What, other than drinking water, can help flush out a kidney stone? Brian Matlaga, M.D., M.P.H., Director of Stone Disease at Johns Hopkins Bayview Medical Center, responds.
Caused by the buildup of salts within the kidneys, kidney stones afflict 1.3 million Americans a year. The most common treatment for kidney stones is to drink lots of water and wait for the kidney stone to pass out of the body. Typically, 2-3 quarts of water a day are advised, along with painkillers to ease discomfort. About 85% of kidney stones pass in this fashion, most within 2-3 days. If the kidney stone still doesn’t pass, further treatment, such as extracorporeal shockwave lithotripsy or surgery, may be warranted.
"The treatment of kidney stones has become increasingly refined and less invasive," says Brian Matlaga, M.D., M.P.H., Director of Stone Disease at Johns Hopkins Bayview Medical Center. "And for some patients, treatment is advancing to the point where we can dispense with other methods altogether and instead effect kidney stone passage with medication." A recent review in The Lancet found that kidney stone patients given alpha-blockers or calcium channel blockers were 65% more likely to pass their stone than patients who didn’t take these medications.
Alpha-blockers and calcium channel blockers are commonly used to treat hypertension, but both drugs also appear to flush out kidney stones by relaxing the ureter and increasing liquid pressure. Dr. Matlaga recommends alpha-blockers rather than calcium channel blockers because the former have fewer side effects. "Rarely, patients may report light-headedness, which resolves once the medication is discontinued. Calcium channel blockers are associated with more side effects, such as a drop in blood pressure when standing up and cardiac effects."
There is a catch. All but one of the trials reviewed in The Lancet examined patients with kidney stones in the distal ureter -- the part of the ureter nearest the bladder. According to Dr. Matlaga, if your kidney stone is nearer the kidney, other treatments may still be necessary. How long will you take medication? "In most cases, my patients try medical therapy for up to a month. If the kidney stone has not passed in that time, surgical removal allows the patient to rid themselves of the kidney stone definitively and get on with life," says Dr. Matlaga.
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