The kidneys are a pair of organs responsible for filtering waste products out of the blood system. These waste products are a result of normal breakdown in muscle tissue as well as metabolism of the food that we eat. Occasionally individuals find that certain chemicals combine in the kidneys to form stones. These stones, if small enough, will pass through the urinary tract system without any symptoms or signs. However, when the stones are larger than they will cause trauma to the ureters and urethra as well as irritation to the bladder as they pass through the urinary tract system.
Thankfully, kidney stones don’t usually cause any medical problems, other than excruciating pain as they pass through the urinary system. And, for the most part, unless the stone is very large, people can pass these stones with pain medication. The stone may cause pain which typically starts on your side or in the back and radiates down to the lower abdomen and groin.
Until the kidney stone moves into the ureter, the tube that connects the kidney to the bladder, an individual may not even know that anything is wrong. However, if the stone is large enough and causes symptoms, pain will begin as it leaves the kidney and travels down to the bladder. At this point an individual may experience pain in their side below the ribs that fluctuates in intensity. This pain can last 20 to 60 minutes and then disappear for short periods. The pain will radiate from the side to the lower abdomen and the individual will also experience nausea, vomiting and fever and chills if there is an infection presents.
As the kidney stone is moving it causes some minor trauma to the ureter which results in bloody, cloudy or foul-smelling urine and pain on urination. Individuals may also experience a persistent urge to urinate. On occasion people will experience only blood in the urine or recurring urinary tract infections and kidney stones will only be picked up when x-rays are done to diagnose other medical problems.
Researchers have been unable to determine how many times kidney stones go unnoticed and are pass through the urinary system. However, once symptoms occur individuals usually consult with their primary care physician for pain relief and to determine the reason for their discomfort. If your doctor suspects that you might have kidney stones there will be several things they will order to confirm the diagnosis.
A blood analysis may be required to look for excessive calcium or uric acid in the blood. These are two of the more common reasons individuals will develop kidney stones. A 24-hour collection of urine may also be requested to evaluate excretion of stone forming minerals that the body produces in order to prevent the formation of kidney stones.
Physicians may also require different imaging tests to evaluate the presence or severity of the stones. Computerized tomography (CT) scan has become the standard of care for evaluating acute kidney stones. It can be performed rapidly and identify stones regardless of the composition. A CT scan also does not require the use of any contrast dye.
Doctors may sometimes start with an abdominal x-ray which can visualize most kidney stones and help to judge the changes in size of the stone over time. An ultrasound is a diagnostic technique that combines the use of high frequency radio waves and is processed through a computer to safely and painlessly view the internal organs. While it is noninvasive it can miss small stones especially if they’re located in the ureter or the bladder.
The final imaging tests which your physician may order is an intravenous pyelography. This study is useful in determining the location in the urinary system and can also determine the degree of blockage. This test uses a contrast dye which is injected into a vein in your arm, and then a series of x-rays is taken as the dye moves through the kidneys, ureters and bladder. This study has largely been replaced by CT scan, but it still remains useful in limited circumstances.
Physicians will not order all of these tests but will evaluate your pain and symptoms through a thorough medical history and physical examination. Once these initial steps have been taken they will discuss with you the different tasks which they can perform in order to more fully determine the diagnosis and the severity of the stones.
MayoClinic: Kidney Infection
NHS Choices: Kidney Infection
KidsHealth: urinary tract infections
Urology Care Foundation: Urinary Tract Infections in Adults