WEBVTT - What Causes the Pain of Kidney Stones?

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<v Speaker 1>Welcome to brain Stuff, a production of iHeart Radio, Hey

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<v Speaker 1>brain Stuff. Lauren vogebon here. Mark Bird of Miami, Florida

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<v Speaker 1>was thirty eight years old when he had his first

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<v Speaker 1>kidney stones. The pain started in his back, like he

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<v Speaker 1>had slipped a disk. Bird was used to back pain,

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<v Speaker 1>so he tried his standard routine of stretching, yoga, and

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<v Speaker 1>frequent trips to the chiropractor, but nothing helped. Then one day,

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<v Speaker 1>he was sitting in his office chair when it felt

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<v Speaker 1>like someone had sneaked up behind him and stabbed him

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<v Speaker 1>in the back of the bowie knife for the article.

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<v Speaker 1>This episode is based on hows to work? Spoke Bird

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<v Speaker 1>when he was forty eight and the veteran of two

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<v Speaker 1>excruciating kidney stone episodes. He said, the pain takes your

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<v Speaker 1>breath away. You're doubled over and thinking I need to

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<v Speaker 1>get to the hospital right now. Every year, half a

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<v Speaker 1>million people visit emergency rooms in the United States with

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<v Speaker 1>kidney's tones, and around one in ten Americans will have

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<v Speaker 1>a kidney stone at some point in their life. We

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<v Speaker 1>humans typically have two kidneys, and their main job is

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<v Speaker 1>to filter waste products out of our blood. Normally, those

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<v Speaker 1>waste products are flushed out of the kidney as urine.

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<v Speaker 1>Your kidneys filter some fifty gallons that's nine liters of

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<v Speaker 1>blood every twenty four hours and eliminate some sixty four

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<v Speaker 1>ounces or two leads of waste. In some cases, however,

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<v Speaker 1>there are excess waste products in the blood that aren't

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<v Speaker 1>flushed out of the kidneys. Those leftover waste products can

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<v Speaker 1>form tiny crystals that bunched together over time to form

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<v Speaker 1>increasingly large stones. Calcium oxalate is the most common component

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<v Speaker 1>of kidney stones, but there are others too, including uric acid, struvite,

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<v Speaker 1>and sistine. The real trouble starts when one of these

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<v Speaker 1>stones leaves the kidney and enters the uritor, which is

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<v Speaker 1>a narrow tube that transports urine from the kidney to

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<v Speaker 1>the ladder. That's when it can feel like you've been

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<v Speaker 1>stabbed in the back. Pain is a hard thing to quantify,

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<v Speaker 1>but the discomfort of passing a kidney stone is routinely

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<v Speaker 1>compared to childbirth or worse. But the source of that

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<v Speaker 1>pain may be surprising. How stuff works. Also spoke with

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<v Speaker 1>Dr Timothy Average, a kidney stone specialist at Prisma Health

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<v Speaker 1>Urology in Columbia, South Carolina. He said, the common belief

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<v Speaker 1>is that the stone itself causes the pain. Patients will

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<v Speaker 1>frequently say it must have a lot of rough edges

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<v Speaker 1>or spikes because this one hurts a lot, or it's

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<v Speaker 1>really large and that's what hurts so badly. That actually

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<v Speaker 1>has nothing to do with the pain. So if it's

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<v Speaker 1>not the stone, what the heck is causing that searing pain.

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<v Speaker 1>The thing is that if a kidney stone is large enough,

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<v Speaker 1>it'll get stuck in the narrow passageway of the uritor,

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<v Speaker 1>causing urine to build up behind it. With nowhere to go,

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<v Speaker 1>the urine exerts increasing pressure on the narrow eutor and

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<v Speaker 1>on the kidney, causing the tissues to stretch like balloons.

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<v Speaker 1>Average explained that stretching is what triggers the pain people

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<v Speaker 1>feel when they have kidney stones. You feel it in

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<v Speaker 1>your back first, and then it can radiate around the

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<v Speaker 1>front and down to the groin. It's pretty excruciating for

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<v Speaker 1>most and the body has all types of nerves for

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<v Speaker 1>sensing things like touch and temperature. The nerves and your

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<v Speaker 1>kidney in eutor detect distension or dilation, just like your intestines, bladder,

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<v Speaker 1>and bowels. An obstructed bowel is also very painful, but

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<v Speaker 1>kidney stones are far more common. The discomfort of kidney

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<v Speaker 1>stones is described as colic since it comes in waves.

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<v Speaker 1>That's because the orator uses involuntary wave like muscle movements

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<v Speaker 1>called peristalsis to move urine from the kidney to the

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<v Speaker 1>bladder in packets or bunches. If the pathway is blocked,

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<v Speaker 1>the pressure builds with every involuntary squeeze of the urotor,

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<v Speaker 1>and so does the pain. In both women and men.

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<v Speaker 1>Urine exits the bladder through the urethra and then out

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<v Speaker 1>from the body. Another common misconceptions as average is that

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<v Speaker 1>the most painful part of having a kidney stone is

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<v Speaker 1>passing it through the urethra, but he says those fears

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<v Speaker 1>are largely unfounded. He said the urethra and men and

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<v Speaker 1>women is much wider than the eurotor, almost twice the size.

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<v Speaker 1>Patients will frequently say to me, oh, I'll know one,

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<v Speaker 1>I pay it out. Often they actually don't. Bird, for

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<v Speaker 1>his part, disagrees. Even though treatment for his kidney stones

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<v Speaker 1>involved internally blasting them with shock waves to break them

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<v Speaker 1>into smaller particles, the largest fragments were still the size

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<v Speaker 1>of bebes. A bird says it felt like urinating and

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<v Speaker 1>I quote shards of glass. One of the many unpleasant

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<v Speaker 1>surprises of Bird's ordeal was that he had to have

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<v Speaker 1>a stent in aserted into his eudor to open the

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<v Speaker 1>passageway from the kidney to the bladder, and the stent

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<v Speaker 1>stayed in for two long weeks. Ural stents are ten

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<v Speaker 1>fifteen inch plastic tubes that's around that are inserted through

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<v Speaker 1>the urethra all the way up to the kidney to

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<v Speaker 1>let urine flow to the bladder again. A stent is

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<v Speaker 1>used in many kidney stone removals to keep the order

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<v Speaker 1>from becoming obstructed again by swelling. After the operation is complete,

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<v Speaker 1>Insertion of the stent is done under heavy sedation. But

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<v Speaker 1>removal isn't, a bird said, the nurses try to use

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<v Speaker 1>the element of surprise. They pull it out like a

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<v Speaker 1>rip chord. Today's episode is based on the article kidney

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<v Speaker 1>stones are excruciating, but the source of pain is surprising

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<v Speaker 1>on how stuff works dot Com, written by Dave Bruise.

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<v Speaker 1>A brain Stuff is production of by Heart Radio in

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<v Speaker 1>partnership with how stuff works dot Com and it's produced

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<v Speaker 1>by Tyler Klang. Before more podcasts from my heart Radio,

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<v Speaker 1>visit the heart Radio app, up Apple podcasts, or wherever

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