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นิ่วท่อไต อาการ สาเหตุ และการรักษาโรคนิ่วในท่อไต 7 วิธี !!

นิ่วท่อไต อาการ สาเหตุ และการรักษาโรคนิ่วในท่อไต 7 วิธี !!

ureter stones

ureter stones

ureter stones ureter stones or ureter stones (Ureteric stone, Ureteral stone, Ureteric calculi, Kidney Stone in Ureter) are small stones that form in the kidney and settle into the ureter. which is the organ next to the kidney This causes the ureter to contract to push the stone out. causing the patient to have severe abdominal pain

This is a disease that is quite common in people. It can be found in about 10% of the world’s population. and because it is a disease caused by kidney stones Therefore, ureteral stones are often found in adults between the ages of 30-40 years and are 2-3 times more common in men than women, especially in the North and the Northeast. as well as kidney stones

ureter (Ureter) is an organ responsible for carrying urine from the kidneys into the bladder. It is a pair of organs that include both the left ureter and the right ureter. It looks like a small tube flanked by both the left and right lumbar vertebrae. It is about 25-30 cm long and 3-5 mm in diameter. The walls of the duct are mucous and muscular. to squeeze the aid in the movement of urine from the kidneys to the bladder

Most ureter stones are smaller than 5 millimeters, but lumps larger than 1 centimeter may be present. In general, ureter stones, if they are about 1 millimeter in size, are likely to come off spontaneously with urine. About 87% If stones are 2-4 mm., 5-7 mm., 7-9 mm. and larger than 9 mm., there is a 76%, 60%, 58% chance of coming off spontaneously in urine. and 25%, respectively, in addition to the size of the stone The chances that the stone will come off on its own also depends on the location. Stones near the tip of the ureter are easier to loose than stones located in the beginning or middle of the ureter.ureter

Causes of kidney stones

This is because ureter stones are lumps that fall into the kidneys. Therefore, the types of stones are the same as kidney stones*, that is, approximately 75-80% of them are calcium oxalate stones, struvite stones, which are ammonium compounds. About 15% of magnesium and phosphate, approximately 6% of uric acid stones, and approximately 2% of Cystine stones.

The mechanism of gallstone formation is chronic precipitation of these substances until they eventually clump together. Which causes these substances to precipitate can be caused by a variety of reasons. such as abnormal concentrations of these substances in the urine (for example, from low water intake Being in a hot place causes the body to sweat and dehydrate. Consistently high gallstone diet, stress, use of certain medications), urinary obstruction which causes the urine to remain in the kidney for a long time (eg congenital urethral stricture Urethral stricture from chronic infectious urethritis), patients with gout (High uric acid in the blood), patients with overactive parathyroid glands. (high calcium in the blood), chronic urinary tract infections, genetics (this disease is found in people with a family history of kidney stones 2.5 times higher than in the normal family), male (result from testosterone tosterone that increases the production of oxalate in the liver), adults 30-60 years of age (children have higher urinary calculus inhibitors than adults), obesity (BMI is too high standard value), etc.

ureter stones are

note : An illustration of each type of gallstone and its causes can be found in the article. kidney stones

Symptoms of kidney stones

If the stone is still small The patient will have no symptoms. And the stone will usually pass out through the urine within 1-2 weeks, but when the stone is larger. or when there is an infection in the kidneys or bladder. It will result in swollen ureter. The ureter is narrowed or narrowed. So it’s easy for stones to get stuck in the ureter. The most common symptoms of this disease are

  • The patient will have severe abdominal pain. There will be a periodic twisting pain in the area of ​​the lower abdomen on one side only. (On the side where the stone is located) for hours or days, which is characterized by this disease. The patient will have pain radiating to the back and inner thighs. (Pain in the testicle or vagina on the same side as the lower abdomen) Patients are often in pain until they struggle. But when you put your hand on it, it feels better. The pain may subside on its own. However, it may recur at regular intervals as long as the stone has not come off.
  • Some patients may experience pain so much that they are sweating, cold, palpitations, palpitations, nausea, and vomiting.
  • When there are symptoms of infection often has a fever which can be either high fever or low fever
  • Patients will not have symptoms of mild scrubbing. Urine is usually clear, not cloudy, not red, with the exception of some people who may have cloudy, red urine.
  • There may be less urination. and is often found with blood in the urine which may not be visible to the naked eye but can be detected by urinalysis in the laboratory

