In my 25 years of working with stone formers, as a nurse in residence at Litholink Corporation and in my own practice, the number one question has always been: ‘How much water do I really need to drink?’ Maybe as important is: ‘How Do I Do It?’
Tread Slowly
Many patients leave their doctor’s office with the vague instruction to increase their water input. How much are you supposed to drink to reduce your stone risk?
Even more, patients are told to go home and start drinking a gallon of water a day. If you don’t drink more than a couple of glasses per day now, how are you supposed to drink a gallon tomorrow?
Drinking more water is a simple way to reduce your stone risk, but simple does not mean easy. Most of you find this task extremely hard. I tell everyone to start out slowly. If you drink one glass per day now, then drink two tomorrow. Set new goals to increase your water consumption each week. I have seen people go from 1 glass per day to 10 glasses per day within a month.
Spend Time to Avoid Pain
I can hear you saying now; “I don’t have enough time in the day to spend it in the washroom”.
This is a legitimate response and one I have heard many times throughout my career. I will not lie. You will spend more time in the bathroom, but you will get accustomed to your more frequent bathroom visits. The bigger picture is the one to focus on. Better hydration means you will be less likely to form more stones; this means that water can reduce ER and doctor visits, and lost time away from work. What is going to the bathroom a few more times a day compared to all of the pain, suffering, and expense you will endure if you don’t drink more water?
Be Willful
I have seen my share of pilots, teachers, surgeons, nurses, and traveling salesman all increase water intake despite the time constraints of their occupations. The one thing they all do is make the time.
I have worked with surgeons and surgical nurses before and it is true that they cannot leave the OR to use the bathroom during an 8 hour open heart surgery. Intermittent dehydration can be a real problem in this case. My clients who work in the OR do their best to drink for the rest of the day to try and make up for the loss. Sometimes there is really no choice. Thankfully this is the exception, not the rule.
Once you make up your mind that you do not want to suffer with the severe consequences that kidney stones bring to your life, you will find a way to incorporate more water into your daily routine. It is your choice, your commitment to your health that creates a one day at a time habit of drinking more water.
How Much?
Under the usual conditions of life, 3 – 4 liters of fluids a day will provide 2.5 to 3 liters of urine volume, and this is enough. The average healthy adult bladder holds about 1/2 liter, so this means 7 – 9 bathroom trips in 24 hours.
Input Doesn’t Always Equal Output
Four factors make the answer harder to come by: sodium intake, geographical location, occupation, and exercise.
Sodium intake
High sodium intake can confuse people. It is does not by itself change how much you need to drink, but salt intake can shift the timing of water loss so you think you are not increasing your urine volume even though you are drinking. It does something more. It increases urine calcium losses, a matter we will come back to at a later time.
When you eat a meal that is high in salt, you can count on it decreasing your urine output. I have clients tell me that they drink “a ton” of water but they never have to use the bathroom. The reason is that water is retained with the excess sodium. High sodium meals will decrease urine output that day and even that night, thus causing bloating, worsened hypertension, and higher risk for stones because of higher urine calcium.
But a steady high sodium intake, not just the effects of one meal, will cause a steady water retention and stable weight gain so after a while the extra water you drink will appear in the urine. In fact, when people lower their salt intake they become less thirsty so they have to focus more on drinking or they will ‘forget’.
Even so, keeping your water intake high and lowering your sodium consumption is best. Stone formers who have no medical contraindications to lower salt diets should be aiming for about 1500 mg of sodium per day. People become accustomed to high water intake and low sodium intake, and can benefit not only from the stone prevention but often from a lower blood pressure. How you lower your sodium intake to this number will be discussed in a future post.
Geographical location
There are actually places on the map that we who deal with kidney stones call the “stone belt”. Basically these are the states that are consistently hot and humid or hot and dry. Why is where you live a problem? Simply put, you sweat more. If you sweat more, you run the risk of becoming dehydrated, and being dehydrated reduces your urine volume and makes you more prone to form a stone. If you live in a hot, humid or dry state, you need to drink more to compensate.
Occupation
Are you working construction in the summer in Texas? Are you a camp counselor in Arizona? Do you wash windows for a living in Florida? Your occupation can be the increased risk factor for your stone disease. The reason is the same as above. You are sweating more and need to drink more than the office worker seated in the air conditioned office whose windows you are washing.
Exercise
I am very proud of you that you are doing your daily exercise. We all know how important that is to maintain good health. Exercise plays an important part in stone prevention so make sure you do it. Just remember to hydrate before, during, and after to balance the water lost from sweating!
Tricks
Here are few ways to make water drinking more enjoyable.
Stylish water bottle
Find a water bottle http://www.zazzle.com/fun+water+bottles that you really like carrying around. Seems like such a silly thing, but it really does help. I like big ones so I don’t have to keep getting up to fill it and it makes me very proud to see it empty. You may find smaller ones keep you inspired and you can easily go refill it as you make your bathroom pit stop. Here is an awesome water bottle I have found to help http://www.amazon.com/Basily-Infuser-Bottle-Around-Hydrated/dp/B00M1UOF3K/ref=dp_ob_title_sports
Make Tasty
Add fruit to your water. Adding lemons to your water has the added benefit of increasing your citrate level which is a natural inhibitor of stones, but use fruit that makes you smile most.
Using the product Mio http://www.makeitmio.com/ has helped many patients who constantly tell me that water is BORING. My reply is always, “better boring water than excruciating stones”. It is at that point that they take another sip.
