient's symptoms.

Kidney stone medications

Doctors usually treat kidney stones using medications that help manage symptoms, prevent future stone formation, dissolve certain types of stones, andTreatments include medications ما يلي:

• Pain management medicationsPain relievers, such as ibuprofen or naproxen, reduce inflammation and pain associated with kidney stones.
• Alpha blockersThese medications relax the muscles of the ureter, making it easier for small stones (less than 6 mm) to pass from the kidneys to the bladder with urine without the need for additional medical intervention. Examples of these medications include: tamsulosin.
• Calcium channel blockers, which also help relax muscles and facilitate the passage of stones, including nifedipine.
• Medications for hypercalciuriaThese medications reduce the absorption of calcium from the intestine and its excretion in the urine, which may help prevent the formation of calcium stones, including hydrochlorothiazide and indapamide.
• Alkaline citrate salts: Increases the pH level of urine, which can help dissolve uric acid stones.
• Allopurinol: This medication is used to treat stones by lowering uric acid levels in the urine.
• Acetohydroxamic acid, which is a highly effective drug that may be used with other long-term antibiotic medications to prevent infection, especially in cases of struvite stones.

Kidney stone medications offer effective options for treating this painful problem, but they must be used under the supervision of a doctor while following a healthy lifestyle to prevent recurrence.

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Kidney breakdown 

In cases where conservative measures are not effective or the stones are too large to pass naturally, health care providers may recommend extracorporeal shock wave lithotripsy (ESWL).

This non-surgical procedure uses focused sound waves; Kidney stones into smaller fragments, which can easily pass through the urinary system.

Ureteroscopy

The doctor may also resort to inserting a small, flexible scope into the ureter.

Percutaneous nephrectomy (PCNL)

For larger or more complex stones, your health care provider may recommend surgical removal through a small incision in the back to access the kidney and remove the stone directly.

Open or laparoscopic surgery for kidney stones

In rare cases, when other treatment options aren't working or haven't worked, your health care provider may recommend a more invasive surgical procedure to manually remove kidney stones.

The choice of treatment depends on the patient's individual circumstances, the size and location of the stones, and the health care provider's assessment of the most appropriate and effective approach.

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How do I protect myself from kidney stones?

Due to the high risk of recurrence, it is essential for individuals who have experienced kidney stones to take proactive steps to prevent new stones from forming.

• Dietary modifications that include:
  • Increase fluid intake and drink plenty of water.
  • Restricting the intake of foods rich in oxalates, such as chocolate, spinach, potatoes, beets and nuts.
  • Reduce consumption of animal proteins, which can increase uric acid levels in the urine.
  • Increase consumption of acidic fruits and vegetables, which can raise levels of citrate in the urine, a substance that can prevent stone formation.
  • Maintain a balanced calcium intake. Adequate calcium from dietary sources can actually help prevent the formation of calcium stones.

• Medications and nutritional supplements after consulting a doctor regarding the dosage and duration, the most prominent of which include:
  • Thiazide diuretics or citrate supplements.
  • Potassium or magnesium citrate.

• Lifestyle modifications, through:
  • Maintain a healthy weight.
  • Stay hydrated, especially during periods of intense physical activity or hot weather, to ensure adequate urine production.
  • Avoid taking excessive amounts of vitamin C and vitamin D supplements;

• Consult your doctor regularly;

How are kidney stones diagnosed?

The diagnosis of kidney stones at Al Mousa Specialist Hospital depends on the symptoms felt by the patient, in addition to a group of medical examinations. The examination steps include the following:

• Medical history and clinical examination: The doctor asks about symptoms and medical history, the presence of previous kidney stones in the family, and any other diseases that may increase the risk of developing kidney stones. Then the patient is examined to evaluate the pain and determine its location.
• Blood tests: Measure kidney function, calcium and uric acid levels.
• Routine urinalysis: To detect the presence of blood, even if it is in microscopic and invisible amounts, or white blood cells that indicate infection, and crystals or other signs that indicate the presence of stones or infection.
• 24-hour urine collection: This may be ordered by your doctor to measure the levels of minerals and chemicals in the urine that may increase or decrease the risk of stone formation, such as calcium, oxalate, uric acid, and citrate.
• Computed Tomography (CT Scan): It is the most accurate and effective examination for diagnosing kidney stones, as it can detect most types of stones, even very small ones, and determine their location and size with high accuracy. 
• Ultrasound: It is commonly used to detect kidney stones, especially if they are relatively large, and it can also reveal kidney enlargement as a result of ureteral obstruction. 

