1 00:00:08,243 --> 00:00:12,673 The biggest kidney stone on record weighed more than a kilogram 2 00:00:12,673 --> 00:00:16,765 and was 17 centimeters in diameter. 3 00:00:16,765 --> 00:00:20,643 The patient didn't actually swallow a stone the size of a coconut. 4 00:00:20,643 --> 00:00:23,464 Kidney stones form inside the body, 5 00:00:23,464 --> 00:00:28,704 but unfortunately, they're extremely painful to get out. 6 00:00:28,704 --> 00:00:33,245 A kidney stone is a hard mass of crystals that can form in the kidneys, 7 00:00:33,245 --> 00:00:34,345 ureters, 8 00:00:34,345 --> 00:00:35,254 bladder, 9 00:00:35,254 --> 00:00:36,846 or urethra. 10 00:00:36,846 --> 00:00:39,595 Urine contains compounds that consist of calcium, 11 00:00:39,595 --> 00:00:40,485 sodium, 12 00:00:40,485 --> 00:00:41,387 potassium, 13 00:00:41,387 --> 00:00:42,406 oxalate, 14 00:00:42,406 --> 00:00:43,476 uric acid, 15 00:00:43,476 --> 00:00:45,487 and phosphate. 16 00:00:45,487 --> 00:00:48,327 If the levels of these particles get too high, 17 00:00:48,327 --> 00:00:51,275 or if urine becomes too acidic or basic, 18 00:00:51,275 --> 00:00:56,635 the particles can clump together and crystallize. 19 00:00:56,635 --> 00:00:58,316 Unless the problem is addressed, 20 00:00:58,316 --> 00:01:03,907 the crystals will gradually grow over a few weeks, months, or even years, 21 00:01:03,907 --> 00:01:08,116 forming a detectable stone. 22 00:01:08,116 --> 00:01:12,214 Calcium oxalate is the most common type of crystal to form this way, 23 00:01:12,214 --> 00:01:16,657 and accounts for about 80% of kidney stones. 24 00:01:16,657 --> 00:01:21,938 Less common kidney stones are made of calcium phosphate, or uric acid. 25 00:01:21,938 --> 00:01:23,777 A slightly different type of stone 26 00:01:23,777 --> 00:01:27,528 made of the minerals magnesium ammonium phosphate, or struvite, 27 00:01:27,528 --> 00:01:31,258 can be caused by bacterial infection. 28 00:01:31,258 --> 00:01:35,169 And even rarer stones can result from genetic disorders 29 00:01:35,169 --> 00:01:38,489 or certain medications. 30 00:01:38,489 --> 00:01:44,099 A kidney stone can go undetected until it starts to move. 31 00:01:44,099 --> 00:01:47,428 When a stone travels through the kidney and into the ureter, 32 00:01:47,428 --> 00:01:52,469 its sharp edges scratch the walls of the urinary tract. 33 00:01:52,469 --> 00:01:57,481 Nerve endings embedded in this tissue transmit excruciating pain signals 34 00:01:57,481 --> 00:01:59,802 through the nervous system. 35 00:01:59,802 --> 00:02:04,142 And the scratches can send blood flowing into the urine. 36 00:02:04,142 --> 00:02:06,892 This can be accompanied by symptoms of nausea, 37 00:02:06,892 --> 00:02:07,734 vomiting, 38 00:02:07,734 --> 00:02:11,144 and a burning sensation while urinating. 39 00:02:11,144 --> 00:02:14,594 If a stone gets big enough to actually block the flow of urine, 40 00:02:14,594 --> 00:02:17,472 it can create an infection, or back flow, 41 00:02:17,472 --> 00:02:21,253 and damage the kidneys themselves. 42 00:02:21,253 --> 00:02:24,124 But most kidney stones don't become this serious, 43 00:02:24,124 --> 00:02:27,353 or even require invasive treatment. 