Water is the most benign way to increase fluid intake, but don’t forget to include other beverages in your daily intake: Green tea, lemonade (no sugar), flavored waters, even fruit like watermelon, grapes, etc. will be helpful.
Be Techy
If you’re a phone app geek like me, download this app and track your progress https://itunes.apple.com/us/app/waterlogged-drink-more-water/id352199775?mt=8
Treats
Eat Your Water
Here is a list of foods that are made up of at least 90% water. Be careful. Some of them are high in oxalate and for those of you who need to limit your oxalate intake I have asterisked them: cucumbers, radishes, iceberg lettuce celery*, tomato*, green peppers, cauliflower, spinach*, starfruit, strawberries, broccoli, grapefruit, baby carrots*, and watermelon.
Channel Your Inner Child
I have straws on my counter top in a cute container. They add color, fun, and make drinking water a much more whimsical experience. They also makes the water go down a bit faster. I find myself downing a glass with ease when I have a straw. My son likes it too. No matter what your age or disposition, straws add fun to an otherwise boring activity.
If you are enjoying some grape or apple juice, dilute it with half water. You will cut down on your sugar and increase your water intake. This is a win-win.
A neat way to add color and zest to your water without added calories or artificial flavors: Freeze grapes, or lemon, lime, or orange peels, and add to your water instead of boring ‘ole ice cubes.
Make new habits
Every time you reach for a diet soda, replace it with water. Soon you will just reach for water and your old diet soda will be a long forgotten bad habit.
Upon waking, drink a glass or two of water with lemon. This helps keep your urine alkaline and gets you feeling ready for the day.
In winter, get some hot water, lemon and honey. It will warm you up on a cold day.
Green tea (yes, low in oxalate).
Le Croix. For those of you who are addicted to bubbles. Try this no calorie, carbonated water. It comes in many flavors and has been a staple in my house for the past year. There are generic versions of it for budget conscience stone formers.
Drink a glass of water before and after a meal. Drink water. Eat less. Yet another win, win. Who knew it would be this fun?
Be Patient and Persist
I want you to know that incorporating large amounts of water into your life takes a bit of time. New habits are built with commitment, patience, and an understanding that you are not perfect. You will have days that you cannot get in the amount of water that you would like to. It is ok. Your goal is to do your best on more days than not. And when you don’t, you can get back on track the next day.
Drinking more water is the number one thing you can do to help prevent further stone formation. It also has no bad side effects. So what do you say? Let’s raise a glass, a refreshing, ice cold glass of water. It might just save you from your next ER visit.
A Reservation
Water is always the first line of treatment for stones.The most important thing to do about supersaturation is lower it, and water will do just that. In relation to kidney stone prevention, more is better. In a perfectly healthy younger (below age 50) person taking no medications, up to 5 or even 6 liters a day is safe provided it is consumed over the whole day and never all at once. But if you have heart disease, kidney disease, or liver disease, or are elderly, great caution is important and the amount of water needs to be determined individually for you. When diuretic drugs are being used, to lower urine calcium excretion for stone prevention or for blood pressure control, water intake needs to be no more than 3-4 liters a day and testing is necessary at intervals to be sure blood sodium levels have not fallen. Many other medications interfere with water excretion; psychoactive drugs can do this, for example. All drugs in use must be reviewed with your physician before drinking large volumes of water, above 2.5 liters daily. It is true that most people can easily and safely drink the extra water needed for stone prevention, but the reservations are important, always.
I have recently put together a private FB page called THE Kidney Stone Diet. It is a group that helps educate you on your physician prescribed treatment plans. I moderate it to keep it clinically sound. Come on over and join the discussion!
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hi, i have gone through the ultrasound and reports says that i do not have stones in kidney but some stone particles are developing or forming. so doctor said to me drink more and more water so that it can pass through urine. i want to know how much water do i need to drink and how much time stone does take to pass on
Hi Shah, I would be sure that the particles were – calcium oxalate, calcium phosphate, uric acid etc; the fluid volume varies with the crystal type. Likewise if you are forming visible crystals you are a stone former and need real treatment, not just water. Regards, Fred Coe
If I drink a couple of beers a day does that count as water intake.
Also I have heard that coffee doesn’t count
Is that true?
Finally I take a lot of vitamins C. and D
Are those contraindicated
Thanks
Hi Arnold, coffee and beer are not a stone risk. Lots of vitamin C is because converted to oxalate. Regards, Fred Coe
How dehydrated does one have to be to form stones? If the urine is light yellow to a yellow color is that ok compared to a dark yellow with a noticeable odor? I drink water when I eat and at other times during the day but not at the large quantities that are recommended such as 8 to 10 glasses. I also drink coffee and red bulls, and I read that, technically, water is being taken in. When I overdo it with the caffeine, I urinate more frequently, but I assume that “flushing” of my kidneys is happening as water goes through the kidneys more frequently and whatever kidney stone forming particles are becoming present, exit my kidneys. I then drink water later. The headaches that come with dehydration are very rare for me.
Sorry for the long question(s). I am paranoid about forming stones, but I do not know more besides the general “eat healthy and drink lots and lots of water/fluids” that can be applied to almost all health conditions. From what I understand from reading articles, stones affect 5% of the American population and another article I read states that the majority of Americans are dehydrated. Am I wrong to assume that stones should be very common then?
Thank you for any assistance.
