Kidney stones are a common urinary problem and the incidence in community studies varies from eight to 12 per cent. This means that one in 10 people will be affected by kidney stones at some point in their lives. “Kidney stone formation is a result of permanent biochemical alterations in the body and thus they are a recurrent phenomenon. According to statistics, the chances of forming kidney stones again are more than 50 per cent in 10 years,” explains Dr Raman Tanwar, MBBS, MS, FMAS, MCh (Urology) at Department of Urology and Andrology at Urocentre, Jyoti Hospital, Gurugram.
He adds, “The battle therefore does not end only with the removal of the stone. Usually, we try to analyse its chemical composition so that more focussed efforts can be made at prevention of the disease, but even if we can’t do that, we can still do a number of things to dissolve them and prevent their formation.”
The first measure to prevent and dissolve existing stones is to increase the amount of water we drink. It is a universal observation that in dry and arid climates, the stone formation incidence is higher. Increasing fluid intake to 10 to 12 glasses in a day is the recommendation for patients who are known to form kidney stones. At the same time, excessive intake of fluids is not recommended as it creates a load on the kidneys. Secondly, one must limit salt intake as an excess in the diet causes more free oxalate and other stone forming substances to reach the kidneys resulting in crystallisation.
Lowering salt intake is a highly recommended step to prevent recurrence of stone formation. Studies indicate that high body mass index is also a very important factor in stone formation. “We recommend patients to maintain a healthy weight (body mass index less than 23.5) to prevent stones. Based on stone composition, we can direct patients to further restrict certain food items like spinach, cashews, brinjals, tea, coffee, etc, for oxalate stones and animal protein restriction for patients forming uric acid stones,” mentions Dr Tanwar.
Small stones, which are less than five to six millimetres, are often managed with a combination of inhibitors. Stone inhibitors like potassium citrate, magnesium and vitamin B6 are available in the form of syrups and their regular intake can help dissolve such small stones. Larger waves are focussed on the stones to break them into smaller pieces that can pass out of the urinary system with the normal flow of urine without getting stuck in the pipes of the kidneys called the ureters, explains the expert.
Extra-Corporeal Shock Wave Lithotripsy, commonly referred to as just lithotripsy has been used for many decades to help patients pass stones without going under the knife. Says the doctor, “We ask patients to strain their urine after the lithotripsy session so that we can get hold of the stone particles and understand the stone composition. Typically, kidney stones may need two to three of these 40-minute sessions of lithotripsy to fragment completely.”
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