What is the quickest way to pass a kidney stone?

Get Screened

Deciding how to manage kidney stones depends mostly on their size: stones 5 mm or less can pass naturally with added fluids and pain medication; larger stones require more extensive measures.

The type of stone matters as well. Some medications can dissolve kidney stones. Those composed of uric acid respond to medications but most stones are calcium concentrates that won't respond to medications, according to the AUA.

Your doctor will likely advise natural passage before other measures such as shock therapy and surgery. If a stone doesn't pass on its own within four weeks, further action may be necessary. Large stones, however, can cause urinary tract and kidney damage so they require immediate measures.

Tests your doctor may use to determine the size and type of kidney stones you have include blood and urine samples, X-rays, computed tomography (CT) and intravenous pyelography (IVP).

Surgery

Surgery is the quickest way to manage kidney stones. Your doctor may choose this option if natural passage doesn't occur within a month or if the stones are large, stuck or blocking urine flow. If an infection, bleeding or kidney damage is present; surgery may be performed. Surgical methods include:

Percutaneous nephrolithotomy: an incision is made in the patient's back to directly break up and remove stones. Recovery takes several days.

Ureteroscopic stone removal: an instrument is inserted through the urethra that cages the stone or shatters it. It takes several days to recover and there is risk of urethra damage.

Open surgery: rarely used today, this major surgery requires six weeks of recovery.

Shock Waves

Extracorporeal shock wave lithotripsy (ESWL) is the most frequently used procedure to manage kidney stones. The stone is targeted with shock waves that break them down into finer particles that are then excreted naturally. ESWL isn't effective for large stones and isn't used when there are blockages, reduced kidney function or if the stones are of certain types. Recovery time is just a few days.

Medication

Medications can help dissolve kidney stones. Potassium citrate/carbonate reduces acidity and can dissolve uric acid stones.

Other medications manage factors that contribute to stone formation. Acetohydroxamic acid (AHA) is used to prevent infection. Allopurinol helps reduce uric acid. Cuprimine and thiola control the release of cystine, an amino acid that does not dissolve in the urine. Hydroclothorothiazide is a diuretic that helps prevent the release of calcium into the urine.

Methlyprednisone and nifedipine may increase natural passage of kidney stones by 87 percent, according to Dr. David Bolong at Global Lithotripsy Services. The effectiveness of these drugs is still under investigation.

Fluids

The most common treatment to speed kidney stone passage is drinking plenty of fluids, about two to three quarts of water a day. According to the Mayo Clinic, drinking enough so that you generate two and a half liters of urine a day is the goal--enough so that your urine is practically colorless.

According to the AUA, research suggests 95 percent of kidney stones will pass within six weeks by drinking plenty of fluids.

Prevention

According to the AUA, you have a 50 percent chance of redeveloping kidney stones. Preventive measures can lower these odds as well as help you speed kidney stone passage.

Generally, avoid fatty meats, drink plenty of water, increase citrus fruit and potassium intake, and reduce glucose and sodium in your diet to reduce your risk of kidney stones and aid in the passage of any kidney stones you may have now.

The National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) recommends that you avoid added oxalate. High-oxalate foods are beets, chocolate, okra, peanuts, rhubarb, spinach, sweet potatoes, Swiss chard and wheat germ. Medium levels of oxalate are in celery, grapes, green peppers, grits, liver, raspberries and strawberries.

Source:

American Urological Association: Management of Ureteral Stones

National Institute of Diabetes, Digestive and Kidney Disease: Kidney Stones in Adults