Just had stone removed the pain from the stone was terrible wondering how much calcium should I be taking afraid if taking to much and is 64oz of water a day ok
Hi Linda, I gather you are about to undertake prevention of more stones. Do not begin with a treatment but with a proper evaluation so you know what is best for you. Here is a good start. Here is another, about the importance of all of you not just the stones. Regards, Fred Coe
I am a 66 yo female who is 5′ 1″ tall and weights about 110lbs who chronically forms kidney stones:
How many ounces of water should I be drinking each day?
Is it best to drink most of my water during/after each meal?
Should my water be mineral?
Should my water be alkaline and what is the best pH?
Should my water be negative ORP?
What time of night can I safely stop drinking water such that I don’t have to get up to go to the bathroom multiple times (after one time, I can’t go back to sleep and can’t do well on only about 5 hours of sleep per night)?
I take 10 of Potassium Citrate each morning in a cup of coffee to be able to get it down as it tastes so BAD! Can’t swallow the pills; won’t go down.
Thank you for all your answers!
Desperate to NOT form more stones!
Hi Wanda,
You need to drink enough fluids so you produce about 85 ounces per day of urine. How much you need to drink to get you to that urine volume depends on different variables. Like, how much sugar you are eating, how much sodium you are eating, how much you sweat, etc. So hard to answer. Have you done a urine collection? You need to drink your fluids throughout the day so that you do not have periods of dehydration. We do not care what type of water you drink and buying bottled can be very expensive. Tap is fine if you prefer that. Cut your fluids a couple of hours before bedtime so you are not being disturbed that many times during the night.
Hope this helps,
Jill
Hi Wanda, fluids may not be the best single treatment. Take a look at a more complete approach. Be sure of what caused your stones. Treatment is for all of you, not just the stones. Regards, Fred Coe
Hi,
I just had a CT scan, and came to know that I have my URETER swollen three times than the actual size. I took Bactrim course for 7 days. I get a thick white discharge now in the morning, and I am starting to feel more urine trips but less urine coming. I’m usually used to drinking tons of hot water and am never tired of it. NOW, my questions are :
1) Can I still drink more water? I see the water goes back to the kidney. I just don’t want to add additional pain. Please clarify.
2) My CT Scan follow up with Urologist is scheduled coming Wednesday but I’m concerned. How do they usually remove stones If in case I have stones? I’m surprised though, because as i said earlier I’m a crazy water drinker.
3) What does my future looks like related to this Ureter swelling? If I’m diagnosed with Prostate, what are all the possible treatment options and how soon I can get cured?
4) Do I need to worry too much about this?
5) I drink only hot water. Exactly 16oz on a microwave 90 secs to 2 mins usually. I’m comfortable drinking all that. Usually I get to dispose full urine in an hour, but now it’s probably less than 25% coming. That worries me a lot.
Looking forward to your advise. Thanks.
Hi Thambi, A swollen ureter – one site – usually means obstruction from a stone or other cause. Both ureters swollen can mean other things including bladder outlet obstruction from your prostate gland. Your urologist will figure all this out when you have a procedure to evaluate the cause. Water is never enough for stones, but in fact you do not even know if it is a stone. So right now, everything waits on the next step with your physician. As for worrying, I would let your physician worry as he/she is responsible for your health and needs to take care of whatever is wrong. Regards, Fred Coe
I’m thinking of starting to drink some warm lemon water every morning upon waking. Someone suggested half a lemon (0.5 oz) with 8 oz of water before breakfast. For me I was thinking of starting out with half of that dose. For convenience, I’m planning on getting my lemon juice from a bottle. Does this sound OK? Wish I could afford your course.
Hi David, Lemons may or not be useful for you. It depends on what has happened. Here is a nice article about confusions that can be avoided. Regards, Fred Coe
I have only 20 and i have 3mm renal stone in right kidney in dec2017 report and 3.1 renal concertation in april report i take proper diet but can’t rid from this stone
Hi Mohit, Preventing stones is a process. Here is a good place to start. Regards, Fred Coe
Just had 3rd Lithrotripsy! Just finished at home urine sample for Litholink! And did blood work!
Drs are doing metabolic panel to find out why my body keeps making stones!
Was wondering how much lemon per ounces of water is enough?
Also can concentrated lemon be use?
Hi Christie, Wait until your physicians have figured out what to do before doing something. Confusion causes trouble. Lemons are not much of a treatment, either. Regards, Fred Coe
Am 90 years old and incontinent. Use at least five pad in 24 hours. Getting up 3-4 times per night. Also have irritable syndrome with diarrhea and constipation that keeps me on the verge of dehydration. Have developed pain down right side from back to front and down to groin. Painful at night..changed mattress but not the cause. Ultrasound shows nothing . Bone density good. How much water do Intake ? I have ph8.2 delivered and drink about 40moz a day . Only take Losartan and Corey plus supplements. Am trying to track this on and off pain down. My diet is not good due to IBS. Any hope for me?
Hi Camille, You do not mention having kidney stones, and the pain you describe is not necessarily from stones. If you do not have stones, there is no need to flood yourself with water. I would focus on better control of the GI symptoms, which usually is possible at any age. Perhaps that will make things a bit better for you. Regards, Fred Coe
Hi CAmille, Given your pain I do not suspect stones. I would try to get better control of the GI symptoms. If your 40 ounces of water causes very high urine volumes, it is possibly too much, as dehydration lowers urine volume a lot. Regards, Fred Coe
Waiting patiently for a 7mm stone to pass. Increased my water intake and have added citrate drinks like low sugar lemonade. My urologist has prescribed flomax for the next month. Question I have – can you pass a 7mm stone? I have passed smaller ones in the past and my doctor gave me the option of removal with stent or a couple more weeks on flomax. In your experience, have you known patients to pass larger stones on their own? Did the 24 hour urine test so now I have a better idea of what I need to change my diet, but I know that will not effect the current stone. Thanks!
