Dr S.M. Bose and Dr S.K. Singh answer readers’ questions.
Q. What are the common complaints of a patient of kidney stones?
A The commonest complaint is pain in the loin, the other being blood in urine (haematuria). In addition to the stone, the patient may also suffer from urinary-tract infection. Such a person complains of fever, a burning sensation and frequency of urination. At times the patient may also pass a small stone along with urine. Rarely, he may present himself as a case of kidney failure. Kidney stones can cause excruciating pain
Q. I am 30 years old. I am in good general health. I have been found to have a stone in my left kidney. It does not give me any problem. Do I require tests and treatment?
A A kidney stone may remain silent for years together. This is known as “asymptomatic stone”. The answer for the treatment depends upon the size, the number, the exact location of the stone and whether it is giving rise to any problem. A few investigations are required to have a proper evaluation. Please consult a surgeon for advice.
Q. Is an operation a must for a kidney stone?
A No. An operation is not a must for all kidney stones. A small-size stone (upto 3 to 4 mm) does not require any intervention. It is likely to pass out itself. A large stone (up to 2 cm) may be broken into small pieces by lithotripsy and the small particles are washed out in urine. A stone, which cannot be broken or in case the lithotripsy facility is not available, can be taken out by an operation.
Q. Is key-hole surgery available for kidney stones also?
A Yes. Key-hole surgery known as percutaneous nephrolithotomy (PCNL) is being practised in many good centres, including the PGI. But all cases are not suitable for this technique.
Q. We know a person (not a doctor) who distributes some medicine for kidney stones and claims a very high success rate. Is there any reliable medicine for dissolving kidney stones?
A A small percentage of kidney stones are uric-acid stones and these are not seen in a plain X-ray. Uric-acid stones can be dissolved by medicines. However, the majority of kidney stones are formed of oxalate, calcium and phosphates. These are seen in a plain X-ray. In allopathy there is no medicine which can claim success in dissolving such stones. It may be true for other forms of therapy also.
As mentioned previously, small kidney stones can pass out and it may be just coincidental that the patient has been taking some form of treatment at the given time. The credit often goes to that medicine!
In a nutshell, kidney stones seen in a plain X-ray cannot be dissolved by medicines.
Q. My two-year-old daughter is in the habit of eating small stones, chalk pieces etc.
A Small stones taken mouth cannot give rise to kidney stones. These will pass out along with stools. However, this habit should be taken care of as it may give rise to other problems.
Dr Bose is Professor and Head of the Department of Surgery at the PGI, Chandigarh. Dr S.K. Singh is Associate Professor of Urology at the PGI.