kidney stones: a '10 out of 10, drop-to-your-knees pain'
about 12 per cent of men and six per cent of women will develop a kidney stone at some point in their life, according to the kidney foundation of canada.
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according to the kidney foundation, kidney stones are not only common in canada, they’re on the rise. getty
“men often say kidney stone pain is worse than giving birth — then they get slapped by their wives,” says urological surgeon dr. shubha de of edmonton’s alberta urology institute.
but many women who have experienced both say, if given the choice, they’d opt for the maternity ward any day. victoria taylor of suburban vancouver is one of them. she experienced her first kidney stone at the age of 28, shortly after the birth of her first child.
“i had pain in my lower back on the left side,” she recalls. “it started slowly, but quickly went from a one to a 10+. i’d never felt pain like that before, not even during childbirth! i was curled up in a ball, moaning and couldn’t think about anything but the pain.”
at the hospital, she was given morphine for the pain and a urine test and ct scan to confirm she had a stone. then she was sent home with a strainer so she could “catch” the stone once it passed, which it did a couple of weeks later.
according to the kidney foundation of canada, chemicals in your urine can form into a tiny crystal that grows into a stone ranging from the size of a grain of sand to a golf ball. the grains of sand pass easily; the golf balls inflict a “10 out of 10, drop-to-your-knees pain,” as de describes it.
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the ache can start in your side, as taylor’s did, but also in the small of your back under the ribs or in your lower abdomen. it can last for minutes or hours and can cause blood in your urine, nausea and vomiting.
de says the pain starts once the stone falls out of the kidney into the ureter tube, which connects the kidney to the bladder.
“when the ureter contracts around a stone and the urine from above gets blocked, that back pressure in the kidney is what causes the pain,” explains de. “when they’re in the kidney or after they pass into the bladder, people don’t feel them at all.”
once a stone is on the move, he says, the majority of people will pass it in two to six weeks. in fact, 90 per cent of stones smaller than five millimetres will pass on their own within hours or days. you can help them along by drinking lots of fluids.
or you could have surgery to blast the stone into pieces
when the stone is too big to pass, however, most people undergo extracorporeal shock wave lithotripsy surgery to blast it apart.
“you lie in a bath of water,” says de, “and we put a big ultrasound probe on your back, which sends sound waves through your back to break up the stone.”
once your kidney is up and running normally, your urine flushes out the stone.
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“it’s a safe, non-invasive procedure, doesn’t require a general anesthetic, there’s low risk of infection and it works about 75 to 80 per cent of the time in one go,” he says. “we actually do it out of our office now.”
who’s most likely to get a kidney stone?
according to the kidney foundation, kidney stones are not only common in canada, they’re on the rise. about 12 per cent of men and six per cent of women will develop a kidney stone at some point in their life. men will usually be diagnosed between the ages of 40 and 60; women between 25 and 30. and once you have one, you’re at a 30 to 50 per cent higher risk of having another in five to 10 years.
taylor, in fact, had two more kidney stones in the six years following her first.
“the second time i knew what was happening because the pain started out the same as it did the first time,” she says. “but it never got as bad because i immediately went to the hospital and was given pain meds.” she passed this one, and the third in less pain and less difficulty than the first.
de says you’re also two-and-a-half times more likely to have a stone if one of your relatives had one. researchers can’t point specifically to heredity, but theorize that genetic and environmental factors, such as having a similar diet, play a role.
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type 2 diabetes in women, but not men, put them at a 30 to 50 per cent increase of developing a kidney stone. increased body size and prolonged periods of immobility also put you at risk, as can certain medications.
your diet can also be a contributing factor. most — 70 to 80 per cent — kidney stones are made of calcium oxalate crystals. consuming too much oxalate, found in spinach and strawberries, can lead to kidney stones, as can eating foods high in protein, particularly meat. too much salt, sugar, vitamins c or d also put you at risk.
the calcium in dairy foods, however, can lower your risk, as can consuming more potassium, magnesium and vitamin b6.
mediterranean diet may help prevent kidney stones
de says research is studying the kind of diets that may help reduce the risk of kidney stones, and both the mediterranean and dash (dietary approaches to stop hypertension) diets come out on top.
“those same diets that are good for your cardiovascular health are very good for kidney stones as well,” he says. “we see a lot of patients who are younger — 30s and 40s — who have these other health issues [such as] high blood pressure or high cholesterol and we think maybe these are all related [to developing stones].”
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he says urologists used to recommend patients prone to stones avoid too much of a certain food, like spinach and strawberries, but then they’d complain that they cut them out and still got kidney stones.
“so i rarely ever counsel patients anymore on what specific food groups to avoid, unless they have certain diagnoses or disturbances in their urine and blood,” says de. “[but] if you could be healthier overall, perhaps your risk of kidney stones goes down, and also your risk of stroke, heart attack, hypertension, fatty liver, et cetera all may go down as well.”
staying well hydrated, which increases urine and keeps it from becoming too concentrated, is one of the best ways to avoid the dreaded stone. if you drink enough fluids to pass between two and three litres of urine every day, “your risk of kidney stones over five years goes down by 50 per cent,” he says.
lemon juice better than apple cider vinegar for prevention
and while de doesn’t put much stock in dubious claims, such as drinking apple cider vinegar, to reduce your risk, he does say lemon juice, which has a high concentration of citrate, a natural inhibitor of kidney stones, is a better option. “mix a quarter cup of lemon juice with two litres of water and use that as your daily fluid intake.”
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as for taylor, “if i have even a whisper of pain in my lower back, i immediately start drinking water,” she says. “and then some more. and even more. i never want to go through that pain again.”
and she hasn’t. she did, however, go through childbirth again. and it was a breeze compared to the kidney stone.
robin roberts is a vancouver-based writer.
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