Your health questions answered by Brown physicians
PHOTOGRAPH : GETTY IMAGES / LJUBA PHOTO ; BELOW : COURTESY OF THAVASEELAN
What can I do to prevent kidney stones ?
Kidney stones affect one out of 11 people in the US . Pain , usually in the back or flank , is the most common symptom , often coupled with nausea , vomiting , or frequency and urgency to urinate . There may also be blood in the urine . Diagnosis is based on symptoms and imaging , such as an ultrasound or CT scan of the urinary tract .
The cornerstone of prevention is water intake , which can dilute calcium , oxalate , and uric acid that contribute to kidney stone formation . For people prone to kidney stones , we recommend drinking approximately 80 ounces of water daily , and eating a diet that ’ s low in salt and oxalate-rich foods like spinach , chocolate , and tea . They should also consume a moderate amount of calcium and plenty of fruits and vegetables , including oranges and lemons ; these contain citrate , which helps prevent kidney stones . If you ’ re at high risk for stone formation , your doctor may make individualized recommendations .
Stones smaller than 5 millimeters in diameter will likely pass without surgery . If your pain is manageable and you can tolerate nonsteroidal anti-inflammatory pain relievers , you can attempt passage at home — though this can take a number of days . Your doctor may prescribe a medication such as tamsulosin to speed passage .
Larger stones usually require a procedure to break up or remove them . These include minimally invasive techniques like shockwave lithotripsy , which uses soundwaves to cause fragmentation of stones ; or ureteroscopy , in which a urologist uses a telescope to access the stone and a thin laser fiber to fragment it . Very large and complex stone disease may require a surgery called percutaneous nephrolithotomy , which removes stones through a small incision in the back and often requires a short hospitalization . HD
Simone Thavaseelan , MD , a Brown Urology physician , is an associate professor of surgery at The Warren Alpert Medical School , the section chief of urology at the Providence VA Medical Center , and the residency program director at Rhode Island Hospital . She specializes in endourology .
Brown Physicians , Inc . is a multispecialty group practice affiliated with The Warren Alpert Medical School of Brown University . BPI serves Rhode Island and southeastern Massachusetts with more than 500 primary care physicians and specialists to provide cutting-edge , team-based care . In each issue of Health Discoveries , we ’ ll ask BPI doctors common health care questions . If you have a question for our doctors , send it to HealthDiscoveries @ brown . edu .
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