Hi Jen, 7 mm is at the top of the passable range and yes I have seen plenty of people pass that size. Your physician is reasonable to offer the option and is responsible for the safety of the kidney and yourself while waiting. Regards, Fred Coe
Waiting patiently for a 7mm stone to pass. Increased my water intake and have added citrate drinks like low sugar lemonade. My urologist has prescribed flomax for the next month. Question I have – can you pass a 7mm stone? My urologist seems to think it can happen as she has seen larger stones pass with other patients. CT scan two weeks ago showed the stone and ultrasound last week shows the kidney is still swollen. Follow up in six weeks. Did the 24 hour urine test so now I have a better idea of what I need to change my diet, but I know that will not effect the current stone. Thanks!
Hi Jennifer, 7 mm is at the upper end of passable and yes I have seen patients pass such stones. I believe I already answered this, so sorry if I am repeating myself. Regards, Fred Coe
Hi
I had a 12 mm stone that was killing me with pain. My urologist put a stent in and did laser but only sand sizes passed. After a second ultrasound I still have pieces that are big and have not passed. The stent is out now but what is the best way to pass these? I’m going on vacation in 2 weeks and really don’t want to deal with the pain by then. Thanks for your assistance.
Hi Mar, The problem you pose concerns the surgery and no one can really assess matters except your surgeon. I am far away and not a surgeon. I would ask her/him how large the remnants are, whether they are just deposits of sand – I suspect they are, and if you can safely go on vacation. Regards, Fred Coe
I have kidney stones 7mm
I leave in a remote island and I can’t find a lot Braun of water.
The Evian water is good?
Hi Alfonso, It is alright. Regards, Fred Coe
diagnosed to have 7 mm gall bladder stone. doctors have told that surgery is not required now. have increased my water intake. pray it gets diluted
Hi Srinivasan, Gall bladder stones have nothing to do with kidney stones and water will not help them. Perhaps your physician meant kidney stone. Regards, Fred Coe
Hi, I have been given conflicting advice. Some say, drink water with a low dry residue to avoid mineral deposits in the kidneys while others have said a water rich in calcium and magnesium will inhibit stone formation. Does water hardness (dry residue) have an effect, if so, what is favorable when choosing a water. Some also say distilled water is good and others say it will have negative health consequences in the long run. I found one interesting study on stones and water but overall the topic seems a bit confusing…https://www.ncbi.nlm.nih.gov/pubmed/9096270
Many thanks!
Ric
Hi Ric, It is an old article concerning changes in urine chemistry. I know of no real trials. Frankly, water is generally dilute enough in minerals that its effects are more or less to dilute urine stone forming salts. The one exception is high sodium, mainly from one way water softeners; that sodium load could be a problem. I have never written about this problem, so have not seriously studied it, so my comment is provisional at best. Regards, Fred Coe
Thanks Prof. Coe, in this case a water high in calcium could be beneficial for someone who forms/has formed calcium oxalate stones as it will increase dietary calcium? Thanks
Hi Ric, In principle, yes. Usually there is not enough calcium to matter in that we need 1000 to 1200 mg daily. But it will not hurt. Regards, Fred Coe
Hi, I have two stones of 3mm each in both the kidneys. Initial CT scan a month ago diagnosed the size to be 1.5&2mm. Have increased the water intake to about 2-2.5litres. No dietary exclusions have been made, as I have to eat outside all the time. Also the sodium levels are normal in the food I eat. The stones haven’t passed yet. It’s been more than a month now. I’m not on any medications. What should I do?
Hi Medha, I gather you have two stones and no prevention program. Here is a good place to start. Water is just one of the beneficial things to do, but there are many, and one needs to know what is abnormal and therefore a potential cause of the stones. As for the stones, if in the kidneys there is no need to do anything except for pain, obstruction, infection, or pain. Regards, Fred Coe
Hi, had a utereroscopy last monday, removal of 9 stones (bilateral) and 2 stents put in. One I had to remove myself, the other is still in place. I was told to increase my water intake, which I have been doing, but with that, everything I need to use the bathroom (or think I do), I get stabbing pains in my kidneys and bladder. Is there any reason for the other stent to stay in place when the doctor told me she grabbed all the stones? What can I do to reduce the pain?
Hi Patricia, stents are awful. Ask your urologist when she can remove it. Then the pain should stop. As for prevention, water is nice but I am sure she would want a lot more. Here is a good place to start in your own reading. Regards, Fred Coe
I have 5.4 cm kidney stone and a cyst 1.2 cm on my kidney… sufferig from too much pain from 4 months… how to reduce pain?
Hi Zainab, A 5.4 cm stone is very large, and should be removed. Your surgeon has probably already recommended that. Regards, Fred Coe
Hi Doc. Fredric! I have plus 4 protein in urine. What medicine should I be taken? I have stents in both sides of the ureters.
Thanks
Hi nel, WIth stents in your ureters there is blood as well, so protein testing is not appropriate – always will be very high. When the stents are out and there is no blood in your urine, look again and I predict the protein will be gone. If not, time to consider its cause then. Regards, Fred Coe
Hello Doc!
I have 4.88 mm one stone in right kidney found 3 days ago. Doctor has given me medicine and asked to drink more water. Is this size of stone remove by just drinking water? or I suppose to do some other measures?