44 00:02:27,353 --> 00:02:30,157 Masses less than five millimeters in diameter 45 00:02:30,157 --> 00:02:33,685 will usually pass out of the body on their own. 46 00:02:33,685 --> 00:02:37,415 A doctor will often simply recommend drinking large amounts of water 47 00:02:37,415 --> 00:02:39,895 to help speed the process along, 48 00:02:39,895 --> 00:02:43,385 and maybe taking some pain killers. 49 00:02:43,385 --> 00:02:47,165 If the stone is slightly larger, medications like alpha blockers 50 00:02:47,165 --> 00:02:50,326 can help by relaxing the muscles in the ureter 51 00:02:50,326 --> 00:02:54,126 and making it easier for the stone to get through. 52 00:02:54,126 --> 00:02:56,406 Another medication called potassium citrate 53 00:02:56,406 --> 00:03:02,987 can help dissolve the stones by creating a less acidic urine. 54 00:03:02,987 --> 00:03:06,197 For medium-sized stones up to about ten millimeters, 55 00:03:06,197 --> 00:03:10,577 one option is pulverizing them with soundwaves. 56 00:03:10,577 --> 00:03:16,226 Extracorporeal shock wave lithotripsy uses high-intensity pulses 57 00:03:16,226 --> 00:03:21,708 of focused ultrasonic energy aimed directly at the stone. 58 00:03:21,708 --> 00:03:25,369 The pulses create vibrations inside the stone itself 59 00:03:25,369 --> 00:03:29,149 and small bubbles jostle it. 60 00:03:29,149 --> 00:03:33,127 These combined forces crush the stone into smaller pieces 61 00:03:33,127 --> 00:03:37,389 that can pass out of the body more easily. 62 00:03:37,389 --> 00:03:40,108 But zapping a stone with sound doesn't work as well 63 00:03:40,108 --> 00:03:42,565 if it's simply too big. 64 00:03:42,565 --> 00:03:47,050 So sometimes, more invasive treatments are necessary. 65 00:03:47,050 --> 00:03:53,071 A rigid tube called a stent can be placed in the ureter to expand it. 66 00:03:53,071 --> 00:03:57,550 Optical fibers can deliver laser pulses to break up the stone. 67 00:03:57,550 --> 00:04:00,980 Stones can also be surgically removed through an incision 68 00:04:00,980 --> 00:04:04,489 in the patient's back or groin. 69 00:04:04,489 --> 00:04:07,901 What about just avoiding kidney stones in the first place? 70 00:04:07,901 --> 00:04:09,821 For people prone to them, 71 00:04:09,821 --> 00:04:12,470 their doctor may recommend drinking plenty of water, 72 00:04:12,470 --> 00:04:15,651 which dilutes the calcium oxalate and other compounds 73 00:04:15,651 --> 00:04:20,615 that eventually build up into painful stones. 74 00:04:20,615 --> 00:04:21,878 Foods like potato chips, 75 00:04:21,878 --> 00:04:22,932 spinach, 76 00:04:22,932 --> 00:04:23,744 rhubarb, 77 00:04:23,744 --> 00:04:26,280 and beets are high in oxalate, 78 00:04:26,280 --> 00:04:29,847 so doctors might advise limiting them. 79 00:04:29,847 --> 00:04:32,432 Even though calcium is often found in stones, 80 00:04:32,432 --> 00:04:36,281 calcium in foods and beverages can actually help 81 00:04:36,281 --> 00:04:39,101 by binding to oxalate in the digestive tract 82 00:04:39,101 --> 00:04:43,143 before it can be absorbed and reach the kidneys. 83 00:04:43,143 --> 00:04:46,222 If you do end up with a kidney stone, you're not alone. 84 00:04:46,222 --> 00:04:48,913 Data suggests that rates are rising, 85 00:04:48,913 --> 00:04:52,852 but that world record probably won't be broken any time soon.