A FRIEND of mine, who had kidney stones, says that the pain is the most excruciating he had ever experienced. Is this true?

Women have actually said that childbirth pain is the most excruciating, but many men cite kidney stone pain as pretty much in that league as well (not that they would have any inkling about labour pains).

However, kidney stones don't often cause symptoms. These are called "silent" stones. But when a stone blocks the flow of urine, the pain is excruciating.

The pain can begin suddenly when the stone starts to move, and is described as sharp and cramping. You will usually experi- ence it in your back and side area, where your kidneys are, or in the lower part of your abdomen.

Most of the time, little stones are passed out through the urine. But when the stone is too large to go easily through, your ureter has to squeeze it out into the bladder. The stone may injure any part of your urinary tract, causing blood in your urine. You may also feel the urge to urinate more often or a burning sensation during urination.

Where is the kidney in relation to the bladder and how do they connect?

There are two kidneys, which are bean-shaped and lie towards your back, below your ribs. They function by removing waste products and excess water from your body. They are connected to the bladder by two narrow tubes called ureters.

The bladder receives the concentrated urine, and stores it by expanding. When your urine is emptied, the bladder contracts into a flat organ. The urine is emptied through the urethra from the bladder.

How do stones get into the kidney? Are they the same as gallstones?

They are actually formed in the kidney itself. They are developed from crystals that build up into hard masses of varying sizes. They usually contain a combination of chemicals. The most common kidney stone is calcium combined with oxalate or phosphate.

If you are prone to frequent urinary tract infections, a type of stone that forms is a struvite stone (also called the "infection" stone). Uric acid and cystine stones are not so common.

No, kidney stones are not related to gallstones. If you have one, it doesn't mean you are prone to the other.

Kidney stones may come in many funny shapes and sizes. There are smooth oval ones, ones with jagged, spiky edges and even ones that look like a staghorn (these stones are formed in an area of the kidney named the pelvis, and maintain that shape!) Some are as large as a golf ball.

Stones can stay in the kidney or pass through any part of the urinary tract. Sometimes, they get stuck.

Will I get a kidney stone? My mother says if you eat too much salt, you will get kidney stones.

Well, there are some risk factors. Men get them more commonly than women. (It's the reverse for gallstones!) The risk also rises when men are above 40, and women are above 50.

Scientists today are not convinced that eating a particular food, salty or otherwise, will cause kidney stones.

But if you have certain disorders like too much calcium or oxalate in your urine, you are definitely predisposed to getting those kinds of stones. And if you have gout, then you are more likely to get uric acid stones than the rest of the population.

If your parents had stones, you are more likely to get them too.

I was told that people who don't drink enough water get kidney stones easily.

It is true. Drinking more liquids (especially water) prevents formation of kidney stones.

Recent studies have shown that this also applies to milk and foods that are high in calcium -- if you drink and eat more of these, it may help prevent calcium stones!

But taking calcium pills may increase your kidney stone risk.

It's best to consult your doctor about what foods you should avoid if you have a certain type of kidney stone.

If I have a kidney stone, do I have to go for surgery? I'm frightened. Is there a way to take them out without surgery?

There are some medications to prevent formation of calcium and uric acid stones, such as allopurinol, which decreases uric acid crystal formation and certain diuretics (thiazides), which prevent calcium stones.

But surgery is the next step if your kidney stone is too large, does not pass out after a time and still causes you constant pain. You should also have it removed immediately if it blocks your urine flow and causes constant infection and bleeding.

The good news is that there are shockwave therapies (extracorporeal shockwave lithotripsy - ESWL) to break down your stones into sand-like particles, without having to lay a scalpel on you.

You lie in a water bath or a cushion and allow the shock waves to pass through you. These won't hurt your skin or softer tissues.

The sand-like particles then pass out easily into your urine.

If the stone is too large to be crushed by ESWL, the surgeon can make a tiny cut in your back and create a tunnel directly into your kidney to remove your stone.

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