Ask-a-Doctor: Dealing with kidney stones

From the Chattanooga Times Free Press

Q: I have kidney stones. What do I have to do to treat and manage them?

J. Patrick Dilworth, MD

J. Patrick Dilworth, MD

A: Stones located in the kidney are typically asymptomatic, not causing symptoms until they move out of the kidney. If you experience severe pain, you may need acute intervention with pain medication and further X-ray evaluation. If associated with fever or other signs of urinary tract infection, you may need urgent surgical intervention to decompress an obstructed kidney. There are a variety of minimally invasive procedures to remove stones that cannot be passed.

If you pass a stone or have one removed, it is typically sent for analysis. Further evaluation depends on that result, your medical history and physical examination, and laboratory testing, including 24-hour urine evaluation.

Dietary recommendations include increased fluid intake, decreased sodium intake and adding citrus such as lemon and lime to your diet. In addition, other dietary recommendations based on an individual’s metabolic profile may include increased or decreased calcium intake, decreased oxalate-rich food intake and reducing nondairy animal protein. Pharmacologic therapies are also customized and may include thiazide diuretics, potassium citrate, allopurinol or others as appropriate.

Ongoing management may include repeat laboratory and urine testing to evaluate response to treatment, as well as periodic re-imaging to assess residual stone burden.

J. Patrick Dilworth, M.D., CHI Memorial Chattanooga Urology Associates; member, Chattanooga-Hamilton County Medical Society