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Sep 29, 2011

Healthy Living is pained by kidney stones

Kidney Stones are common enough for most people to know about them. In fact, for a person who has passed stones, vivid memories of the excruciating pain make for a good story. But kidney stones can be prevented through proper hydration. Healthy Living looks at the causes of kidney stones and the main thing you can do to prevent them.

Dr. Fernando Cuellar, Internist/Intensivist

“We have joke in healthcare that passing a kidney stone is like having a baby in men. So we tend to then to get a taste of what labor is.”

Marleni Cuellar, Reporting

This joke gives just a small picture of what a person may experience when passing a kidney stone. The kidneys usually filter waste products from the body through the urine; but sometimes, due to several factors, this process becomes obstructed, most often because of a stone.

Dr. Fernando Cuellar

Fernando Cuellar

“A kidney stone is exactly that a stone that is found in some part of the urinary tract, in the kidney itself, the tubes that connect the kidney to the bladder, in your urethras. So any stone in any part of that we can loosely refer to as a kidney stone.”

There is no single definitive cause for kidney stones; it may be a single factor combination.

Dr. Fernando Cuellar

“Primarily though one we always we have to have the background of the family history we always have to ask questions if members of the family are known to have kidney stones. Gender plays a large role; pedominantly in males. Predominantly in males, but the most salient and documented fact is that kidney stones form because of lack of drinking adequate amounts of water.”

But how would you know if you have kidney stones? The answer is pain—sudden and intense pain.

Dr. Fernando Cuellar

“Number one pain, it’s an excruciating pain, it’s usually around the lower back area or what we call the flanks or the side which is located between the rib and the hip bone. It’s usually localized around this area and comes to the front of the belly and then sometimes radiating  or going down towards the genital area. A sudden, abrupt onset of pain—which would be one of the first suspicion there would be a stone involved. Other than that, you would see urinary changes—from pink to a red looking color like blood in your urine. So those are the two cardinal signs of a kidney stone.”

Some people may also experience obstruction in their urine flow, feeling the urge to pee but not being able to have a ‘free flow.’ This type of obstruction can cause damage to the kidneys in the long-term and why recurring episodes of stones should be avoided.

Dr. Fernando Cuellar

“When you have stones its some part of the urine tract, it leads to back flow into kidney and will slowly not an overnight process—if you have people who have stones for a long time; who have repeasted episodes of stone formation can eventually lead over 10-20 years damage to that kidney.   Actually when a stone is passed a full work up has to be done to see what the stone is made of—is it made of calcium, uric acids, struvite. If it is calcium we need to determine where that person is going wrong. So a whole protocol of study so as to avoid future recurrence of kidney stones.”

The diagnosis for kidney stones in Belize is usually through cat scans, and ultrasounds. These methods would confirm the presence of stones, how big it is where it is located; all very important factors on deciding treatment.

Dr. Fernando Cuellar

“The recommendation is that the size of the stone one millimeter or less is usually passed. So the size is important. The location is important also. When it is in the kidney or the top third of the urethra; it’s less likely that it will pass as opposed to when it’s already below. So the size, the location of the stone. The stone sometimes have different contours and shapes—some people will refer to geometry of the stone. So some are easier to move along than others. We have the technology that is most often used worldwide and is not available in Belize is called lithotripsy. Which is the use of sound waves to crush the stones so that it can be passed in dust or dirt.”

Typically physicians refer patients to a clinic in neighboring countries where lithotripsy can be done as surgery is not the preferred option.  The main recommendation is to prevent the formation of stones by keeping the body hydrated.

Dr. Fernando Cuellar

“Only way you know if you drink enough water is if when you look at your urine make sure that’s its clear almost water looking, if its dark or concentrated yellow then you know that you back in your water.  The fact that we are in a warm environment, we sweat a lot and we don’t take the amount of water—people who work in office don’t have the thirst stimulus as oppose to somebody who would have that thirst stimulus there—they have to be and make sure that they need to drink enough water.”

Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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