Hi Saad, a <5 mm stone has a good chance of passing. I gather it is in the kidney and presently doing no harm. I do not know the medication, so cannot comment. More water is a reasonable part of prevention of more stones, but only part. I imagine the medication is meant as the main part. Regards, Fred Coe
You said “Every time you reach for a diet soda, replace it with water. Soon you will just reach for water and your old diet soda will be a long forgotten bad habit.” Unfortunately, this was not true for me. I cannot tolerate plain water in anything but small amounts, unless I am hot and very thirsty. HOWEVER, I eventually found the beverage that has cured my stones: icy chamomile tea (dilute) sweetened with a Stevia sweetener (that is mostly erythritol). Erythritol is a natural sweetener, and non-nutritive. This was my breakthrough.
Hi MarkM,
Thanks for sharing your breakthrough. Water is always best to drink as it has no calories, oxalate, sugar, etc. Best of luck with your stone prevention! Hope you remain stone free.
Best, Jill
Hi Mark
I wanted to mention that Paul Pitchford, the noted author of the great book: “Healing With Whole Foods,” mentions in his book, that you can drink 4-6 cups of chamomile tea daily as part of a liver & gall bladder stone dissolving protocol.
So, your drinking this tea instinctively , is fortuitous, in more ways than one!
🌷 Emily
Hi Again Emily, I want to make clear that I do not endorse any products on this site, but I do always favor patients saying what they wish so long as the advice is not contrary to good practice. Regards, Fred
Hi Again Emily, I want to make clear that I do not endorse any products on this site, but I do always favor patients saying what they wish so long as the advice is not contrary to good practice. Regards, Fred
Can Pellegrino or other carbonated water be used just as Le Croix?
Hi Candance,
Sure you can use Pelligrino.
Jill
Hi Candace Rose,
I wanted to warn you & everyone ~
that it is a major error to drink carbonated water. The carbonation process additives, disrupts your calcium intake and absorption so then you’re dealing with major dental issue & bone / joint issues. I know firsthand as this happened to me. I then researched it and found out that carbonated water is the culprit. Google it!
Plain filtered water is best. They say if you guzzle a lot you urinate a lot
If you sip all day you are able to truly hydrate your cells as your not urinating it all out, as when we guzzle a cup or two of water.
Good luck!
Emily.
Hi Emily, I make a principle of having any patient comment on the site, but I do not necessarily agree with this one. Even so, it seems harmless enough. Regards, Fred
Some of the fruits and vegetables you say are high in oxalates are low in oxalates on other charts like cauliflower and watermelon. Please clarify because I am having a lot of trouble figuring out what to eat as I have calcium oxalate kidney stones
Hi June,
Cauliflower and watermelon are NOT high in oxalates. Make sure you get the Harvard list as that is the one we use.
Best, Jill
I have been diagnosed with kidney stones in both my right and left kidney. Have one in my right kidney that is 9 mm. Is it true that surgery is the only option for me? I started drinking 60 to 68 ounces of water daily a week ago. I am constantly having to go to the bathroom, which is a good thing. Is there anything else I can do? Oh I also squeeze fresh lemon in my water every day
Hi Diana,
First off you need to complete a 24 hour urine collection. Once you do this you can find out exactly what is causing your stone issue. The kidney stone diet can be found right here on this website. But get tested!
Jill
I have had surgery to remove some stones. When he finished he still was not able to get one that was about a 6 and a bunch of little ones. My doctor said it looks like I am growing a rock garden. That was about several years ago. The one that is left was not blocking anything and he told me to drink lots of water and lemonade. Periodically I get pain and drink water right away. I would appreciate the diet on your website How to Drink Enough water. Your website is wonderful and very educational..Thank you
Hi Marene, If you are indeed forming many stones, diet may not suffice, and water alone surely will not suffice. I would suggest you read a bit more about prevention and move to a more reliable approach. Here is my best on the matter. Regards, Fred Coe
Mam I have kidney stone of 6 mm so is it necessary to remove by surgery method
Hi Ibtesam, Stone removal is optional unless the stone is causing obstruction, significant pain or bleeding, or infection. If it grows it may no longer be able to pass, so some surgeons offer elective removal, others do not. You might be wise to find out why you made the stone and take steps to avoid more. THe same steps tend to reduce growth of stones already present. Regards, Fred Coe
Mam I have kidney stone of 6 mm n my age is between 16 to 17 so is it necessary to remove by surgery method
I had A PCNL surgery last August for a 20mm and an 8mm stone in my right kidney at that time they also noticed that I have Urethral stenosis in my right urethra. They did a 24 hour urine test and it was normal other than showing I had An increase in calcium which was believed because the stones were calcium oxalate and they were. They also did blood work and checked my thyroid and calcium levels which were all normal. I went In for my recheck the other day and I had trace blood in my urine and i Have a 17 mm stone In my left kidney and 2 small stones already forming in my right kidney. I do Not understand why this is happening. Now I will Have my second PCNL in the same year. The doctor put me on 20meq of potassium citrate which I have A hard time swallowing because they are large and not coated. Does this medication actually have successful results with preventing kidney stones? Will I have To be in on this for the rest of my life? Are my kidneys damaged from these stones? 2.5 years ago I had My 4th baby and my only c-section and after I was Readmitted to the hospital for 5 days due to high blood pressure which I did Not have while pregnant or immediately after the c-section. I went Home on blood pressure meds. I am Currently off of blood pressure meds because my bp went down to normal a few days after being released from the hospital. Could these stones be cause by that high blood pressure. It was so high they thought i was going to have a seizure. I was Healthy before I had The baby and ever since then it’s been one thing after another. I workout And I worked Out while i was pregnant. I know I dont Drink enough water. But after the first surgery I was Drinking more. I dont Eat a lot of salty or high in oxalate foods. I an Just at a loss as to why. And I’m scared I will Have kidney failure because of these stones. I have Had 5 altogether.
