Can i drink alcohol with kidney stones

Doctor's letter : Kidney stones & renal colic

EXPLANATION Kidney stones form from normally dissolved constituents of the urine, which initially deposit as small crystals and over time grow into larger lumps - doctors speak of so-called concretions. As the debris loosens and travels down towards the bladder, the kidney stones turn into ureteral stones, which can cause extremely painful colic. "About twenty percent of the population develop a kidney stone in the course of their life," says Martin Kuhlmann, chief physician of the nephrology department (nephrology) at the Vivantes clinic in Friedrichshain. Men are three times as likely to be affected as women.

CAUSES Kidney stones are a disease of civilization and thus a toll on prosperity and abundance: overeating, overweight (obesity), alcohol and too much animal protein promote the sometimes extremely painful suffering. “Contrary to what is often claimed, table salt does not play such an important role,” says Kuhlmann. Kidney stones are formed from minerals ingested with food, which are particularly deposited in concentrated urine. This is why doctors advise those affected to drink two to three liters of fluids a day - especially water - in order to regularly flush the kidneys and urinary tract.

SYMPTOMS Kidney and ureter stones can go unnoticed for a long time. First of all, unproblematic grains of semolina or small stones are formed, which are discovered only by chance during a medical examination, if at all. Only when the deposits grow into larger stones and loosen - that is, they begin to migrate in the kidney and urinary tract - do they become dangerous. If larger stones get into the ureter, they can cause severe discomfort. The affected ureter spasms to move the kidney stone downward - causing the severe, spasmodic pain of renal colic, which can radiate to the genitals, thighs and groin. It is said that they were similar in intensity to the pain of childbirth. Some doctors and those affected go even further and speak of what is known as the pain of annihilation, which is so severe that those affected fear for their lives. "The greatest danger is life-threatening urosepsis, blood poisoning with bacteria from the urogenital tract," says Kuhlmann. If a stone blocks the ureter and prevents the urine from flowing out, bacteria can enter the bloodstream from the urine that has built up in the kidney. The first signs of this are malaise, fever and chills. "Urosepsis is potentially fatal and needs antibacterial treatment in a hospital," says Kuhlmann.

DIAGNOSIS Doctors first check whether the typical kidney stone symptoms are caused by other diseases such as gallstones, gynecological diseases, or appendicitis. To diagnose possible bleeding and urinary tract infections, doctors examine midstream urine. The patient first lets a little urine to flush the urethra through. Only then is the urine collected as a sample. Further urine tests show whether the kidneys have been damaged and how well they are still filtering toxins from the blood.

In order to determine the position and size of the urinary stones, various imaging methods are used, which can show the urinary stones to different degrees depending on their composition. "The most common type of stone consists of calcium salts, which can be seen very well in conventional X-rays," says Kuhlmann. In the case of the so-called prosperity stones made from uric acid, on the other hand, computed tomography (CT) is necessary to diagnose them. In addition, ultrasound, known as sonography, is also used. "In our kidney stone laboratory, we analyze the composition of the stones after they have been removed or natural loss in order to specifically prevent new stone formation," says the chief physician.

TREATMENT "When treating kidney stones, urologists and nephrologists have to work hand in hand," says Kuhlmann. If the ureter is not closed and there is no risk of urine congestion, so-called conservative procedures can support the natural removal of the stones. Warmth from baths or compresses, up and down movements such as climbing stairs or hopping, and plenty of fluids should help flush the stone out of the body.

"However, if there is a threat of infections and urine congestion or the colic is too painful, the stone must be actively removed," says Kuhlmann.

In the case of urinary congestion, urologists first place a ureteral splint. This is a 28 centimeter long silicone tube that extends from the bladder into the kidney and is provided with holes. The urine that has built up in the kidney enters the tube through these holes and can drain past the stone into the bladder. This reduces the pressure on the kidney and the pain subsides. The splint also expands the ureter so that larger stone fragments can be removed during a subsequent operation without injuring it. The ureteral stent remains in the body for a while after the operation to stabilize the urethra and facilitate the drainage of stone debris. The doctors give antibiotics against bacterial infestation and the threat of urosepsis.

Kidney stones are now almost always removed endoscopically. This means that urologists perform a ureteroscopy, using the natural route via the urethra and bladder to get to the stone in the ureter or renal pelvis, which they remove whole or broken up by a laser. Doctors describe this procedure as minimally invasive, as no skin incisions are necessary and the patient can leave the clinic more quickly. "Kidney stones are rarely removed with open surgery, for example when the kidney is completely filled with so-called pouring stones," says Kuhlmann.

Another option is external shock wave therapy. Shock waves are a type of amplified sound waves that penetrate the layers of the body and only release their energy when they hit the kidney stone. Stones that are no larger than two centimeters can be smashed in the kidney. “However, shock wave therapy is not always accurate, and stones that burst can damage the kidney tissue.” Every third patient suffers from colic after such an operation, which is caused by the stone debris. "In comparison, endoscopic procedures are gentler."

Prevention Regardless of the way in which a kidney or ureteral stone leaves the body: As soon as it is outside, it should be taken to the laboratory for analysis. Because its composition can provide clues as to what those affected can do to avoid stone formation again. In principle, animal protein and fat should only be consumed in moderation. Obesity, which is also a risk factor, can be counteracted with sufficient exercise and a balanced diet, for example a Mediterranean diet. Since urinary and kidney stones form particularly in concentrated urine, you should drink at least two to three liters of water a day - more if you do sweaty exercise or go to the sauna. “Contrary to popular belief, beer is not a good drink for flushing the kidneys and urinary tract,” says nephrologist Kuhlmann. On the contrary: "Beer promotes the formation of uric acid stones."

The editors of the magazine "Tagesspiegel Kliniken Berlin 2016" compared the Berlin clinics that treat this disease. For this purpose, the treatment numbers, the hospital recommendations of the outpatient doctors and the patient satisfaction were compiled in clear tables in order to make it easier for the patient to choose a clinic. The magazine costs 12.80 euros and is available in the Tagesspiegel shop.

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