More than a million times a year, Americans experience a medical disorder that can cause more pain than they’ve ever known before.  In most cases, the victims are adults – but not always.

“It hurt very, very bad,” says Jake Riley, pointing to his side. 

Valerie Harper, the boy’s mother, explains her son’s problem to Dr. Carden Johnston, an emergency room pediatrician.

“Well, he woke up real early this morning, and I thought he might have a stomach virus. He kept crying in pain so much we decided we’d better bring him,” she says. 

Now, in the emergency room, the 10-year-old is feeling better; he’s no longer crying and vomiting as he was early this morning because of the pain. Looking over the results of blood and urine tests, the doctor suspects the problem was a kidney stone.

“He’s got red blood cells in his urine, and he’s got blood and that’s indicative that this very well could be a kidney stone,” Dr. Johnston says.

Both Jake’s mother and father have had kidney stones.  There are different kinds of kidney stones, and their cause is unclear.  But all have one thing in common:  they can hurt.

“The stone forms in the kidney, and it goes down the little tube toward the bladder and it gets hooked up in the valve right before it gets to the bladder, and it causes all the pain,” Dr. Johnston says.

The best way to try to prevent kidney stones is to drink lots of water, Dr. Johnston recommends.

“We’re talking about eight glasses a day. Now Jacob is a little small, so he should get around six glasses a day, six big glasses … 8-ounce glasses, so that’s a lot of water to drink every day and he should get used to doing that,” Dr. Johnston says.

For now, Jake can go home. His pain has subsided, and there’s a good chance he passed the kidney stone.
But he needs to start drinking more water because most people who’ve had one kidney stone, later on, have another.

Tips for Parents

Kidney stones are much more rare in children than in adults. Experts at Johns Hopkins Medical Institutions say children get kidney stones about 1% as often as adults – it is estimated that adults have a one in 10 lifetime chance of developing serious kidney stones. Adults are more likely to pass their stones with only medical management for pain. Children are more likely to have their stones removed.

According to pediatric urologist Dr. Steven G. Docimo, “Odds are that the stones will eventually cause trouble, growing to obstruct the kidney.” 

Some stones can be treated with extra corporeal shock wave lithotipsy. But the more “resistant” kidney stones may have to be surgically removed.

Kidney stones have plagued mankind for thousands of years. Scientists have even found traces of kidney stones in mummies more than 7,000 years old. Today, more than 1 million cases are reported each year in the United States, mostly in adults.

Kidney stones sometimes occur when urine becomes too concentrated.  This causes minerals and other substances in the urine to form crystals on the inner surface of the kidneys. Eventually, these crystals may combine to form a small, hard, stone-like mass.  Sometimes this mass, or stone, breaks off and passes into the ureter (one of the two thin tubes that leads from the kidney to the bladder). If the stone blocks the ureter, pain occurs.

Symptoms

Not all kidney stones cause symptoms. According to the Mayo Clinic, it’s not unusual for stones to be discovered in the kidneys during X-rays for an unrelated problem. If the kidney stone becomes large or causes a blockage or an infection, your child may experience “intense, colicky pain” that fluctuates in intensity over a period of five to 15 minutes. The pain starts in the back or side just below the edge of the ribs. As the stone moves toward the bladder, the pain may radiate down toward the groin. If the stone stops moving, the pain may stop, too. Other symptoms may include the following:

• Bloody, cloudy or foul-smelling urine
• Nausea and vomiting
• Persistent urge to urinate
• Fever and chills if an infection is present

In children, kidney stones are frequently linked with what Dr. Docimo calls “an underlying anatomical abnormality,” such as spina bifida, a reconstructed urinary tract or augmented bladder. The Mayo Clinic also lists the following “risk factors” that may increase the chances of developing kidney stones:

• Family or personal history:  If someone in your family has kidney stones, you’re more likely to develop these stones, too.
• Age, gender and race:  Most people who develop kidney stones are between 20 and 40 years of age. Men are more likely to develop kidney stones than women are, although for unknown reasons the number of women with kidney stones is increasing.
• Certain diseases:  Rare, inherited diseases, such as renal tubular acidosis and cystinuria, can increase the risk of kidney stones.
• Certain medications:  Taking certain types of water pills (diuretics), some thyroid medications or calcium-based antacids (Tums, Alka-Seltzer, Rolaids) may increase your risk of forming kidney stones. On the other hand, thiazide diuretics may help lessen the chance of stone formation.
• A single kidney:  Although most people have two kidneys, approximately one in every 1,500 babies is born with only one kidney. Many people live full healthy lives with a single kidney, but they do have an increased risk of kidney stones.
• Diet:  A diet that’s high in protein (meat, chicken, fish) and low in fiber (fruits, vegetables and whole grains) may increase your risk of some types of kidney stones.
• A lack of fluids:  If you don’t drink enough fluids, especially water, your urine is likely to have higher concentrations of substances that form stones.
• Limited activity: You’re more prone to develop kidney stones if you’re bedridden or very sedentary for a period of time. That’s because limited activity can cause your bones to release more calcium.

The best way to prevent kidney stones is to drink lots of water so the stones get washed out of the body before they become large.

References

• Johns Hopkins Medical Institutions
• Mayo Clinic
• University of Michigan