From the Guidelines
Kidney stones typically do not hurt specifically after eating, but rather the pain is related to the stone's movement within the urinary tract, causing blockage and pressure buildup. Pain from kidney stones is usually related to the stone's movement within the urinary tract, causing blockage and pressure buildup, rather than being triggered by food consumption. The most common symptom is severe, sharp pain in the side and back, below the ribs, that may radiate to the lower abdomen and groin. This pain, often called renal colic, tends to come in waves and fluctuate in intensity as the stone moves. However, some people might notice increased discomfort after meals due to increased urine production following fluid intake with meals, which can cause the stone to shift.
Key Points to Consider
- If you have kidney stones, staying well-hydrated by drinking 2-3 liters of water daily can help pass the stone 1.
- Taking pain medications as prescribed by your doctor, such as ibuprofen (400-600mg every 6-8 hours) or prescription pain relievers for severe pain, can help manage symptoms.
- Certain dietary changes may help prevent future stones, including limiting sodium, animal protein, and oxalate-rich foods, depending on your stone type, as suggested by studies on dietary management of kidney stones 1.
- If you experience severe pain, fever, chills, vomiting, or blood in urine, seek immediate medical attention as these could indicate complications requiring urgent treatment.
Preventing Recurrent Nephrolithiasis
The American College of Physicians recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis, based on low-quality evidence 1. Pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol may also be recommended to prevent recurrent nephrolithiasis in patients with active disease in which increased fluid intake fails to reduce the formation of stones, with moderate-quality evidence supporting this approach 1.
From the Research
Kidney Stone Pain and Eating
- Kidney stone pain is not directly related to eating, but certain foods can increase the risk of stone formation or exacerbate existing stones 2, 3.
- Dietary recommendations should be adjusted based on individual metabolic abnormalities to prevent stone formation 2.
- A low oxalate diet and increased dietary calcium intake are recommended for patients with absorptive hyperoxaluria 2.
- Fluid intake to promote urine volume of at least 2.5 L each day is essential to prevent stone formation, regardless of eating habits 2, 3.
Managing Kidney Stone Pain
- Nonsteroidal anti-inflammatory drugs are the preferred analgesic option for patients presenting to the emergency department with renal colic 4.
- Alpha-blockers may be beneficial for patients with distal ureteral stones more than 5 mm in size 4.
- Medical expulsive therapy (MET) should be used with caution in children and pregnant women 4.
Preventing Kidney Stone Recurrence
- Lifestyle modifications such as increased fluid intake should be recommended for all patients with kidney stones 3.
- Thiazide diuretics, allopurinol, or citrates may be prescribed for patients with recurrent calcium stones 3.
- Patients at high risk of stone recurrence should be referred for additional metabolic assessment to guide tailored preventive measures 3.