Health

Kidney Stones & Constipation: Understanding Common Urological Challenges

Having kidney stones is common. However, kidney stones are no fun. More than half a million in the US are hospitalized because of kidney stones every year. People between the ages of 30 and 60 are mostly affected.

Kidney stones and constipation are both infamous medical conditions in humans and to see if one is related to the other, we will need to dig deeper into both the states, their symptoms, diagnosis, treatment, and correlation.

1. Understanding The Human Excretory System

kidney stones and constipation
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Biologically, the excretory system works to remove excess, unnecessary substances from the body fluids of an organism and thus plays a crucial role in maintaining homeostasis and preventing the body from damage.

The function of the excretory system is to eliminate the waste products of metabolism and to drain the body of used-up and broken-down components in a gaseous or liquid state. In humans and other mammals, reptiles, and birds, the waste materials are usually excreted as urine, and mammals also expel them through sweating.

The excretory system consists of organs that are specifically meant to perform the excretion processes. In short, the term excretory refers to the urinary system. Most organs when healthy produce metabolic or other wastes which is why the entire organism depends on the function of the excretory system. Damaging of any one of the systems can cause critical conditions, such as kidney failure.

1.1. The Complex System Consists of the Following Organs

1.1.1. Kidneys

These are bean-shaped organs located around the lower back, one present on each side of the spine. They are mainly responsible for filtering the blood and removing remains such as urea, creatinine, and excess ions and regulating fluid and electrolyte equilibrium. The filtered waste comes out of the body as urine.

1.1.2. Ureters

To transfer the urine from the kidneys to the bladder, there’s a requirement for a passage. Ureters are muscular ducts that help urine travel from the kidneys to the urinary bladder. In an adult human, the ureters are around 25-30 cm long.

1.1.3. Urinary Bladder

After filtration and transfer of waste products from the body, the function of the urinary bladder is to store the urine until it is ready to be eliminated. The bladder is a hollow, muscular, and elastic organ that is located on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra.

1.1.4. Urethra

To finally excrete the waste products from the body, there’s another duct connecting to an external opening in the body, which is termed the urethra. The urethra is a muscular duct lined with mucous membranes and is different for both males and females. The male urethra is more complex due to its dual function of urination and ejaculation.

2. The Bean-Shaped Organs

kidneys
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In humans, the two reddish-brown, 12 cm long, bean-like structures located on either side of the spine are called kidneys. The pair of kidneys are blood-filtering organs in humans. The blood from the body travels to the kidneys via the renal arteries and exits into the renal veins. Each of the kidneys is connected to ureters to help transfer the waste products from the kidneys to the urinary bladder.

The kidneys are responsible for controlling the volume of several body fluids, fluid osmolality, acid-base equilibrium, electrolyte concentrations, and emptying toxins. The filtration takes place in the glomerulus, and about one-fifth of the blood received in the kidney is filtered. The substances that are reabsorbed are solute-free water, amino acids, glucose, bicarbonate, and sodium. Excreted products include ammonium, hydrogen, uric acid, and potassium.

The kidneys also play a role in regulating blood pressure by adjusting the blood volume and the constriction of dilation of blood vessels. The enzyme renin is released by the kidneys when blood pressure drops to trigger stimuli that raise the blood pressure. The kidneys are also accountable for converting inactive vitamin D into its active form, calcitriol, which synthesizes the hormones erythropoietin and renin.

As of today, chronic kidney diseases have been recognized as a leading public health problem across the globe. The estimated prevalence of kidney diseases in people all over the world is around 13.4 percent and the count of patients who suffer from kidney failure and require replacement is about 5 to 7 million. 

3. A Gist of Kidney Diseases

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There are a variety of medical conditions that primarily affect the kidneys, some of which can be fatal, leading to death. It is important to have kidneys to have a normal functioning body.  Damage to the kidneys can affect the body’s ability to filter your blood, remove extra water from the blood, and help balance your blood pressure. 

The damage to kidneys leads to the accumulation of waste products in your body, causing swelling in your ankles, weakness, poor sleep habits, nausea, and shortness of breath. Without proper management and treatment, these developing symptoms can stop the kidney’s function leading to kidney failure.