Diagnosis of kidney stones

A doctor can diagnose this condition based on a history of symptoms. History of kidney or urethral stones or urinary stones come out from physical examination urine test Examination of the kidneys, ureters, by X-ray or ultrasound. And there may be other special tests as well, at the discretion of the doctor, such as a urinary tract endoscopy, etc.

ureteral stones

in patients with ureteral stones Doctors often can’t find anything wrong. Some people may find Abdominal and back muscles contracted. or there is a slight tenderness in the area of ​​pain

The symptoms of ureteral stones are often similar to abdominal pain for a number of reasons, including:

  • peptic ulcer disease (Peptic ulcer) There will be chronic abdominal pain that comes and goes in the middle of the chest or under the epigastrium. Pain is often associated with meals. The pain characteristics may be burning pain, persistent pain, colic, or a feeling of hunger before meals. and sometimes there may be nausea, vomiting, or belching
  • conjunctivitis (Pyelonephritis) pain in the lumbar region or on one side. with high fever, chills, cloudy urine
  • salpingitis (Adnexitis) will have pain in the lower abdomen. When you put your hand on it, you will feel pain. Patients may also have a high fever.
  • appendicitis (Appendicitis) there will be pain in the right lower abdomen for hours in a row, when you press it with your hand, you will feel pain. and the patient may have a fever
  • ectopic pregnancy (Ectopic pregnancy) pain in the lower abdomen, palpitations, fainting, pale face and often have a history of lack of menstruation
  • menstrual pain (Dysmenorrhea) is a spasmodic twisting pain in the lower abdomen only during menstruation. When you press it with your hand, you won’t feel pain.
  • Gallstones (Gallstones) are severe, intermittent torsion pains under the epigastric region or under the right ribcage. which may ache in the right shoulder or the area of ​​the back under the right shoulder blade and have nausea accompanied by vomiting

Complications of kidney stones

If the stone is large and cannot come off on its own In addition to causing chronic abdominal pain, if left unattended, it may also cause urinary tract infections. including chronic nephritis and may lead to renal failure, so large ureteral stones He needed to be cured quickly before serious harm could occur.

How to treat kidney stones

Treatment for ureteral stones depends on the size of the stones. that the patient has an infection with and kidney disease, such as when there is a swollen kidney

