A 45-year-old grocery sales clerk has been suffering from bouts of severe pain in his left flank region. He blamed it on prolonged standing for 8 hours straight while working. He was taking over-the-counter pain medications for his pain. One day, he found fresh blood in his urine. He went to a doctor who performed urine tests, CT scans, and x-rays. He was diagnosed with urinary calculi. •Discuss possible factors that may have been responsible for the development of the stone and use this case to show how the patient’s diet and water intake can help analyze the composition of the calculi. Factors responsible for the development can include his family or personal history, being over 40, his gender, his diet, weight, over the counter medications, and possible dehydration. He will need to drink plenty of water, avoid excess caffeine, black tea, grapefruit and apple juices. He should also avoid foods high in oxalates, limit his sodium Intake, limit his animal protein and avoid mega-doses of vitamin
C. By following this dietary and water intake method it should help analyze if the calculi composition is Calcium oxalate, Calcium phosphate, Cystine, Magnesium ammonium phosphate, or Uric acid. •What would be the test results of his white blood cells, blood calcium levels, CT scan, and x-ray? Urinalysis will be positive for nitrite, leukocyte esterase, and blood. The white blood cell (WBC) count will be elevated, with a left shift. Creatinine level will also be elevated in outlet obstruction. CT scan will demonstrate bladder calculi if the test is performed without IV contrast material. The unenhanced spiral CT is sensitive but yet specific in diagnosing calculi along the urinary tract and even pure urate calculi can be detected this way. KUB detects radiopaque stones because pure uric acid and ammonium urate stones are radiolucent and can be coated with a layer of opaque calcium sediment.
The sonogram will show a classic hyperechoic object with posterior shadowing, and it is effective in identifying both radiolucent and radiopaque stones. (Basler, 2014) •Suggest the best treatment for the patient and a plan to prevent recurrence post-treatment. Treatment is with analgesics, antibiotics for infection, medical expulsive therapy, and, sometimes, shock wave lithotripsy or endoscopic procedures. •Facilitate calculus passage with α-receptor blockers such as tamsulosin. •For persistent or infection-causing calculi, complete removal using primarily endoscopic techniques. (Preminger, 2014)
Drink plenty of water, get the proper amount of calcium according to your age, reduce sodium , limit animal protein such as red meat, poultry, eggs, and seafood , and avoid stone-forming foods such as beets, chocolate, spinach, rhubarb, tea, most nuts rich in oxalate, and colas rich in phosphate.
Preminger,G. (2014, July). Urinary Calculi. Merck Manuals. Retrieved from: http://www.merckmanuals.com/professional/genitourinary_disorders/urinary_calculi/urinary_calculi.html Pendick, D. (2013, Oct). 5 steps for Preventing Kidney Stones. Harvard Health Publications. Retrieved from: http://www.health.harvard.edu/blog/5-steps-for-preventing-kidney-stones-201310046721 Basler, J. (2014). Bladder Stones Workup. WEbMd. Retrieved from: http://emedicine.medscape.com/article/2120102-workup#showall