Thursday, September 23, 2010

7.17 Renal Colic/Kidney Stone. End PN 7

Physician's Notebooks 7  - - See Homepage

Last chapter of Physician's Notebooks 7.  Updated 24 December 2018

17. Renal Colic/Kidney Stone 
Renal colic is a pain attack that starts low back, one-side, left or right, and sweeps around the side and at worst goes down and into the groin. Its time pattern is to build to a peak and then to let up, and it repeats that pattern. At start, it may be confused with intestinal pain but after the start the pattern cannot be mistaken.
   It is due to a stone of certain size (not too big or it would not go down and not too small or it would not get stuck). The stone starts in a kidney, goes down its ureter and gets stuck at its narrow part near the bladder, and the pain starts from muscle spasms of the ureter trying to push the stone into the bladder. Most stones pass and the pain suddenly stops. Then in men the stone will pass through the penis giving a weird sensation and be seen in urine. (But stones may be passed and not felt or seen)
   Most stones are calcium phosphate, a few are from uric acid, from getting dehydrated. Calcium phosphate stones are worsened by alkaline condition such as you might get from taking sodium bicarb or too heavy eating of high vegetable diet. Uric acid (urate) stones are worsened by high acid such as you might get from taking too much vitamin C.
Tests:  Get ultrasound scan (Good because safe and cheap and can repeat much if need). Urinalysis should show blood and the pH acid or alkaline gives important hint of type of stone. Get blood test for uric acid, calcium, inorganic phosphorus, parathyroid hormone and 25-OH vitamin D.
   If you find a stone in urine, have it analyzed. Most are calcium due to dehydration. A minority may be due to various metabolic, kidney or hormone diseases. Taking too much vitamin D could cause kidney stone.
   Uric acid stone is from blood uric acid above 10 mg% and makes emergency because it can damage kidney. Also high uric acid may cause big toe gout.
   The most important prevention is at least one liter water each morning and good fluid intake rest of day.

End of Physician’s Notebooks 
The Next Physician's Notebooks, 8, is Sex! Sex! Sex! and you may start reading now by clicking 8.(0-1) Sex! Sex! Sex!/Notebooks & Intro

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2. Nutrition & Chemistry
3. Testing the Systems
4. Infections & Symptoms; Treatments & Remedies
5. Skin to Bones; Surface & Structure
6. Heart, Lungs, Blood Circulation and Longevity
8. Sex! Sex! Sex! Also Gynecology & Obstetrics and Child
9. Brain & Mind; Psychology & Behavior: Cry for Happy in an Anxious Age
10. Healthy Longevity, Cancer, Death
11. Unpopular Essays
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