How to pass a kidney stone

Few men who have endured the pain of passing a kidney stone speak highly of the experience.

Unfortunately, according to the  National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), kidney stones occur in one in 11 men in the U.S., so millions are likely to encounter one or more of these hard masses, which develop from crystals that separate from your urine. Typically, urine contains chemicals that prevent or inhibit the crystals from forming.

Kidney stones can be as small as a grain of sand, or as large as a golf ball. How they are treated depends on their size, says Dr. Adam Rubinstein, an internal medicine physician at Advocate Condell Medical Center in Libertyville, Ill.

For many men, the best option is to pass a kidney stone naturally through your system, he says. But it isn’t easy, or pain-free.

“You’re passing a solid mass through a very tiny, and sensitive, passage,” Dr. Rubinstein says. “So, unfortunately, in most cases, you need to gut it out.”

If a stone is less than or equal to 4mm in size, it is more likely to pass spontaneously, he says. Bigger than that, the stone is unlikely to pass on its own. And if the stone is bigger than 9mm—about 10 percent to 20 percent of the cases—you’ll probably need a procedure to extract it or break it up, he adds.

“We’re talking about ‘managing the pain’ with most kidney stones,” Dr. Rubinstein says. If the pain is tolerable, over-the-counter pain meds such as Ibuprofen, Naproxen or Tylenol usually help. “Sometimes we prescribe Tamsulosin (generic Flomax) to help the stone pass easier,” he says.

So if passing a kidney stone doesn’t interest you, then it’s best to play good defense, he says.

Here is the game plan Dr. Rubinstein recommends:

1. Drink enough fluids to produce two liters of urine per day. This dilutes your urine and prevents stones from forming.
2. Dietary changes may be advised based on the type of stone you pass. Yes, kidney stones need to be analyzed because composition can vary.
3. Drink a tablespoon of lemon juice each day. The natural citrate in lemon juice helps to inhibit stones from forming.
4. Medications are sometimes prescribed to help prevent new stones from forming in patients with a history of kidney stones.