Kidney Stones: Symptoms, Treatment, and Prevention Tips

Q: Kidney Stones: Symptoms, Treatment, and Prevention Tips

Hello： After experiencing severe pain in my left lower back, I went to the emergency room and was diagnosed with kidney stones. <br>The doctor mentioned that the stones are relatively small, approximately 0.4 and 0.3 centimeters. <br>I was advised to drink plenty of water and tak

Excretion and Prevention of Kidney Stones

Hello, after experiencing severe pain in my left lower back, I went to the emergency room and was diagnosed with kidney stones.
The doctor mentioned that the stones are relatively small, approximately 0.4 and 0.3 centimeters.
I was advised to drink plenty of water and take medication to help pass the stones.
However, before my follow-up appointment, I did not notice any small stones in the toilet.
Although my back no longer hurts, I still feel a strange sensation.
During my follow-up, after reviewing the urine test results, the doctor said that the urine was quite clean and that the stones should have been passed.
I informed the doctor about the lingering strange sensation in my back, and he suggested that it might be due to the healing of the area or that there could still be small stones that haven't been fully passed.
He prescribed a week's worth of medication and advised me to return if the strange sensation persists.
I would like to ask if this strange sensation in my back indicates that the stones have not been fully passed.
I inquired about the possibility of undergoing another CT scan, but the doctor said that was not feasible and that I would need to undergo a direct endoscopy instead.
Assuming that my urine test results could be inaccurate due to my increased water intake, could the stones lead to other kidney issues? Is there a chance of experiencing severe pain again? What is the likelihood of naturally passing a 0.4 cm kidney stone? Besides drinking water, are there other methods to increase the chances of passing the stones?
Lastly, I would like to know how to prevent kidney stones.
In addition to drinking plenty of water and reducing the intake of foods high in oxalates, can taking calcium citrate lower the incidence of kidney stones? If so, are there any precautions I should be aware of? I usually take fish oil, fenugreek, elderberry, and astaxanthin.
My father has a history of kidney stones and gout.
I apologize for the many questions, and thank you for your help.

R, 20~29 year old female. Ask Date: 2023/08/22

Dr. Jian Weihong reply Urology

Hello: After experiencing severe pain in my left lower back, I went to the emergency room and was diagnosed with kidney stones.
The doctor mentioned that the stones are relatively small, approximately 0.4 and 0.3 centimeters.
I was advised to drink plenty of water and take medication to help pass the stones.
However, before my follow-up appointment, I did not notice any small stones in the toilet.
Although my back no longer hurts, I still feel a strange sensation.
During the follow-up, after reviewing my urine test results, the doctor said that the urine was quite clean, and the stones should have been passed.
I informed the doctor about the lingering strange sensation in my back, and he suggested that it might be due to the healing of the area or that there could still be small stones that haven't been completely expelled.
He prescribed medication for another week and advised me to return if the strange sensation persists.

I would like to ask if this strange sensation in my back indicates that the stones have not been fully passed.
Would it be necessary to perform an ultrasound for further evaluation? I inquired about the possibility of undergoing another CT scan, but the doctor said that was not feasible and that I would need to undergo direct endoscopy instead.
Assuming that my excessive water intake has led to inaccurate urine test results, could the stones cause other kidney issues, or would I experience severe pain again? Is the likelihood of naturally passing a 0.4 cm kidney stone high? Besides drinking water, what other methods can increase the chances of passing the stones?
Stones smaller than 0.5 cm are generally likely to be expelled, but it is preferable to use medication to expedite the process.
Lastly, to prevent kidney stones, aside from drinking plenty of water and reducing the intake of oxalate-rich foods, can taking calcium citrate lower the incidence rate? Depending on the type of stones, are there any specific precautions I should take?
In summary, drink plenty of water, limit sugary drinks, stay active, and avoid prolonged sitting.
Wishing you good health.

Reply Date: 2023/08/22

More Info

Understanding kidney stones is crucial for both treatment and prevention. Kidney stones, also known as renal calculi, can cause significant pain and discomfort, and their management often requires a multifaceted approach.

Symptoms of Kidney Stones
The most common symptom of kidney stones is severe pain, often described as a sharp or stabbing sensation, typically felt in the lower back or side, and may radiate to the abdomen or groin. Other symptoms can include hematuria (blood in urine), frequent urination, nausea, and vomiting. In your case, the "weird feeling" in your back could be residual discomfort from the stone passing or irritation in the urinary tract. It’s also possible that small fragments of the stone may still be present, causing lingering sensations.

Diagnosis and Treatment
In your situation, the doctor has indicated that the urine test results were clean, suggesting that the stone may have passed. However, if you continue to experience discomfort, it’s important to follow up with your healthcare provider. While a CT scan is a common diagnostic tool for kidney stones, your doctor may recommend an alternative approach, such as an endoscopic procedure, if necessary.

Regarding the size of your stones (0.3 to 0.4 cm), these are generally considered small and have a high likelihood of passing naturally. Drinking plenty of water is indeed one of the best ways to facilitate this process, as it helps dilute the urine and can assist in flushing out the stones.

Increasing the Chances of Passing Stones
In addition to hydration, there are several strategies you can employ to increase the likelihood of passing kidney stones:
1. Medications: Your doctor may prescribe medications that help relax the ureter, making it easier for stones to pass.

2. Dietary Changes: Reducing sodium intake can help prevent stone formation. Foods high in oxalates (like spinach, nuts, and chocolate) should be limited if you are prone to calcium oxalate stones.

3. Citrus Intake: Consuming lemon juice or lemon water can increase citrate levels in urine, which may help prevent stone formation. Citrate can bind to calcium, reducing the likelihood of calcium stone formation.

Prevention of Kidney Stones
To prevent future occurrences of kidney stones, consider the following recommendations:
- Hydration: Aim for at least 2-3 liters of water daily, which helps dilute urine and reduces stone formation.

- Diet: Limit foods high in oxalates and sodium. Incorporate more fruits and vegetables, and consider a balanced intake of calcium from dietary sources rather than supplements unless advised by your doctor.

- Calcium Citrate: Taking calcium citrate may help reduce the risk of stone formation, especially if you have a history of calcium stones. However, it’s essential to consult with your healthcare provider before starting any new supplements.

- Regular Check-ups: Given your family history of kidney stones and gout, regular follow-ups with your healthcare provider can help monitor your condition and adjust preventive measures as necessary.

Conclusion
In summary, while the symptoms you are experiencing may not necessarily indicate that a stone is still present, it is essential to communicate any ongoing discomfort to your healthcare provider. They can determine if further imaging or intervention is needed. Maintaining hydration, adjusting your diet, and possibly incorporating supplements like calcium citrate can significantly aid in both the treatment and prevention of kidney stones. Always consult with your healthcare provider before making any significant changes to your health regimen, especially considering your family history of kidney stones and gout.

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