Have you ever heard that passing a kidney stone is more painful than giving birth? Each year, more than 1 million people in the U.S. rush to the emergency room with pain caused by a kidney stone. Kidney stones are hard, pebble-like pieces of material that form in one or both kidneys. They’re caused by high levels of certain minerals in your urine. Stones vary in size from tiny crystals that can only be seen with a microscope to stones over an inch wide. Tiny stones may pass out of your body without your even noticing. With larger stones, you won’t be so lucky. Stones that are larger than a pencil eraser can get stuck in the urinary tract—and that can really hurt.

Everyone is at some risk for developing kidney stones. “It is a very common condition,” says Dr. Ziya Kirkali, a urologist at NIH. “One out of 11 individuals in the U.S. is affected by this disease.” Kidney stones can form at any age, but they usually appear during middle age (40s to 60s). Of those who develop one stone, half will develop at least one more in the future.

“Probably one of the most important reasons why people form stones is dehydration,” Kirkali says. When urine is too concentrated, minerals can build up and form stones. “I can’t over-emphasize the importance of drinking plenty of water, because that’s the most effective way of preventing kidney stone disease.”

During the warmest months of the year, you’re at greatest risk of becoming dehydrated. “So it is really important to drink more than you usually drink during the cooler days or months,” Kirkali says.

To detect kidney stones, your doctor may order lab or imaging tests. Lab tests look in urine for blood, signs of infection, minerals (like calcium), and stones. Blood tests can also detect high levels of certain minerals. “About 80% of all stones are made of calcium oxalate,” Kirkali says. Knowing what the stones are made of can help guide treatment.

Treatment also depends on the stone’s size and location. CT scans or plain X-ray imaging can help your doctor pinpoint the location and estimate the size of a kidney stone. Depending on what your doctor finds, you may be prescribed medicine and advised to drink a lot of fluids. Or, you might need a procedure to break up or remove the kidney stone.

There are different procedures for breaking up or removing kidney stones. One method delivers shock waves to the stone from outside of the body. Other strategies involve inserting a tool into the body, either through the urinary tract or directly into the kidney through surgery. After the stone is located, it can be broken up into smaller pieces.

Once you’ve had a kidney stone, you have an increased chance for having another. NIH-supported scientists are studying ways to prevent kidney stones from returning. “We always tell our patients to drink more, but it’s not so easy to really increase your fluid intake,” Kirkali says. A new study is testing a method to encourage people to drink more fluids each day. Other NIH-funded studies are trying to unravel why some people seem more at risk of developing kidney stones. Still others are looking into how to better detect stones and treat them.

Don’t let the pain of kidney stones send you to the emergency room. Keep hydrated! But if you develop any of the symptoms shown in the “Wise Choices” box, see your doctor right away.

Written by: NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Tianna Hicklin, Ph.D.

Coughs help your body clear your airways of irritants and prevent infection. But a deep cough from your chest may signal bronchitis or pneumonia. Although they may have different underlying causes, their symptoms can be similar—and both can be serious enough to send you to the doctor.

Bronchitis and pneumonia both involve Inflammation in the chest. Both can cause coughs that bring up a slimy substance called phlegm to help clear out germs and pus. And both can cause shortness of breath and wheezing.
Bronchitis is a condition in which the bronchial tubes that lead to the lungs become inflamed. Viruses, bacteria, and even toxins like tobacco smoke can inflame the bronchial tubes. Most of the time, though, bronchitis is caused by an infection with one of several types of viruses. If you develop bronchitis during flu season, a likely culprit may be the flu virus. Cold viruses are also common causes at this and other times of year.

Pneumonia is caused by an infection of the lungs. “About 1/3 of cases are caused by viruses, but most of them are bacterial related,” says Dr. Kenneth Olivier, a lung infection expert at NIH. “They’re from bacteria that are quite common, like Streptococcus pneumoniae, which is the leading cause of bacterial pneumonias in all ages in the U.S.”
If you get a fever with bronchitis, it is usually mild (below 101 degrees Fahrenheit). In more serious cases, you may have chest pain, feel short of breath, or wheeze when you breathe in.

“Pneumonia, on the other hand, typically is associated with fever, sometimes very high, spiking fever,” Olivier says. Breathing problems, chest pain, and other symptoms also tend to be more severe with pneumonia. If you have a fever and chills, trouble breathing, or a cough that is bringing up thick phlegm, especially if it’s yellow or green, go see your doctor.

Your doctor can listen to your lungs by placing a stethoscope on your chest. “Frequently, the physician can hear areas where the breath sounds are altered,” Olivier says. If you have pneumonia, your doctor may hear bubbling, crackling, or rumbling sounds from the lungs.

You may be sent for a chest X-ray, which can show whether the lungs contain fluid or pus from an infection. An X-ray is the best way to diagnose pneumonia and rule out bronchitis. Whichever illness you have, resting and drinking plenty of fluids are important ways to care for yourself.

If you’re diagnosed with bronchitis, your doctor probably won’t give you antibiotics. Because viruses are the usual cause of bronchitis, antibiotics are seldom helpful. If you’re wheezing, however, you may be given medicine to open your airways. Your cough may last 10 to 20 days.

Because bacteria are often the cause of pneumonia, your doctor may prescribe antibiotics. It can take 1 to 4 weeks to recover from pneumonia. Some people require treatment in the hospital.

Germs that cause colds, the flu, and lower airway infections are contagious. The best way to prevent getting bronchitis or pneumonia is to avoid getting these infections. And when you’re sick, take care not to spread your germs to others (see “Wise Choices” box for tips).

Guard Against Airway Infections
-Wash your hands often with soap and water.
-Use alcohol-based hand gel if you’re unable to wash them.
-Cough into a tissue, your elbow, or your sleeve.
-Ask your doctor about vaccines for you and your children. Certain vaccines can prevent airway infections caused by harmful viruses and bacteria.
-Avoid people who are coughing or showing signs of infection.
-Avoid tobacco smoke.

Written by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Tianna Hicklin, Ph.D.