Renal stone disease is an ancient and common affliction over a 70 years life span , it is estimated that about 15% of people will develop renal stones , although very few individuals die as a direct result of stone disease . It does lead to significant suffering from pain , urinary infections and destructive disease to the kidneys though newer and more effective methods of stone treatment are available , the actual cause of stone formation frequently remains unknown , so recurrence is bound to occur , urinary stones occur in all parts of the urinary system . 97% of all urinary stones are located in the kidney and ureter , only 3% are found in the bladder and urethra
COMPOSITOR :
Urinary stones are actually biominerals , they contain both inorganic and organic sub stones . There are different types of stones , Calcium oxalate is by far the most common stone constituent , as seen in at least 80 % of all stones . The formation of urinary stones has a multi factorial origin . Socio economic genetic constitutional factors , as well as diet , drugs , anatomic , functional and metabolic abnormalities , all play a part when a constituent exceeds the saturation in the urines . It crystallizes , these crystals grow and join together to form a deficiency of some substances which inhabit the growth and segregation of crystals in urine , will also permit stone formation .
COMMON SYMPTOMS OF STONE FORMATION :-
1mild/moderate or severe pain
2.passage of blood in the urine
3.passage of tissue in the urine
4.urinary infection
5.burning sensation ,when urinating
6.no symptoms at all
To evacuate the presence of stones , preliminary urine analysis followed by ultrasonography will give most of the information , to study the actual kidney function an IVU series [ x-ray ] needs to be performed . In case of further doubts additional tests like isotope renogram , cystoscopy and retrograde studies of the urinary tract and spinal CT may also be done .
Initial treatment will focus on relief from pain . After this , the next step will be to facilitate either passage or removal of the stone , itself , 80-90 % of all stones less than 5 mm will pass out on their own .I
If the stone is smooth , even stones of 7-8 mm may pass out on their own . stones larger than this will invariably need to be removed by one of the many methods available . If there is an anatomical abnormalities , the priority will be to correct that abnormality while removing the stone
One or two solitary stones in the kidney can be treated preferably by ESWL . This is a method by which pressure waves from a machine are focused on the stone and the stone is powdered . The stone fragments will pass out in the urine and the stone is powdered . The stone fragments will pass out in the urine stream over a period of 1 to 12 weeks .
Larger stones in the kidney are preferably removed by PCL . In this method , when the patient needs to be admitted , a small puncture is made in the kidney , the stone is identified , fragmented and removed completely
Stones lower down in the urinary tract may be treated either by ESWL or again by endoscopic methods . In this a small endoscope is passed into the urinary tract from out side i.e., the stone is visualized and fragmented
Open surgery for stones in the ureter are used only in complicated cases . Uric acid ones which are generally seen only on the ultra sound , and not on the x-rays , and if less than 1cm can be easily dissolved
Most patients with urinary stones need to make the following changes in their diet these include :
1.high intake of natural fluids like water , dilute butter milk , citrus juices etc , coffee tea or milk should be limited to 1 to 2 cups a day
2.food must preferably be vegetarian , and high in fiber
3.most eaters should limit the amount of sugar and calcium rich food like sweets etc., should be avoided especially on an empty stomach
patients suspected of having other metabolic or endocrinal problems will need to under go detailed testing . These are generally reserved for patients having recurrent stone formations .
SURGERY CAN BE AVOIDED AND CURED BY TAKING HOMOEOPATHIC MEDICINES :
FATTY LIVER , LEFT HYDRONEPHROSIS IS SECONDARY TO DISTAL URETERIC CALCULUS , MILD PROSTE TO MEGALY CURED BY HOMOEOPATHIC TREATMENT
Case History; of the patient whom I have treated (reports enclosed)
Patient name –Mr. Antony Age—39 years Date-03-05-2010
A male aged 39 years , business man , consulted for renal calculi, He presented the following symptoms pain in left loin , radiating to genitals , frequent urination with yellowish colored urine , left renal calculus with recurrent episodes of pain along the urinary tract . Indigestion with nausea < after meals , fatty food , sour eructation and regurgitation . He loved spices , salt and fried things , constipation , patient is very fat and weight 90 kgs height 5 feet –8 inches
History of presenting illness :
The patient had sudden pain in the left loin and rushed to casualty . the pain was actually managed with some pain killers and intra muscular injection , An ultra sonogram of abdomen was advised which is elicited with the impression of a left renal calculus with a distal uretric calculus just above the vesico uretric junction
USG REPORT; IMPRESSION
Fatty liver , left hydronephrosis is secondary to distal ureteric calculus mild prostetogamy
History of dyspeptic symptom with fullness of abdomen . Abdominal distension with few mouthfuls and regurgitation . He also had frequent and burning micturition , sudden pain in abdomen and left lion which radiated to left testes , since 2 years , he also had painful micturation , nausea and vomiting . I advised him to undergo a imaging study which revealed , mild nephrosis on the left side with a calculus measuring left ureter is dilated and shows calculus in the distal part , it measures 9×6 mm in size and normal texture , it measures 4.1 x 3,3 cms , volume 25 CC . he had treatment for dyspepsia and also reported recurrent urinary tract infections , his appetite , bowel habits were normal . sweat profusely , all over , sleep was good and dreams were on a day to day happenings , he has craving for hot food . The patient is keen , intellectual , sensitive , hurry and perfect in his duties , when urinary tract is set on fire , tenesmus , intolerance before , during , after urine passes drop by drop with raw scalding burning paroxysms
Physical generals ;
Back ache , localized only in the lumbar region ineffectual desire for urine , he craved muttons , chicken , non vegetarian food , burning sensation dyspepsia for more than 4 years
Pain in left renal angle radiating to the left testicle , left ureteric calculus with pain in hypogastrium of flatulent dyspepsia , hot patient
Food type ;-non vegetarian , too much liking , food meat , chicken , fish ++
Intolerance ; potatoes + , fatty food + meat
Sweat –more over axial ++ sleep disturbed , thirst too much
Urine – frequent and burning urination , severe burning , but passes little at a time , flatulence , worsened , pain , burning palms , when asked to drink plenty of water
First prescription ;
1] sarasaparilla 1M – 3 dose , only one day M/A/N
2] berberis vulgaris Q –daily 3 times for 1 month
3] cantharis 30 — TDS , daily 3 times for 1 month
4] colocynthis for acute of colic
pain in back reduced , frequent urination pain reduced , urine burning , relief urination regular
2ND prescription ;;
1] lycopodium 1 M – 3 dose daily night at bed time for 3 days only
2] berberis vulgaris Q –30 ml for 1 month
3] sabal saralatha Q —30 ml
4] colocynthis 200 – for acute colic
5] sarsaparilla 200—30 ML pills tds for 1 month
MEDICINES
1] cantharis vesicatoria – cantharis is a valuable remedy in the passage of renal calculi , kidney region is sensitive ; colic cutting , smarting or burning , biting or as if raw , causing mental excitement , constant and intolerable , urging to urinate before , during and after urination , when urinary tract is set on fire , tenesmus , intolerable before , during , after urine passes drop by drop with raw , scalding – burning paroxysms , fury of mind , frenzy of sexual excitement match with turmoil of water of life .
