What is Lithiasis or Calculus?
Lithiasis or Calculus is a multifactorial disease. Generally known as stone, it is a common phenomenon that occurs in 1 in every 20 people. Although it can occur in people of any age, it is more frequent in people, who are within the age group of 20 and 40.
Lithiasis or Calculus is a disease in which, hard and small mineral particles and acid salts are deposited in any organ or duct of the body.
Symptoms of Lithiasis or Calculus:
Usually Lithiasis or Calculus does not exhibit any of its symptoms unless and until the stone obstructs the function of the organ or duct. When it does obstruct, it can cause severe general symptoms like –
- Pain in the specific organ region
- Feeling of chillness
- Spasm and irritation
In case of renal lithiasis, the symptoms are -
- Pain while urinating in case of renal lithiasis
- Persistent need to urinate
- Pink, brown or red urine colour
- Foul smell in urine
- Small amount of urine
Pathophysiological consequences may include kidney infection and swollen kidneys.
In case of gallbladder lithiasis, the symptoms are -
- Gallbladder infection or cholecystitis
- Biliary tree infection ascending cholangitis
- Inflammation in pancreas
For gastric stone, the pathophysiological consequences may include torsion, colic obstruction, and necrosis along with difficulty in breathing in nasal passage.
Types of Lithiasis or Calculus:
Depending on the type of the stone and depending on the position in which the stone has occurred, the type of Lithiasis or Calculus is determined.
- Lithiasis or Calculi in the Urinary System – When the stone is formed in the urinary tract including the bladder, urethra or ureter, it is called renal calculi or nephroliths. There can be different types of renal stones like Calcium stones, Struvite stones, Uric acid stones and Cystine stones.
- Lithiasis or Calculi of the Gallbladder and Bile Ducts – When the stone or a calculus is formed in the gallbladder or anywhere in the bile duct, it is known as gallstone. Usually, these stones are developed from the presence of bile salts and cholesterol derivatives.
- Lithiasis or Calculi in the Gastrointestinal Tract – When the stone is formed in the gastrointestinal tract, it is known as enteroliths. This type of stone can be enormous in size.
- Calculi in the Nasal Passages – Although it is a rare type of calculus development, but when stone is formed in the nasal passages, it is known as rhinoliths.
- Calculi in the Tonsils – When the stone is formed in the tonsil glands, it is called tonsillar calculi or tonsilloliths.
- Calculi in the Salivary Glands - When stone or a calculus is formed in the submandibular salivary glands, it is known as the salivary calculi or sialoliths.
Diagnosis of Lithiasis or Calculus:
Diagnostic tests are followed when a doctor suspects Lithiasis in a patient through the symptoms. The tests that are run on the patient includes –
- Blood tests, to check the uric acid and calcium levels in the blood
- A 24 hours urine test to check if there are too many stone forming mineral substances in the urine, or if the stone preventing substances have lessened.
- Abdominal X-ray and CT scan can reveal the presence of stones.
- MRCP magnetic resonance cholangiopancreatography is done to diagnose stone or obstruction in pancreas.
- HIDA scan biliary radionuclide scanning is done to diagnose stone in gallbladder.
Treatment for Lithiasis or Calculus:
The general treatment for Lithiasis or Calculus is either to break down the stones, if the size is small with the help of medication or to remove it through surgery when the medications don't work or the size is bigger. However, the procedures of getting rid of the stone might also vary depending on the location. Few of these procedures are stated below:
Treatment for Renal Lithiasis or Renal Calculus (Renal Stones):
Depending on the type of stone, the treatment procedure is determined. Usually, in case of small renal stones, it is recommended that the patient drinks a lot of water that will increase the urine flow. In this case, the stone is intended to be passed through urine and hence, it can cause a little discomfort and pain. To reduce this pain and discomfort, ibuprofen, naproxen sodium and acetaminophen are given. Along with this, alpha blocker medicines are given to help the muscles of the ureter get relaxed, so that the small stone gets passed through it.
The other treatments for Renal Lithiasis or Renal Calculus include -
- Percutaneous Nephrolithotomy or Tunnel Surgery, in which small telescopes and instruments are inserted through the back of the body to remove the renal stone.
- Ureteroscope insertion to break the stone and pass it through urine.
- Extracorporeal Shock Wave Lithotripsy (ESWL) that breaks the stone into tiny pieces.
Treating Lithiasis or Calculus Formed in Gallbladder (Gall Stones):
Usually a surgery called cholecystectomy is done to remove the entire gallbladder, in order to remove the stone. Traditionally the open cholecystectomy was done to make incisions in the abdomen to remove the gallbladder, however in the recent days a laparoscopic cholecystectomy is done to make small incision of the abdomen and remove the gallbladder. Sphincterotomy is also done to make surgical cut into the muscle of common bile duct, so that the stone is passed.
Apart from surgery, the old technique of prostate massage is done by professional and skilled doctors to pass the stone. However, in case of acute prostatitis, this is not done as it may spread the infection. Prostate massaging is a procedure that is useful when medicines do not work.
Prevention of Lithiasis or Calculus:
Lithiasis or Calculus is a painful disease. To make sure that it does not occur; it can well be prevented by –
- Drinking at least six to eight glasses of water a day
- Having a diet low in salt and protein
- Eating lesser oxalate-rich foods
As soon as the symptoms are recognised and diagnosed as Lithiasis or Calculus, the medicines must be taken properly.