 How can kidney stones be prevented?

Strategies for preventing kidney stones depend on the type of stones the body tends to form, but there are general tips that apply to most types, including:

• Drink sufficient amounts of fluids, especially water: It is recommended to drink about 2.5 to 3 liters of fluid during the day, or enough to produce about 2 liters of urine.
• Reduce salt in food, as it increases the amount of calcium in the urine, which increases the risk of calcium stones.
• Limit processed foods, fast food, canned meats, and salty snacks.
• Moderate consumption of animal protein because it increases the levels of uric acid and calcium oxalate in the urine, which increases the risk of forming certain types of stones.
• Limit foods rich in oxalate, especially if you are prone to forming calcium oxalate stones, such as spinach, beets, chocolate, nuts, coffee, tea, and sweet potatoes.
• Eat calcium-rich foods with foods rich in oxalates, such as eating milk with spinach, as this helps bind the oxalates with calcium in the digestive system before they reach the kidneys, which reduces their absorption.
• Maintain a sufficient amount of calcium from food sources, because it helps prevent calcium stones by binding to oxalates in the intestine.
• Avoid calcium supplements unless recommended and under the supervision of a doctor, as they may increase the risk of stones in some people.
• Reduce added sugar and sugary drinks. 
• Avoid soft drinks because they contain phosphoric acid.
• Eat sufficient amounts of fruits and vegetables rich in potassium, fibre, magnesium and antioxidants. 
• Maintain a healthy weight and an active lifestyle to help maintain kidney health.
• Monitor the color of your urine. Dark, concentrated urine is a sign that you are not drinking enough fluids.

In conclusion, kidney stones are a painful health problem, but with the right understanding and appropriate intervention, you can successfully overcome this experience and prevent its recurrence.

Frequently asked questions 

 What is the drink that breaks up kidney stones?

Some natural drinks help prevent the formation of kidney stones or break up small stones, but there is no magic drink that completely dissolves all types of stones, especially if they are large. The most common drinks include:

• Lemon juice is a natural source of citrate, which prevents the formation of calcium and oxalate stones. 
• Diluted apple cider vinegar contains citric acid, which may prevent stones from crystallizing, but it should not be used in large quantities, just a teaspoon in a cup of water once a day. 
• Pomegranate juice, its antioxidants, may reduce mineral deposition and protect the kidneys.
• Boiled parsley drink is a natural diuretic and may clean the urinary tract.
• Tart cherry juice or cranberry juice,  helps prevent uric acid stones.

What is forbidden food for kidney stone patients?

Modifying the diet works to prevent the increase in the size of existing stones. The type of food prohibited depends on the type of stone, but the general list of foods and drinks that should be avoided or reduced includes the following:

• Foods rich in oxalates, such as spinach, beets, Swiss chard, cabbage, nuts, chocolate, cocoa, wheat bran, raspberries, strawberries, and grapes.
• Sodium-rich foods such as salt, canned foods, fast food, pickles, processed meats and salty cheeses.
• Animal protein for uric acid stones, such as red meat beef, lamb, especially skinned poultry, fish and eggs in large quantities.
• Soft drinks.  
• Alcohol because it causes dehydration and increases uric acid.  
• Coffee and heavy tea in large quantities because they contain oxalate.
•  Added sugars, as they increase the excretion of calcium and oxalates in the urine, such as sweetened juices, sports drinks, and sweets.
• Vitamin C in doses, because it turns into oxalate in the body.  

What is the best effervescent to break up kidney stones?

Choosing the best type of effervescent used to break up kidney stones depends on the type of stone and the reason for its formation, and it must be used under medical supervision. The most popular types include the following:

• Urisulfin effervescent, or potassium and magnesium citrate, helps break up uric acid stones and calcium oxalate stones, as well as prevents the formation of new stones.
• Plimox effervescent or sodium citrate, to treat uric acid stones, but it is not suitable for patients with high blood pressure.
• Effervescent uric acid or sodium bicarbonate  in cases of uric acid stones, but it raises blood pressure and causes bloating.