Prisma Health Magazine

PRISMA HEALTH MAGAZINE

stones, including extracorporeal shock wave lithotripsy, or ESWL. Sound waves generated from outside the body, pin- pointed using X-ray imaging, break up a stone into pieces small enough to be eliminated with urination. Another option uses a miniaturized digital camera mounted inside a small, flexible tube and a laser inserted through the penis or uretha into the bladder. Pulsed laser energy breaks the stone up into small pieces. In both procedures, the patient is asleep. How does a physician decide which method would work best? It depends on the location and size of the stone, Dr. Wingo pointed out. For those that are of the smaller variety and closer to the kidney, lithotripsy works fine, but he said he probably would use pulsed laser energy for larger stones. Dr. Fiscus said for very large stones, patients can be treated with percutaneous nephrolithotomy, or PCNL. A small incision is made in the patient’s back, and the physician uses a scope and an instrument that allows him to pluck or vacuum the stones. If you have kidney stones once, are you more likely to have them again? Dr. Wingo pointed out that if you don’t make any changes in diet or lifestyle, you have at least a 50% chance of this problem recurring.

large amounts of tea, coffee, soda and dark vegetables aren’t helpful. Dr. Fiscus added that peanuts, rhubarb and spinach are high in oxalates and suggested a heart-healthy diet with “everything in moderation.” He said citrus fruits inhibit stone formation, so adding lemon or lime to your water is probably a good move. He said kidney stones are associated with issues such as obesi- ty, hypertension and diabetes, as well as consuming too much sodium and animal protein. People sometimes pass small stones, the size of a grain of sugar or a little more substantial, without knowing it. Larger stones, especially those that make their way from the kidneys to a ureter, a narrow duct that leads to the bladder, can cause intense back pain that might radiate around to the abdomen; nausea; vomiting; and painful urination. According to Dr. Wingo, good hydration is the best strategy to help avoid kidney stones, along with a 24-hour urine col- lection that should reveal what’s going on with kidney function and the level of electrolytes in the patient’s urine. Potassium citrate tablets and thiazide diuretics such as chlorthalidone, a drug that reduces the level of calcium in the urine, are options, as is tamsulosin, which can be used to help a patient pass a small stone. The drug relaxes the ureter and increases the chance of passing a stone of less than 5 mm in diameter. If none of this relieves the symptoms, it’s probably neces- sary to attack the stones. There are two main options to treat

“If you make modifications, you can reduce your risk to near zero,” he concluded. “It just depends on how aggressive you are with your modifications.” KIDNEY STONES By the Numbers 3 TIPS to avoid kidney stones: drink more water; reduce sodium and animal protein in your diet; maintain a healthy weight. – MySouthernHealth.com If you drink a lot of water, most kidney stones pass through the urinary tract on their own within 48 HOURS . – www.medicinenet.com Most urinary stones develop in people between the ages of 20 AND 49 . – www.medicinenet.com About 11% OF MEN and 6% OF WOMEN in the United States have kidney stones at least once in their lifetime. – U.S. Department of Health and Human Services

80% OF KIDNEY STONES are calcium oxalate stones; 10% TO 15% are classified as struvite; 5% TO 10% are either calcium phosphate or uric acid; and 1% TO 2% are cysteine. – www.medicinenet.com Southerners are up to 50% MORE LIKELY to develop kidney stones than people in other parts of the country. – MySouthernHealth.com

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