Kidney Stones in Crohn's Disease: A Comprehensive Guide

Crohn's disease, a type of inflammatory bowel disease (IBD), can bring about a range of side effects that vary from mild to severe. One such side effect that many people may not be aware of is the increased likelihood of developing kidney stones. In this comprehensive guide, we will explore the connection between kidney stones and Crohn's disease, as well as the risk factors, symptoms, and management strategies to help you cope with this condition.

 

Understanding Kidney Stones

Kidney stones are formed when there is a decrease in urine volume and an increase in stone-forming substances in the body. They can cause intense pain, discomfort, and even block normal urine flow. It's essential to identify the warning signs of kidney stones, so you can seek medical attention and prevent complications.

Symptoms of Kidney Stones

If you develop kidney stones, you will likely experience the following symptoms:

• Intense pain in the sides, lower back, or abdomen beneath the ribs
• Pain when urinating
• Pink, red, or brown urine
• Cloudy and/or foul-smelling urine
• Nausea
• Vomiting
• General malaise

It's vital to consult with your doctor if you begin experiencing any of these symptoms. They may recommend increasing your fluid intake, taking a pain reliever, or even medical intervention like surgery, depending on the size and nature of the stone.

The Link Between Crohn's Disease and Kidney Stones

There are several reasons why people with Crohn's disease are more likely to develop kidney stones, including malabsorption and dehydration.

Malabsorption

Malabsorption, a condition where the small intestine isn't able to absorb nutrients properly, is common in people with Crohn's disease. For example, fat in the small intestine could bind to calcium, releasing oxalates. These stone-producing substances can then be absorbed into the kidneys, increasing the risk of kidney stone formation.

Dehydration

Dehydration is a significant risk factor for kidney stones. People with Crohn's disease are more likely to experience dehydration due to symptoms such as diarrhea and more concentrated urine, which increases the risk of kidney stones.

Other Complications Associated With Crohn's Disease

Crohn's disease can impact your health in various ways aside from kidney stones. This may include ulcers, inflammation throughout the digestive tract, malnutrition from lack of vitamin absorption, colon or colorectal cancer, bowel obstruction, and more. It's important to speak with your treating physician about any new or different symptoms that may arise.

Occasionally, these issues may become so severe that surgery is required to remove or temporarily bypass diseased or obstructed parts of the bowel. This typically leads to a need for colostomy or ileostomy supplies.

At 180 Medical, we carry a wide variety of ostomy products and accessories to assist those who have been impacted by Crohn's disease to the point of needing ostomy surgery. We'd love the opportunity to help you find the right supplies for your individual needs. Contact us today!

Managing Kidney Stones in Crohn's Disease

To avoid serious complications from kidney stones associated with Crohn's disease, early recognition and adequate therapy are crucial. A multimodal intervention, including dietary, medical, and surgical approaches, is essential.

Identifying Metabolic Risk Factors

It's crucial to start by identifying metabolic risk factors contributing to increased urinary supersaturation. A careful anamnesis with diet history should be performed, along with the collection of two or more 24-hour urine samples and evaluation of the nature and extent of the bowel disease. Renal function, given by serum creatinine and urea, along with serial urinalysis should be performed in all patients. 24-hour fecal fat measurement may also prove helpful.

Fluid Intake and Dietary Adjustments

Patients should be encouraged to increase their fluid intake to ensure a high urine output (the goal is a daily urine volume of approximately 2 L). They can do their self-monitoring if instructed to collect 24-hour urine samples. They can also be counseled to check their urine specific gravity at specific intervals using urine test strips, aiming to avoid excessively concentrated urines.

In addition to increasing fluid intake, patients should also make dietary adjustments to help prevent kidney stones. This may include reducing fat intake, increasing dietary calcium, and avoiding foods high in oxalates.

Medications and Supplements

Physicians may prescribe medications and supplements to help manage kidney stones in Crohn's disease patients. For example, alkalinizing agents like sodium bicarbonate can increase the solubility of uric acid, dissolve existing stones, and prevent recurrences.

Other medications and supplements that may be helpful include potassium citrate, magnesium replacement, and pyridoxine, which can decrease oxalate synthesis.

Monitoring and Prevention

After successful management of kidney stones, prevention of stone recurrence is imperative. Stone/crystalline analysis, along with blood and urine laboratory analysis, must be performed, with an appropriate treatment and prevention plan designed based on these findings.

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