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The biggest kidney stone on record weighed more than a kilogram
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and was 17 centimeters in diameter.
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The patient didn't actually swallow a stone the size of a coconut.
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Kidney stones form inside the body,
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but unfortunately, they're extremely painful to get out.
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A kidney stone is a hard mass of crystals that can form in the kidneys,
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ureters,
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bladder,
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or urethra.
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Urine contains compounds that consist of calcium,
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sodium,
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potassium,
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oxalate,
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uric acid,
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and phosphate.
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If the levels of these particles get too high,
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or if urine becomes too acidic or basic,
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the particles can clump together and crystallize.
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Unless the problem is addressed,
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the crystals will gradually grow over a few weeks, months, or even years,
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forming a detectable stone.
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Calcium oxalate is the most common type of crystal to form this way,
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and accounts for about 80% of kidney stones.
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Less common kidney stones are made of calcium phosphate, or uric acid.
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A slightly different type of stone
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made of the minerals magnesium ammonium phosphate, or struvite,
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can be caused by bacterial infection.
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And even rarer stones can result from genetic disorders
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or certain medications.
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A kidney stone can go undetected until it starts to move.
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When a stone travels through the kidney and into the ureter,
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its sharp edges scratch the walls of the urinary tract.
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Nerve endings embedded in this tissue transmit excruciating pain signals
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through the nervous system.
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And the scratches can send blood flowing into the urine.
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This can be accompanied by symptoms of nausea,
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vomiting,
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and a burning sensation while urinating.
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If a stone gets big enough to actually block the flow of urine,
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it can create an infection, or back flow,
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and damage the kidneys themselves.
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But most kidney stones don't become this serious,
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or even require invasive treatment.
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Masses less than five millimeters in diameter
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will usually pass out of the body on their own.
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A doctor will often simply recommend drinking large amounts of water
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to help speed the process along,
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and maybe taking some pain killers.
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If the stone is slightly larger,
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medications like alpha blockers can help by relaxing the muscles in the ureter
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and making it easier for the stone to get through.
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Another medication called potassium citrate
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can help dissolve the stones by creating a less acidic urine.
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For medium-sized stones up to about ten millimeters,
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one option is pulverizing them with soundwaves.
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Extracorporeal shock wave lithotripsy uses high-intensity pulses
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of focused ultrasonic energy aimed directly at the stone.
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The pulses create vibrations inside the stone itself
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and small bubbles jostle it.
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These combined forces crush the stone into smaller pieces
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that can pass out of the body more easily.
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But zapping a stone with sound doesn't work as well
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if it's simply too big.
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So sometimes, more invasive treatments are necessary.
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A rigid tube called a stent can be placed in the ureter to expand it.
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Optical fibers can deliver laser pulses to break up the stone.
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Stones can also be surgically removed through an incision
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in the patient's back or groin.
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What about just avoiding kidney stones in the first place?
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For people prone to them,
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their doctor may recommend drinking plenty of water,
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which dilutes the calcium oxalate and other compounds
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that eventually build up into painful stones.
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Foods like potato chips,
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spinach,
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rhubarb,
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and beets are high in oxalate,
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so doctors might advise limiting them.
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Even though calcium is often found in stones,
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calcium in foods and beverages can actually help
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by binding to oxalate in the digestive tract
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before it can be absorbed and reach the kidneys.
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If you do end up with a kidney stone, you're not alone.
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Data suggests that rates are rising,
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but that world record probably won't be broken any time soon.