Kidney Stones: Symptoms, Treatment, and Prevention Tips - Urology

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Confirmed as 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, and advised me to drink plenty of water and take medication to help pass the stones.
However, before my follow-up appointment, I did not see 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 mentioned to the doctor that I still feel a 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 passed.
He prescribed me medication for another week and advised that I could 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 having another CT scan, but the doctor said that was not possible and that I would need to undergo a direct endoscopy.
Assuming that my urine test results could be inaccurate due to my increased water intake, could the stones cause other kidney problems, or would I experience 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.
Apart from drinking plenty of water and reducing the intake of foods high in oxalates, does taking calcium citrate help lower the risk of occurrence? If so, are there any precautions I should be aware of? I usually take fish oil, finasteride, 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: 2023/08/23

Dr. Du Shixi 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, and advised me 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 the back pain has subsided, I still feel an unusual sensation.
During my follow-up, the doctor reviewed my urine test results and said that the urine was quite clean, indicating that the stones should have been passed.
I expressed my concerns about the lingering unusual sensation in my back, and the doctor 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 a week's worth of medication and advised me to return if the unusual sensation persists.

I would like to ask if this unusual sensation in my back could indicate that the stones have not been fully passed.
Would it be necessary to perform an ultrasound to assess this? I inquired about the possibility of undergoing another CT scan, but the doctor said that was not feasible and that I would need to have a direct endoscopy instead.
Assuming that my excessive water intake has led to a false negative in my urine test, could the stones cause other kidney issues? Is there a chance that I might experience severe pain again? What is the likelihood of naturally passing a 0.4 cm kidney stone? Besides drinking water, are there any other methods to increase the chances of passing the stones?
Stones smaller than 0.5 cm generally have a high chance of being expelled, but medication is often recommended 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 of stone formation? Depending on the type of stones, are there any specific precautions I should take?
In summary, I should drink more water, limit sugary drinks, stay active, and avoid prolonged sitting.
Wishing you good health.

Reply Date: 2023/08/23

More Info


Kidney stones, or renal calculi, are hard deposits made of minerals and salts that form inside your kidneys. They can cause significant pain and discomfort, particularly when they move through the urinary tract. Understanding the symptoms, treatment options, and preventive measures is crucial for managing this condition effectively.


Symptoms of Kidney Stones
The symptoms of kidney stones can vary depending on the size and location of the stone. Common symptoms include:
1. Severe Pain: Often described as sharp or cramping, this pain typically occurs in the lower back, side, or abdomen. It may come in waves and can be accompanied by nausea or vomiting.

2. Hematuria: Blood in the urine, which can appear pink, red, or brown.

3. Frequent Urination: An increased urge to urinate, often with little output.

4. Painful Urination: A burning sensation when urinating.

5. Cloudy or Foul-Smelling Urine: This can indicate an infection.

In your case, the initial severe pain you experienced led to the diagnosis of kidney stones, and the subsequent "weird feeling" in your back may be due to residual effects from the stone or irritation in the urinary tract.


Treatment Options
For small stones (typically less than 5 mm), the treatment often involves:
1. Hydration: Drinking plenty of water helps flush out the stones. Aim for at least 2-3 liters of water daily.

2. Medications: Pain relievers and medications to help pass the stone may be prescribed.

3. Monitoring: Regular follow-ups to ensure the stone is passing and to check for any complications.

In your situation, since your urine tests came back clean, it is likely that the stone has passed. However, if you continue to experience discomfort, it may be worth discussing further imaging tests with your doctor, such as an ultrasound, to rule out any remaining small stones or other issues.


Prevention Strategies
Preventing kidney stones involves lifestyle and dietary changes:
1. Stay Hydrated: As mentioned, drinking plenty of fluids is essential. Aim for enough water to produce at least 2.5 liters of urine daily.

2. Dietary Adjustments:
- Limit Sodium: High salt intake can increase calcium in urine, leading to stone formation.

- Reduce Oxalate-Rich Foods: Foods high in oxalates (like spinach, nuts, and chocolate) can contribute to calcium oxalate stones.

- Calcium Intake: Contrary to what some may think, adequate dietary calcium can help prevent stones. However, calcium supplements should be taken cautiously.

3. Citrate Supplements: Citrate can help prevent stone formation. Calcium citrate supplements or consuming foods high in citric acid (like lemons and oranges) can be beneficial.


Specific Concerns
Regarding your question about calcium citrate, it can indeed help reduce the risk of stone formation, particularly calcium stones. However, it is essential to consult with your healthcare provider before starting any new supplements, especially considering your family history of kidney stones and gout.

In conclusion, while the likelihood of passing a 0.4 cm stone naturally is high, ongoing symptoms warrant further evaluation. Maintaining hydration, adjusting your diet, and possibly incorporating citrate can significantly reduce your risk of future stones. If you have persistent symptoms or concerns, don’t hesitate to follow up with your healthcare provider for further assessment and tailored advice.

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