How much do you know about urinary stones?

This is the 3798th article of Da Yi Xiao Hu

Has anyone around you ever suffered from urinary tract stones, or have you ever experienced an attack of urinary tract stones yourself: sudden severe lower back pain (often sudden colic caused by factors such as strenuous exercise), accompanied by nausea and vomiting, and/or hematuria and bladder irritation symptoms.

Today, let’s talk about urinary stones, which are so painful that they can make people roll on the ground.

First of all, urinary stones refer to stones that occur in the urinary system, such as the kidneys, ureters, and bladder. They are a common urinary system disease that can be caused by metabolic abnormalities (urine pH, hypercalcemia, hypercalciuria, etc.), urinary tract obstruction or infection, and certain drug factors. Among them, kidney and ureteral stones are the most common.

Secondly, let’s take a look at the typical symptoms of urinary stones.

Pain: It is the most typical symptom of kidney stones and ureteral stones. It is usually sudden, severe and unbearable pain, which occurs in paroxysmal attacks and is located in the waist or upper abdomen. It can radiate along different parts. If it is ureteral stones, it may also be accompanied by bladder irritation symptoms (frequent urination, urgency, and pain when urinating).

Hematuria: Usually it is microscopic hematuria, and only a few people have hematuria visible to the naked eye. The amount of hematuria is related to the degree of damage to the urinary tract mucosa caused by the stones.

Nausea and vomiting: When ureteral stones cause urinary tract obstruction, the ureteral lumen and wall will be partially dilated, spasmed and ischemic. Because the ureter and gastrointestinal tract share common nerve innervation, nausea and vomiting may occur.

Bladder irritation symptoms: If the stones are accompanied by infection, or if there are stones in the ureteral bladder wall, there may be bladder irritation symptoms (frequent urination, urgency, and pain when urinating)

Among them, the clinical manifestations vary depending on the location: the typical symptom of bladder stones is sudden interruption of urination; the typical symptoms of urethral stones are difficulty urinating, dripping urination, and painful urination.

So, how to treat urinary stones?

First of all, if severe renal colic occurs suddenly, you should go to a regular hospital for medical treatment in time, avoid strenuous exercise, and treat it mainly with antispasmodics and analgesics.

Secondly, if the stones have reached the point where artificial intervention is required, the stones should be removed as much as possible, and medication for stone removal, extracorporeal shock wave lithotripsy, or surgical stone removal can be chosen depending on the size of the stones.

In daily life, what issues should we pay attention to in order to improve or even avoid the formation of urinary stones?

In terms of diet, we should avoid excessive intake of any one nutrient, especially avoid excessive intake of foods high in purine or fat. Maintain nutritional balance, increase the intake of fruits rich in citric acid; limit the intake of oxalic acid in the diet; limit the intake of sodium salt; and increase the intake of coarse grains and fiber.

Urinary stones have particularly strict requirements for drinking water: increasing water intake can increase urine volume, thereby reducing the supersaturation of urinary stone components and preventing the recurrence of stones. It is recommended that the daily water intake be above 2.5-3.0L, and the daily urine volume be maintained at above 2.0-2.5L. Regarding the type of drinking water, it is generally believed that non-dairy liquids with low oxalic acid content are appropriate.

In terms of exercise: avoid lying or sitting for long periods of time, and exercise appropriately to prevent stone deposition.

We should also develop good living habits in our daily lives, paying special attention to not holding our urine and not drinking too little water; we should also maintain a positive and relaxed state of mind.

Urinary stones may seem scary and serious, but in fact, as long as we maintain good eating and living habits in our daily lives, have regular physical examinations and follow-up checks, seek medical treatment promptly during the acute phase, and undergo surgical intervention when necessary, defeating them will not be a problem!

Author: Shanghai Sixth People's Hospital (Lingang Campus Emergency Department)

Chen Danhua