Answer
The diagnosis of Bruce's condition is kidney stone(s) ( renal calculi or nephrolithiasis). Stones can develop in the kidneys or in the ureters. In this case the stone seems to be lodged in one of Bruce's ureter. The pain he feels is due to messages being sent by pain receptors as his ureters try to dislodge the stone with waves of peristaltic contractions (proximal to distal ends of ureter ). Bruce does not complain of nausea, vomiting or fever so one assumes that this is not a very serious attack with associated infection.
After being diagnosed -- urinalysis and imaging-- Bruce has several options:
1. Waiting. If the pain is not too severs, and there is no infection , Bruce can increase his intake of fluids and wait for his ureters to dislodge the stone by peristaltic action.
2. Breaking up the stone. If the stone is large Bruce's doctors may suggest breaking up the stone--lithotripsy-- into smaller fragments by ultrasound( shock wave lithotripsy/ ECSWL). After the stone is broken up , Bruce would have to wait for the stones to pass naturally. While waiting, he would need to take copious amounts of fluids, pain medication --if needed- and medications to relax the ureters.
3. Surgical intervention. This would be a resort if the stone is very big and if here is attendant infection, Surgical treatment may involve normal surgical incision into the abdomino-pelvic cavity in order to extract the stone, or alternatively, a ureteroscope tube may be used in a less invasive procedure.
Work Step by Step
In any case, after the stone is removed, Bruce would do well to follow certain preventative measures. Some of these are , (1) drinking adequate amounts of fluid each day; (2) reducing the amount calcium in his diet. Some stones are uric acid stones, but many stones are calcium phosphate and calcium oxalate stones.; (3).Too much Vitamin D in the diet is also associated with the formation of kidney stones , so Bruce would need to watch his consumption of Vitamin D.