The damages can be caused by either diabetes, high blood pressure, or several other chronic conditions. Once the kidney function stops permanently, you will require the assistance of dialysis to filter out the waste from your blood. Dialysis cannot repair the kidneys but can help you live a bit longer.

Here are some commonly occurring kidney diseases:

3.1. Chronic Kidney Diseases

The most common form of kidney disease is chronic kidney disease, and it is usually caused by high blood pressure. If you have high blood pressure, it is dangerous to your kidneys, as the pressure affects the glomeruli severely. Glomeruli are tiny blood vessels, where the cleansing of blood takes place in the kidney, and too much pressure destroys those vessels, diminishing the function of the kidneys, gradually.

Another major cause of chronic kidney disease is diabetes. The increased level of blood sugar damages the blood vessels in the kidneys over time resulting in impaired function of the kidneys. Due to less cleaning, your body will soon be filled with toxins leading to severe consequences.

3.2. Kidney Stones

This is a very common kidney disease affecting millions around the world. Also termed renal calculi, kidney stones are waste deposits turned into rock-like structures when minerals and other substances in the blood become concentrated and crystallize. They can vary in size, ranging from smaller grains to large and more painful stones.

The common symptom of developing kidney stones is feeling intense and sudden pain, conventionally in the lower back, side, or abdomen. Other symptoms can be the presence of blood in the urine, frequent urination, and the repetitive urge to urinate.

The treatment solely depends on the size of the stones, smaller ones can flow out with urine, while larger ones may require surgical methods or ureteroscopy. The best ways to prevent kidney stones are to stay hydrated, proper diet, and address issues that may lead to stone formation.

3.3. Urinary Tract Infections

Although these bacterial infections typically affect either the urethra or the bladder and can be easily treated, can spread to the kidneys causing kidney failure, if left untreated. UTIs are known to be more prevalent in women and can occur at any age.

The common symptoms of UTIs include frequent urge to urinate, burning sensation during urination, blood in the urine, discomfort in the lower abdomen, and a feeling of insufficient emptying of the bladder. In cases where kidneys are involved, fever, back pain, and nausea can be characterized as the symptoms of a UTI.

Apart from these three common diseases that affect the kidneys, there are several others, namely, Glomerulonephritis, which is an inflammation of the glomeruli, Polycystic Kidney Disease, Nephrotic Syndrome, Interstitial Nephritis, Hematuria, Kidney Cancer, Wegener’s Granulomatosis and many more.

4. What are Kidney Stones?

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Renal calculi better known as kidney stones,are solid masses made of crystals and can develop anywhere along your urinary tract, which comprises the kidney, urinary bladder, ureters, and urethra. It can be a painful medical issue and the causes differ based on the type of the stone.

Different kinds of stones include:

4.1. Calcium Stones

These are the most commonly found stones and are typically made of calcium oxalate, although they might contain calcium phosphate or maleate. To reduce the risk of developing calcium stones, you must refrain from eating too many oxalate-rich foods such as potato chips, peanuts, chocolate, and spinach. However, even though some kidney stones are made up of calcium, having a sufficient amount of calcium can also reduce the risk of stones.

4.2. Uric Acid

The next most common type of kidney stones is uric acid stones. These stones typically occur in people with gout, diabetes, obesity, and other metabolic disorders. The main cause of the formation of uric acid stones is the presence of excess uric acid in the urine. One of the major reasons that leads to an increase in uric acid is a diet rich in purine, such as organ meat, red meat, or seafood. 

4.3. Struvite

The presence of struvite stones is more prevalent in people suffering from a urinary tract infection better known as UTI. These stones are also known as infection stones or magnesium ammonium phosphate stones. These can grow quickly creating consequential discomfort and blockages.

4.4. Cystine

This is a rare type of kidney stone occurring in humans, affecting 1 out of 7000 people. They are likely to occur in both men and women diagnosed with a genetic disorder termed cystinuria. In this type, cystine, which is an acid naturally formed in the body leaks from the kidneys into the urine. These stones are known to be quite painful and require specialized treatment.

