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Adequate fluid intake key to tackling urinary stones

Urinary stones and urinary tract infections are common in this part of the world. 
Dr.Dilip Kumar Sharma, a specialist urologist at Zulekha Hospital, Sharjah, shares his knowledge of the infections with Khaleej Times and gives his suggestions on preventive steps and diagnosis.

The urologist says adequate intake of fluids will go a long way in preventing problems related to urinary stones. He suggests that everyone should at least take four litres of water a day to keep kidney stone ailments at bay.

A urinary stone is a common affliction which is consequent to the warm climate in the region and dietary habits. Men are twice more likely to develop kidney stone than women, and it may occur, albeit rarely, even in children.

Stone formation process

Increased concentration of crystal forming matter in urine followed by physical and chemical changes causes these substances to precipitate and form stone. Diet, drugs, metabolic disorders or other medical conditions might contribute to the formation of stones. Struvite stones are almost always associated with certain urinary tract infection.

Symptoms

u Persistent pain

u Recurrent urinary infection

u Urinary obstruction

u Progressive kidney damage

About 70 to 90 per cent of stones are tiny and pass out of the body without notice.

Advances in management

Non-invasive: Extracorporeal Shock Wave Lithotripsy (ESWL)

Shock waves are generated outside the body and are focused on the stone to get them fragmented to encourage their excretion through urine.

Minimally invasive: Ureteroscopy stone. (Key Hole Surgery) Laparoscopic Stone Removal, advantages: No incision.

The patient can return to full activity in a short period of time.

Prevention

Fluid intake: Four litres a day so that urine output is three litres. More water is needed after exertion and during summer.

Sodium restriction: The patient should restrict their sodium intake. ‘No salt on the table’ should be the policy as salt intake increases the amount of calcium in the urine. Dietary calcium is not believed to affect stone transformation. Over-indulgence in dairy products is to be avoided. Do not drink more than three glasses of milk a day. Fibre intake is beneficial for people with kidney stones.

Protein restriction: Animal protein has been consistently associated with kidney stone.

Purine (uric-acid) restriction: Patients with gout should reduce intake of beer, alcoholic beverages, organ meat, legume, spinach, cauliflower, mushroom and asparagus.

Oxalate restriction: Reduced intake of coffee, tea, colas, dry fruits, fresh grape, apple juice, tomato and spinach.

Urinary tract infection

Urinary tract infection is the most common bacterial infection of humans of all ages. Females are more prone to develop UTI.

Signs and symptoms

The patient can have high grade fever of 38.5 degree Centigrade (101.3 degree Fahrenheit) with headache, loss of appetite, nausea and vomiting, burning and pain during urination and increased frequency of urination. The patient will pass cloudy, foul- smelling and even blood stained urine. Elderly males will have hesitancy and slow urinary stream or dribbling of urine.

URINARY INFECTION 
DURING PREGNANCY

Symptoms: Burning & pain during urination, frequent urination, incomplete bladder emptying, passing turbid urine or blood in urine.

Diagnosis: By urine examination: Urine culture and ultrasound of urinary tract

Treatment: good hydration and antibiotics

Dr Dilip Kumar Sharma