Both Kidney and gallbladder can get stones. Although the mechanisms are somewhat similar, the presentation of kidney stone and gallstone is quite different. This article will discuss what kidney stones and gallstones are and the differences between them in detail highlighting their clinical features, symptoms, causes, risk factors, tests and diagnosis, prognosis, and also the course of treatment/management they require.
What are Kidney Stones?
Kidney stones consist mainly of crystal aggregates. The stones form in the collecting ducts and, may be, deposited anywhere from renal pelvis to urethra. 0.2% of the world population has kidney stones. It occurs mostly during the third to fifth decades. Kidney stones are commoner in males than females. Dehydration, urinary tract infections, increased serum calcium, high dietary intake of oxalates, small intestinal diseases or resection, renal tubular acidosis, and drugs increase the risk of kidney stones. 40% of stones are made of calcium oxalate. Calcium phosphate (13%), triple phosphate (15%), oxalate/phosphate (13%), uric acid (8%), cysteine (3%), and mixed stones (6%) make up the rest.
Renal stones may be asymptomatic or may present with a variety of symptoms. Kidney stones cause loin pain. Stones in the ureter cause flank pain, radiating from loin to groin. Bladder stones cause pain while urinating. Stone in the urethra cause pain and low flow. Stones can get infected. Bladder infections cause fever, painful urination, blood stained urine and frequent urination. Pyelonephritis causes fever, nausea, vomiting and loin pain.
Urine may contain pus cells, red blood cells, and crystals. Urine culture may yield a causative organism. If kidney function is compromised, high blood urea and creatinine can be there. Full blood count may also show features of an infection.
Stones not causing obstruction between attacks may be managed conservatively. Increasing fluid intake increases urine formation. Urine may flush the stone out if small enough. Larger stones may be fragmented using extra-corporeal shockwave lithotripsy or surgery. Antibiotic treat coexisting infections.
What are Gallstones?
Liver produces and releases a fluid called bile to help with digestion. The main function of the gallbladder is to store and concentrate this bile, which helps in the digestion and absorption of fats and fat-soluble vitamins in the small intestine and in the elimination of waste products.Bile contains cholesterol, pigments, and phosphates. If the concentrations of these vary, different kinds of stone may be formed. Pigment stones are small, friable and irregular. The commonest cause of pigment stones is increased blood cell breakdown. Cholesterol stones are large and solitary. They occur commonly in obese old females. Mixed stones are multifaceted.
Almost 8% of the population above 40 year of age gets gallstones, and 90% of them are asymptomatic. Smokers and pregnant females get symptomatic gallstones commonly. Gall stones can lead to gall bladder inflammation, biliary colic, pancreatitis and obstructive jaundice. Acute cholecystitis follows stone impaction at the neck of the gallbladder. It may result in continuous right upper abdominal pain, vomiting, nausea and fever.
Blood test presents elevated white blood cell count. Ultrasound scan shows thickened gall bladder wall, fluid around the gallbladder and stones. Chronic cholecystitis results in vague abdominal pain, abdominal distension, nausea, flatulence, reflux, and gastric ulcers. Cholecystectomy following remission of the chronic inflammation is the recommended treatment.
What is the difference between Kidney Stones and Gallstones?
• Gallstones are commoner than renal stones.
• Kidney stones are made up of calcium salts mostly while gallstones are not.
• Kidney stone affect younger population while gallstones occur in people above 40.
• Gallstones present with right upper abdominal pain while renal stones present with loin pain.
• The presentation differs according to the site of the stone in the urinary tract while all gallstones present with similar features in general.
• Both conditions need antibiotics.
• Both can be managed conservatively or aggressively according to the clinical condition.
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