Managing Kidney Stones: Dietary Tips and Treatment Options Explained

Please let me know what foods and drinks are recommended, and whether I should continue to monitor the kidney stones?

Hello, Doctor: Two years ago, I had a stone about the size of a grain of rice on my right side.
I went to the emergency room, received medication, and had a contrast dye injection.
The doctor said it was small, so I could drink water to pass it.
After two years, I am in pain again, but this time it’s on the left side.
I went to the emergency room again for an injection, IV fluids, and medication.
This time, another doctor mentioned that I have a stone approximately 0.7 cm in size and asked if I wanted to pursue further treatment, including possibly breaking it up.
I felt scared and said I would try drinking water to see if I could flush it out.
The doctor advised me to come back immediately if I experience pain and told me not to drink milk, eat seafood, or drink tea at night, and to drink more lemon water.

Could you please clarify what I should eat and drink to help with stone passage? I found the doctor who explained this to me was impatient and reluctant to let me ask more questions.
I also found conflicting information online, with some saying to drink more milk.
Should I cooperate with the hospital to break the stone, or should I first try drinking a lot of water to see if it passes? (The original doctor prescribed about 50 packets of a powder to alkalinize my body, which is a pink crystalline powder that tastes sour.) Thank you for your help.

Hun, 20~29 year old female. Ask Date: 2006/11/14

Dr. Liu Jianting reply Urology

For individuals with kidney stones, the general principle is to drink plenty of water, unless there is a family history of stones, in which case dietary considerations should be taken into account.
In fact, there is a wealth of information available online and in bookstores.
If kidney stones cause infection or urinary obstruction, treatment should be considered.

Reply Date: 2006/11/14

More Info

Managing kidney stones can be a complex process, and it often requires a combination of dietary adjustments, hydration, and sometimes medical intervention. Given your history of kidney stones and the recent diagnosis of a 0.7 cm stone, it’s understandable that you have concerns about the best course of action.

Dietary Recommendations
1. Hydration: The most crucial aspect of managing kidney stones is to stay well-hydrated. Aim to drink at least 2 to 3 liters of water daily. This helps dilute the urine, reducing the concentration of substances that can form stones. If you are experiencing pain, it’s essential to increase your fluid intake further.

2. Citrus Fruits: Drinking lemon water is beneficial because citric acid can help prevent stone formation. It can also help dissolve small stones. You might consider adding fresh lemon juice to your water throughout the day.

3. Limit Certain Foods:
- Dairy Products: While calcium is essential for bone health, excessive dairy intake can contribute to calcium oxalate stones. If your doctor advised you to limit milk, it’s wise to follow that recommendation.

- Seafood and High-Purine Foods: Foods high in purines, such as certain seafood, can increase uric acid levels, leading to uric acid stones. It’s advisable to limit these foods.

- Oxalate-Rich Foods: If you have calcium oxalate stones, you should limit foods high in oxalates, such as spinach, beets, nuts, and chocolate.

4. Moderate Protein Intake: High protein diets can increase the risk of stone formation. It’s best to consume protein in moderation, focusing on lean meats and plant-based sources.

5. Avoid Excessive Salt: High sodium intake can increase calcium in urine, which may lead to stone formation. Aim to limit processed foods and added salt in your diet.

6. Consider Supplements Carefully: If you are taking any supplements, particularly vitamin C, be cautious. High doses of vitamin C can increase oxalate levels in urine.

Medical Management
Regarding the treatment options, if your stone is 0.7 cm, it may still be possible to pass it naturally, especially if you are diligent about hydration. However, if you experience severe pain, blood in your urine, or if the stone does not pass after a reasonable period, you should seek medical attention.

1. Monitoring: If you choose to try passing the stone naturally, keep track of your symptoms. If the pain becomes unbearable or if you notice any complications, return to your healthcare provider.

2. Extracorporeal Shock Wave Lithotripsy (ESWL): This is a non-invasive procedure that uses shock waves to break up stones into smaller pieces that can be passed more easily. If the stone does not pass on its own, this may be a viable option.

3. Medications: The powder your doctor prescribed to alkalinize your urine can help prevent further stone formation. It’s essential to follow your doctor’s instructions regarding this medication.

Conclusion
In summary, focus on staying well-hydrated, consuming a balanced diet with limited oxalates and purines, and following your doctor's advice regarding medications and potential treatments. If you have any doubts or if your symptoms worsen, do not hesitate to consult your healthcare provider for further evaluation and guidance. Managing kidney stones often requires a tailored approach, so working closely with your healthcare team is crucial for optimal outcomes.

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