2] lycopodium clavatum- kidney colic from left ureter to right bladder , pain in black before micturating ; ceases after flow ; slow in coming , must strain , retention of urine , grasy pellicle in urine , red sand in the urinr and uric acid diathesis ; mental and physical ; make the essential totality
3] berberis vulgaris —berberis is on excellent remedy whwn the stone is in the pelvis of kidney or in the ureter burning , sore sore sensation in kidneys , renal colic of left side , most characteristic in berberis is pain only in hips and loins
4] sabal sarrulatha Q – sabal sarrulatha Q is homoeopathic to irritability of the genito – urinary organs , general and sexual debility , promotes nutrition and tissue building , constant desire to pass water at night enuresis , paresis of sphincter vesicae , chronic gonorrhea , difficult urination , cystitis with prostatic hypertrophy . urine regular , pain left side , left shoulder occasionally , no any pain and no burning and pinching pain
3RD prescription ;
1] lycopodium 1M –3 dose
2] sabal sarrulatha –30ml
3] berberis vulagaris Q —30ml
4] cantharis 30 –tds for 1 month
5] conium 200—weekly one dose for 3 weeks only
after 4 months or so , one fine morning , the patient rang me up to convey his congradulations . To fill the details ; the patient started having severe colic a night before , medicines plus plenty of water to drink brought a big piece of stone out at the end of urination , with relief after . After an hour or so of short lived relief , he again had spasmodic colic , again the same schedule of medicines and plenty of water , again with a jet of urine , another piece of stone was expelled .
Feels better , urination regular , no pain , other generals good , better no complaints , USG report NORMAL
REPORTS (BEFORE AND AFTER)
patient—Mr.Antony age-39 yrs male
ref—Dr.B.S.Suvarna visit date —03/05/2010
ULTRA SOUND OF ABDOMEN
Liver shows fatty infiltration , no focal lecions or diffuse pathology
Intra and extra hepatic billiary passages are not dilated
Intra hepatic IVC & hepatic veins are normal
Gall bladder is distended with clear contents & normal wall thickness
No calculi or debris seen
Pancreas is normal to the extent seen . no calculi or ductal cilatation seen
Spleen is normal in size and texture , no focal lesion
No free fluid noted in peritoneal or pleural space
Para-aortic & aorto –caval regions are normal . diaphragmatic movements
Satisfactory . no evidence of sub diaphragmatic pathology seen
Both the kidneys are normal in size & texture with normal cartico medullary
Differentiation . left kidney shows moderate hydronephrosis
No evidence of calculi or hydronephrosis seen on right side
Right kidney measures 10.1×1.7 . left kidney measures 10.2 x1.8 cms
Left ureter is dilated and shows calculus in the distal part , it measures 9×6 mm in size
Urinary bladder is distended and appears normal . no vesical calculus seen
Prostrate shows mildly enlarged in size and normal texture
It measures 4.1×3.6×3.3 CMS . volume –25 CC
Impression : FATTY LIVER
LEFT HYDRONEPHROSIS IS SECONDARY TO DISTAL
URETERIC CALCULUS
MILD PROSTATOMEGALLY
Patient name –Mr. Antony age —40 years –male
Ref-Dr.B.S.suvarna visit date —–25-01-2011
ULTRA SOUND SCANNING
Liver shows fatty infiltration . no focal lesions
Intra & extra hepatic biliary passages are not dilated
Intra hepatic IVC & hepatic veins are normal
Gall bladder is distended with clear contents & normal wall thickness . no calculi
Or debris seen
Pancreas is normal to the extent seen , no calculi or ductal dilatation seen
Spleen is normal in size & texture . no focal lesion seen
No free fluid noted in peritoneal or pleural space
Para aortic & aorto-caval regions are normal , diaphragmatic movements satisfactory . no evidence of subdiaphragmatic pathology seen
Both the kidneys are normal in size & texture with normal cortico medullary differentiation . no evidence of calculi or hydronephrosis seen bilaterally
Right kidney measures 11.8×1.9 cms
Urinary bladder is distended with clear contents and normal wall thickness
No vesical calculus seen
Prostate appears normal in size and texture .
It measures 3.6×23.8×2.5 cms—-volume 22 cc