Hi Kate, I answered your other version of this question. Reading the new one, I am beginning to believe the stones are calcium and your urine calcium is indeed too high and that your high diet sodium and low urine volume could easily cause your stones. But I have little to go on, and your physicians have all the details. Here is my best article on how to proceed with treatment, including diet and meds as needed. Take a look and see if you fit in. Regards, Fred Coe
in how many days from urine can pass out 2.8mm kidney stone by drinking daily 4 liter of water or remove kidney stone pizz give me some tips
Hi Aang, a 2.8 mm stone is likely to pass. How long is not possible to predict. Lots of water is good. But keep your physician involved as even a small stone can obstruct a kidney and damage it. If this is happening your physician will have to remove the stone. Regards, Fred Coe
Hi,
First of thanks for writing this article it’s very helpful and I want to know how much time a 3 mm stone takes to form because I had kidney stone operation 6 months ago and now today I find I’ve another stone. Please also let me know timing
Hi Abhishek, Probably the 3 mm stone was already present and simply grew. Months are sufficient for this. Six months are enough for an entirely new stone to form. Regards, Fred Coe
At age 75 I have encountered my first Kidney Stones (2-6mm and a 9mm)…First of all I live in Florida and every morning I walk about 2 hours…Every other day I’m lifting weights at the Gym..After research I’ve come to the conclusion I’m always dehydrated because I really don’t drink water other then drinks like coffee that I use water to make…I’ve upped my water to at least 4 liters per day..(I do eat a lot of foods with high oxalates) I will have the Stones removed this July at the hospital with a machine that will blast the stones and a stint..I’ve also did a lot of research of vitamin K2 and will be supplementing daily of K2 M7…I’ve always eaten the high oxalates, but I believe with all the exercise I’ve incorporated in the last couple years I just didn’t drink enough fluids…I don’t look forward to the procedure to remove them, but I’m actually excited about hydration now…Can do nothing but help…Jeff
Hi Jeffry,
Excellent job incorporating all that exercise! Can’t think of a better way to spend your time. You might want to think about getting rid of the highest oxalate food sources like spinach and almonds. And make sure you incorporate some calcium into your diet. This article might help you!https://kidneystones.uchicago.edu/the-kidney-stone-diet/ Keep up your hydration! Best, Jill
Thanks for the reply…Just a note..every morning I had oatmeal with 2 large tablespoons of 100% unsweetened cocoa and a small hand of Walnuts…Sounds like a good habit to eliminate the oxalates, and have dropped spinach…
Thanks for the info. I just turned 30 and experienced my first stones. The first time it happened I was camping in the wilderness and decided to be rushed to the hospital an hour away, as I had no idea what was happening to me.
I’m currently in a lot of pain passing the 2nd one, and trying to save money by not going to the ER, as I know what it is now.
As a professional musician, I sweat a lot during performances (especially durint the summertime and in hot places) Does the bubbly water hydrate as much as regular water? There are different kinds with extra minerals, should I avoid those kinds?
I noticed you don’t mark grapefruit as high in oxolates.. But that’s one of the foods people keep saying to avoid. I only ask cause I love grapefruit and would be glad to not be so afraid of it. After this mystery I’m in, I will defineately focus on lemon water, and water consumption in general. Luckily I don’t have a habit of drinking sugary drinks and sodas BUT I do have a habit of having 2 to 4 alcoholic drinks a day. (Usually NOT 4, but I’m being honest) will alchohol be bad for me as someone who is now prone to kidney stones?
Thank you again for the informative post. Defineately bookmarking this.
-Tevis
Hi Tevis, The real issue is to be evaluated via 24 hour urine and blood testing to be sure what is wrong and aim treatment there. I am sure fluids are important given your work but there may be more. Regards, Fred Coe
hello
i drink 4-5 liter of water daily but still my kidney stones form very fast. it was just 4 months that i doctor put jj stent and i passed kidney stone. After that day I regularly drink this much water. why kidney stones are still form and now i had 5 mm stone arter 4 months.
please help if you you have and solution.
i don’t have urici acid
Hi Rupinder, If your stone form so rapidly and are not uric acid it would seem you must have considerable excess of calcium or oxalate in your urine or possibly a very high urine pH. Have you had 24 hour urine testing, blood testing? Here is a good article on how to proceed. Regards, Fred Coe
have also suspected myself having kidney stones need your advice please
Hi Keziah, This whole site is about advice for kidney stones. But perhaps this is the best place to start. Regards, Fred Coe
After urination still I am feeling it again and again
Hi, I am not sure what you feel, nor what exactly is wrong. Can you say more about the problem so perhaps I can offer some suggestions? Regards, Fred Coe
Hii….iam having renal calculi of size 5mm in my left uvj area….is drinking plenty of water can pass out my stone…or i need a surgery…plse help me find d way to cure…sometimes due to its pain iam just vomiting…
Hi Pandu, for the present stone I am afraid only your surgeon can decide how to manage things for you. Long term you want to prevent more stones, and this is a good introduction. Regards, Fred Coe
This is vinod having 5.2 stones on both ends
Do I need a surgery or drinking plenty of water enough to remove 5.2 mm stones on both left and right side of my kindeys
Hi Vinod, multiple stones need a lot more than water most of the time. Here is a good place to read about a better approach to prevention. Regards, Fred Coe
thank u so much for advice
i have been suffering from kidneystone, what can i do to dissolve it
Hi Emmanuel, Prevention is all one can do unless stones are uric acid. They alone dissolve. Here is a good place to begin prevention. Regards, Fred Coe
Thank you so much for the detailed information!