  • Take pain medication as prescribed by your doctor. including antispasmodics (Antispasmodics) such as Atropine (Atropine) or Hyoscine (Hyoscine) 1-2 tablets, but if the pain is severe, the doctor will prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac. (Diclofenac) intramuscular injection 1/2-1 tube each time and/or hyoscine intramuscular injection 1/2-1 tube each time. If symptoms improve, the doctor will give The drug should be taken at home, 1-2 tablets every 6 hours, followed by appointments for follow-up within 1-2 weeks. But if the gall still hasn’t come off and recurrent abdominal pain suggests that it may be a large stone in the ureter.
  • If the medication has not subsided within 6 hours or the pain recurs If the doctor has diagnosed and found that it is a small stone. Your doctor will prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and/or antispasmodics. (Antispasmodics) to relieve pain as well. Along with recommending that you drink a lot to wait for the stones to come off on their own. However, if the stones are found to be large, they may need to be treated with a stone shatter machine or surgically removed. Because if left unattended can lead to dangerous complications. namely
    • Extracorporeal shock wave lithotripsy (ESWL) or Stone Breaker It uses high-frequency sound waves to deliver energy through the skin to the stone to break up the stone. is a convenient way Has a high success rate, heals quickly, does not cause harm or scars. No need to stay in hospital and is an external treatment But there are important complications. It may be a bruise in the treated area. Blood in the urine, pain 2-3 days after treatment
      treatment of ureteral stones
    • Ureterorenoscopic stone removal (URS) A small ureteroscope is inserted through the bladder into the ureter. and using a gallstone (Basket) or shattering it using a laser or ballistic lithotripsy, often used for gallstones smaller than 5 millimeters.
      treatment of ureteral stones
  • treat kidney stones Because as long as there are kidney stones There is always a chance of recurrence of ureteral stones.
  • Self-care for kidney stonesureter stones symptoms Patients should do the following:
    1. Drink plenty of clean water in the amount recommended by your doctor. especially those who have had kidney or ureter stones in the past But if you’ve never had a stone before Should drink at least 6-8 glasses of clean water a day when there is no disease that restricts drinking water, such as heart failure.
    2. Patients should not buy medicines and take them on their own.
    3. You should not buy vitamin and mineral supplements and take them on your own without consulting your doctor. This can be the cause of kidney and ureter stones such as vitamin C, vitamin D, and calcium.
    4. Most ureter stones are as small as a matchstick (less than 6 millimeters) and usually come off on their own. If possible, the patient should urinate in the potty. to observe if any stones have come off as well This is because most stones tend to come off on their own within a few days. The abdominal pain will disappear completely. When the gallstone comes out (But keep in mind that there is still a chance of new stones forming later if not properly cared for.)
    5. when cured should prevent recurrence By drinking 3-4 liters of water per day, drinking a glass of lemon juice per day to help increase the citrate in the urine that has the effect of inhibiting the formation of stones. This includes limiting or reducing the intake of foods high in oxalate, uric acid and cystine.
    6. go see a doctor by appointment But when there are abnormal symptoms such as more abdominal pain Or have a high fever should seek emergency medical attention. To prevent complications that are harmful to the kidneys
    7. In the case of frequent recurrent gallstones Your doctor may send you to analyze the composition of the gallstone. to be used as a guideline for treatment and to give the correct advice especially in terms of food in order to avoid recurrence of gallstones

How to prevent kidney stones

  • Drink plenty of clean water, at least 6-8 glasses a day.
  • Limit or reduce the intake of foods that contain substances that cause kidney stones. such as Foods high in oxalate (e.g. betel nut, carrots, spinach, mimosa, cabbage, spinach, spinach, kale, broccoli, beetroot, cassava leaves, eggplant, tomatoes, figs, sweet potatoes, bamboo shoots, asparagus, onions, tops, tea, yogurt, chocolate, kidney beans. soybeans, sesame, nuts, various berries), Foods high in uric acid (e.g. meat, offal, poultry, seafood, seaweed, cockles, gravy, asparagus, spinach, top vegetables, kidney beans like black beans and red beans), Foods high in cystine (e.g. meat, milk, chicken, duck), etc.
  • taking vitamin and mineral supplements Especially vitamin C, vitamin D and calcium, always consult your doctor first.

Generally, ureteral stones are mild and treatable. But there may be relapses, so it should balance the diet appropriately, that is, eating a variety of foods. and reduce food containing gallstones Together with drinking plenty of water, do not let the body become dehydrated.

Related Matters

References
  1. Textbook of general medical examination 2. “Ureteric stone/Ureteral stone”. (Dr. Surakiat power Pages 857-858.
  2. Find a doctor. com.”Ureteric stone”. (Prof. Honorary M.D. Puangthong Kraipiboon). [ออนไลน์]. Accessed from: haamor.com. [02 ก.ค. 2016].
  3. Village Doctor Foundation. Village Doctor Magazine, Volume 182, Column: Suggesting Medicines – Explaining Diseases. “ureter stones”. (Dr. Surakiat power [ออนไลน์]. Can be accessed from : www.doctor.or.th. [02 ก.ค. 2016].

illustration : www.webmd.com, www.kidneystoner.org, www.consultant360.com, www.consultant360.com, medchrome.com, lifeinthefastlane.com, www.westchesterurology.com, www.urologistindia.com, www.urology-textbook.com

Compiled by the Maid Thai website (Medthai)


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