5. Symptoms and Causes

symptoms and causes
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The characteristic feature of a kidney stone is that it can cause intense pain in the lower back region of the body. The symptoms start to show when the stones move down the ureters, which results in pain on one side of your back or abdomen. In men, the pain might also radiate to the groin area. Typically the pain comes and goes but is intense and people who suffer from this pain tend to become restless.

Kidney stones cause a variety of symptoms, all of which vary based on their size and location. Here are some common symptoms:

One of the hallmark symptoms of kidney stones is severe pain, typically described as sharp, stabbing, or cramping. This pain usually occurs in the lower back or side, or below the ribcage, and might radiate to the groin area or abdomen. As the pain is generally concentrated on one side of the body, people feel restlessness and discomfort.

The presence of blood in urine is a significant symptom of kidney stones and can cause the urine to change its colour to pink, red, or brown. People with kidney stones have the urge to frequently urinate accompanied by a burning sensation during urination. The urge to urgently urinate also develops due to kidney stones, even when the bladder is not full.

Some might also experience nausea and vomiting, especially if the pain is severe. In cases of kidney stones caused due to a UTI, you might experience fever or chills. The presence of infection alongside kidney stones can change the urine odour and colour.

It is more likely for people between 20-50 years of age to develop kidney stones. Multiple factors are responsible for the growth of kidney stones. In the United States, the white population is more prone to developing kidney stones as compared to the black population. According to research by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), men are more likely to develop stones than women.

Dehydration, obesity, diabetes, a diet with high levels of protein, glucose, or salt, hyper parathyroid condition, gastric bypass surgery, bowel diseases, medications such as diuretics, anti-seizure drugs, and calcium-based antacids are among other factors that lead to an increasing risk of developing kidney stones.

6. What is Constipation?

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Technically, having less than three bowel movements is considered constipation. However, the duration can differ from person to person. The bowel patterns are unique for everyone until and unless you stray away too far from your usual pattern.

Regardless of your bowel pattern, the longer you take before you defecate the more it becomes difficult for the waste to pass. Other factors that characterize constipation include dry and hard stools, painful bowel movements, and a feeling that you haven’t emptied your bowels.

What makes it happen though? Constipation happens because your large intestine absorbs too much water from your feces, which makes it dry making it hard and difficult to expel out from your body. To explain it broadly, the food passes through the digestive tract, and the intestines gradually absorb the nutrients and the remains that pass from the small intestine to the large intestine become fecal matter.

The colons absorb the water from the feces making it more solid. If you have constipation, food takes time to pass through the digestive tract, giving the colons more time to absorb more water from the waste, thus making it dry, hard, and difficult to push out.

7. Causes of Constipation

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Several causes lead to constipation including lifestyle factors, medications, and medical conditions. Lifestyle factors include consuming less fiber, dehydration, not getting enough exercise, changes in routine, stress, and resisting the urge to have a bowel movement.

Medications that cause constipation include strong pain medicines like narcotics containing codeine, non-steroidal anti-inflammatory drugs, antihistamines, iron pills, antidepressants, antacids made of calcium, blood pressure medications,  and antiseizure medicines.

Multiple medical conditions such as hypothyroidism, diabetes, hypercalcemia, colorectal cancer, irritable bowel syndrome, spinal cord injury, structural defects in the digestive tract, and autoimmune diseases like lupus.

8. Cause of Constipation

Kidney stones and constipation
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So far we can see these are two different medical conditions that largely affect the excretory system and bowel movements, hampering overall health. The presence of kidney stones causes inflammation in the bowel leading to changes in bowel patterns. Certain medications that are used to treat kidney stones may further lead to constipation.

Stones larger in size pose as an obstruction in the urinary tract which can lead to excessive retention. When concentrated urine accumulates in the bladder it can induce pressure on the bowels, resulting in changes in movement and function.

To establish normal bowel movements after kidney stones here are a few things you can try: increase your fluid intake, stay hydrated at all times, and water softens stools for better movement, and include more fibers into your diet like fruits and vegetables. If the situations don’t get better it is always advisable to take medical assistance.

Pushpita Narzary this side. I am a 20-year-old undergrad, currently pursuing a Bachelor's in Technology from the National Institute of Technology, Silchar. Although I belong to the engineering domain, I have always had a love for writing. My passion…

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