Nature Says, "None Shall Pass." Urology Says, “Kidney Stones Will.”

“Worse than childbirth.”

“I couldn’t stand still or sit down.”

“There wasn’t a position that made it better.”

“I was sure I needed emergency surgery.”

This is how millions of Americans have described a kidney stone. Sudden and severe - the pain is impossible to ignore.

It's also one of the most common urologic conditions, affecting more than 1 in 10 Americans at some point in their lives. They can occur at any age but are more likely for adults over 50 and for people who have had stones before.

Despite how common kidney stones are, there are ways to prevent them. It sounds too good to be true, but simple lifestyle habits, especially staying well hydrated, can make a major difference in reducing risk.

If a stone does develop, treatment options have come a long way.

Stone Formation and Prevention

Kidney stones form when minerals and salts in the urine become highly concentrated and begin sticking together, creating small crystal-like “pebbles" that can keep getting bigger. Some stones are as tiny as grains of sand, while others can become large enough to block the flow of urine and trigger intense pain.

One of the biggest contributors to their formation is dehydration. When we don't drink enough fluids, stone-forming materials are given a chance to bind together. Staying consistently hydrated helps flush the kidneys and reduces the amount of time stone-forming materials sit in the urinary tract.

You can keep intake simple during the day to meet the output target; drink 12 to 16 ounces of water when you wake up, with each meal, in between meals, and again at bedtime. The goal is to produce enough urine – around 2 to 3 quarts per day – to keep the kidneys flushed. Spread fluids throughout the day; don't try to play "catch up" all at once. At night, don't be afraid to drink water. Urine naturally becomes more concentrated overnight, making it easier for stones to form. It's normal and healthy to get up once during the night to urinate and drink some water before going back to sleep.

High salt intake, excess animal protein, and certain foods high in oxalates (such as nuts, spinach, tea, and chocolate) can also prompt stone formation. Your family history and certain medical conditions will also factor into your risk of developing kidney stones.

After having one kidney stone, prevention matters even more, because the likelihood of developing another increases. “Stones beget stones,” explains Dr. Joseph Song, Board-Certified Urologist at Georgia Urology. “If somebody has stones remaining in their system, those stones act as seeds, or focus points, where more stone crystals can latch on.”

Some foods and supplements naturally contain elements that help deter stone formation.

• Citrate is one of those stone inhibitors, and as the name suggests, it comes from citrus. Lemonade is a great choice because it's low in oxalates, although be mindful of the sugar content.
• Magnesium is another stone deterrent, and readily available over the counter; just be sure to check in with your physician before starting any new supplements.
• Calcium is a vital mineral that's misunderstood and worth mentioning here. Especially for women taking calcium supplements for bone health, it is not advisable to stop taking them due to kidney stones. In fact, normal dietary calcium intake can have a protective effect, whereas unnecessary restriction can do the opposite.
• Apple cider vinegar and sodium bicarbonate are also useful for prevention, but not treatment.
• Studies show that even drinking 1.5 cups of black brewed coffee a day could help prevent stones.** However, since coffee is also a diuretic, it’s important to level up on how much water you consume. Just like when you exercise and sweat, you’ve got to make up for the fluids that are lost.

“If making changes to the diet and fluids don’t seem to reverse some of those at-risk factors, then there are medications that we can give to further lower the risk of kidney stones,” says Dr. Song. “In fact, there are lots of both prescription medications and home remedies for preventing kidney stones. However, prevention is much easier than a cure. In general, one of the biggest misconceptions is that, ‘If I take XYZ, it’ll shrink my stone, or it’ll cause my stone to dissolve.

“Typically, most of the stones we see are not the kind of stones that will dissolve over time. In the cases where the stones may be amenable to dissolution, that process can take months,” Dr. Song said.

While there are some dietary things you can do to prevent stones from forming, for someone who is experiencing pain, he says that, “Overloading on citrus or apple cider vinegar or sodium bicarb most likely is not going to be beneficial. [For] things like cranberry juice, the data shows it has very little effect in terms of preventing kidney stones.”