Is there anything you can tell me about how to know when I’m starting to suffer from hyponatremia? I’ve been getting kidney stones regularly, and doctors always tell me something like, “drink as much water as possible.” The first time they told me that, I ended up in an urgent care with hyponatremia that caused me to vomit. Now I’m terrified of that reoccuring since it can hurt my brain, but it’s a constant struggle to drink the right amount. I am on 50 mg/day of hydrochlorothiazide now, which I know can lower sodium levels further. I also take FlowMax when having stone symptoms, and the lightheadedness from that drug is hard to distinguish from hyponatremia symptoms. Sometimes when I take FlowMax and drink lots of water, I find myself getting overly tired and going to sleep before bedtime. Is that a sign that my sodium levels are too low? What other signs should I watch out for?
Hi Adam, Indeed massive hydration + a thiazide can cause hyponatremia and one must avoid that. The problem you pose is one of judgement and management, and I cannot say exactly because I have no detailed information. But in general the dose of thiazide can be about 1/2 of your present, in many cases, if your diet sodium is not too high – less than 100 mEq (2300 mg), and fluid need not exceed 2.5 liter/d if all other stone risk factors – urine calcium, oxalate, citrate – are controlled. Because this is a real juggling act, my comments are mere generalizations, and your physicians are totally responsible for finding the ideal compromise for you. But I can say with vehemence that hyponatremia is not acceptable, and stone management needs to work around it. In passing, many drugs can foster hyponatremia, especially antidepressants and other psychoactives. Regards, Fred Coe
I have been drinking 3qts a day, I’m told I have a 6mm stone on the right & multiple small ones on the left. My doc put me on Flomax & I have only taken 2 doses as of today. Low sodium, I have been trying to get more calcium, low protein diet. I am also making sure to not touch foods high in oxulates. My question is With all of these things combined realistically what is the time frame for my stones to pass? Aldo my doc prescribed me a low dose vitamin D med. I thought that vitamin D in pill form was bad for kidney stones. Is this correct?
Hi Kelly,
The Kidney Stone Diet is for preventing new stones and aiding existing stones not to grow. As far as when you current stone will pass, I am not sure. If pain or fever exists go to ER. Does your doc say that is will pass or will you need surgery to remove?
Best, Jill
My doc said the stones should pass on their own due to size. I am not sure though. It’s frustrating because I have been on the medication for 10 days now & nothing has happened. I feel pain here & there but nothing major. I think the anticipation of it all is the most bothersome because I previously passed a stone about 4 years ago & it was the most painful thing I’ve experienced to date.
Hi Kelly,
The anticipation of it is the hardest. If pain persists, or fever presents please seek medical intervention. Also, think about joining our Kidney Stone Prevention Course. Make sure this doesn’t happen again if you can: kidneystonediet.com
Best, Jill
Thank you so much Jill, I will take a look at that. I appreciate your responses & insight 🙂
Hi Kelly,
My pleasure.
Jill
Hi Kelly, with a delayed stone, there is risk of kidney damage from obstruction. Your urologist is the key person and she/he needs to be sure that your kidneys are not at risk. Regards, Fred Coe
Thank you so much my doc just referred me to a urologist, I appreciate it.
I have a 4mm kidney stone in the lower pelvic ureter it started out the size of a 6mm kidney stone in the upper ureter and now has moved down to the lower pelvic ureter. It has been 46 days. Doctor is so big on doing surgery, he has been from the beginning and I asked if I could wait and he agreed. I went back and he still wants surgery. I really want to let my body pass this naturally. During this time I have passed a 5mm stone and the lab could not analysis it. I don’t understand that, frustrated as that is a huge stone. I don’t understand why I keep getting them. I came across your article and I thank God I did because I have learned and gained so much knowledge. I told my PCP about the 24 hour urine analysis and she agreed to do it. She was able to find another stone I passed in June 2019 and it was a 90% calcium oxalate dihydrate and 10% calcium phosphate. Told me about a low oxalate diet. I am tired of dealing with these stones and the doctor is saying I really need to do surgery. I don’t understand why I can’t keep trying to pass this naturally. Please advice how much longer I could keep on trying the natural approach and how much more water I need to drink. I just started increasing my water intake to 5 liters a day,plus drinking 1 cup coconut water, 1 cup diluted lemonade and orange juice, plus a mixture of applecider vinegar with fresh squeezed lemons and honey. The X-Ray now shows that my kidney’s have 3 small more small stones in the kidneys again. Thank you for writing your article as it is very knowledgeable It has helped me to understand more about kidney stones. If you could advice any more insight that was be helpful. Thank you, Laura.
Hi Laura, If the stone is obstructing the kidney it should be removed. Your surgeon is the one to judge this, and I would do as she says. Kidney damage from an obstructing stone, or infection that could affect the kidney are best avoided. As for cause, here is my favorite article on how to proceed. You really need to if you want to stop forming stones. Regards, Fred Coe
I was diagnosed with a few tiny renal calculi with mild focal calyectasis in the left kidney measuring around 2.2*1.5mm with 130-160HU in the upper pole calyx and 1.7*1.8mm in the middle calyx. Does mild focal calyectasis make this worse? Please ensure me if it goes naturally, and what extra care should I take?
Hi Vamshi, Any dilation of a calyx causes some stagnation, so crystals form better. It means you should pursue stone prevention measures with a bit more zeal than usual. The low HU suggest uric acid. Regards, Fred Coe
Doctor,
Is that true beer reduces the risk of having kidney stones? I have seen this on dozens of blogs but can’t help asking you. Do they help with this problem? Thank you for your valuable post.
Hi Pasindu, Not really. It is just that beer is mostly water, and water is always valuable for stone prevention. Regards, Fred
How much litres of water should I intake and for how many days for my kidney stone to flush out? The size is less then 4mm.
Hi Shazia, Water may or may not matter. What matters is that you have a urologist supervise your care during stone passage to protect the kidney against injury from obstruction. Regards, Fred Coe
Does the type of water make a difference? Our tap water (San Francisco Bay Area) is very hard with minerals so I drink bottled water. Should I drink Spring Water? Purified Water? Some other type? I want to order water delivery so I don’t have to worry about stocking up on water every week. Thank you, Lisa
Hi Lisa, Usually not. Although water can add sodium or calcium, it adds so much more water the net effect on stones is negligible. Just use whatever water is safe and cheap, usually that from the kitchen sink. Regards, Fred Coe
Hi Fredric L Coe,
I am 25 and my kidneys have a tendency to form stones since I was 15. Two years ago I had surgery because a 4.5 mm stone in left ureter was causing an obstruction. This year again 4.5 mm and 11.5 mm stone blocked the left ureter so I was again operated for DJ stenting. Even after the current, I have 5-6mms sized calculi in the right kidney’s upper and lower calyces. Another of 5mm in left kidney’s upper calyx.
Now I am taking 4-5L of liquid every day and don’t want another surgery when the stone will come down.
1. What can I do about the tendency of my kidneys which is forming stones apart from maintaining liquid intake
2. How long it might take me to pass these stones (in general for 5-6mms)
3. Is there anything I can do to avoid DJ stenting again when these stones will come out?
Hi Dushyant, Your prime goal is prevention. Here is my best introduction, and I strongly urge you follow the scheme for diagnosis and treatment. Being so young prevention is crucial. Water alone is well known to be inadequate, as in your case. Regards, Fred Coe
My daughter (26 years old) had been diagnosed with having kidney stones (7mm). The urologist told her when she hurts she shouldn’t drink water? She is waiting for the results of her ultra sound to see if they will be able to use the Shock Wave Lithotripsy treatment or will she need a surgery. Why can’t she drink too much water if it hurts her again? Thank you
Hi Caroline, I do not know. If she has an obstructing stone more water will fill the collecting system, I suppose, and cause pain. But the correct approach is to relieve the obstruction – which is being planned. Regards, Fred Coe
I went to a urologist to have my bladder function tested because I was frequently getting UTI symptoms with an occasional positive culture. My doctor said my pelvic floor is too tight from years of “holding my pee”. I am only 24 years old and I don’t recall holding my pee, though perhaps I do it subconsciously. Doctor suggested I practice kegels, urinate every 2 hours and only drink 3-4 cups of water a day. 3-4 cups of water per day seems like such a small amount of water per day and it’s really concerning me. I used to get headaches often from not drinking enough water. I brought this up with my doctor and he said “3-4 cups should be enough.” How can this be?
Hi Samantha, I would suggest a second opinion as this does seem perhaps out of the ordinary advice for so young a woman. It is the low fluids I am concerned about. I thought Kegels exercises strengthen the pelvic floor muscles, too. But I am not a bladder expert, so what I say cannot be considered ‘expert’. Regards, Fred Coe
Hello, I too am very thankful for this article! I am 36 yo female in ok health (overweight- but no pre-existing conditions to speak of) went to the ER a few days ago with back pain and found out I have a total of 12 (non obstructing) 1-2mm stones in both kidneys (5 right,7 left) I have had 1 stone prior, almost 3 years ago while 9 mo pregnant I had a 5mm obstructing stone- which is why my OB induced labor almost 2 weeks later. I have no idea if/when the stone passed as my Dr didn’t seem to care since I was no longer in pain. I feel I have ALL the questions but first, is 12 stones at once “normal” ? I am still shocked at how many stones I have and quite terrified that I have to go thru that pain so many times! Also, will the pain be less than it was with the 5mm stone since they are all 1-2mm? I sure hope so!! The ER just gave me IV fluids, the “bad news”, a handful of pain meds and sent me home to “pee rocks” so im anxious at the least! Thanks again for sharing your knowledge!
Hi Katie, I presume the ER did a CT and you do not have a stone in the ureter obstructing a kidney. That is crucial as obstruction is dangerous. Assuming the stones are all in the kidneys, you need to find out why you do this, and this article is a good place to begin. It gives a plan, and if you follow it the reasons for stones will usually be apparent and likewise treatment. Water is rarely enough to prevent stones long term in a case like yours. Regards, Fred Coe
I had lithotripsy treatment yesterday. Can I have detox water or plain water is necessary?
Hi Yumna, All water is fine. Detox water is a vague idea as you can make it in so many ways. I would prefer water for the few weeks after a surgery. Regards, Fred Coe