Does drinking a lot of water help a stone pass faster?

If you’re in the unfortunate position of trying to pass a kidney stone, you’d probably want to speed up the process along as much as possible. One common strategy used by patients and occasionally suggested by physicians is to drink tons of water in order to try to “flush” out the stone rapidly.

Well, does this actually work? A recent review by the Cochrane Collaboration, a group that publishes information on the effectiveness of healthcare treatments, looked at whether aggressively increasing your fluid intake during a stone episode is effective.  You can read their review here: “Fluids and diuretics for acute ureteric colic

For those of you who just want the short answer: Their review found that aggressive fluid hydration during a kidney stone episode did not help reduce pain or improve the chances of successful stone passage.

For those who want a little more detail, we’ve summarized the two articles used in their review below:

Edna and coworkers published a study on this topic back in 1983. In their study, 60 patients presenting to a hospital in Norway with a kidney stone attack were either given no fluid for 6 hours or 3 liters of intravenous fluid over 6 hours (a liter is about 34 oz). The amount of pain experienced and average duration of pain experienced was compared between the two groups and no differences were seen. The two groups also did not differ in how often surgery was required (11 times in the fluid group and 10 times in the no fluid group).

In a study by Springhart and colleagues published in 2006, forty-three patients presenting to an emergency room in the United States with a kidney stone were either given vigorous hydration or minimal hydration to see if those given the vigorous hydration would do better. Those given “vigorous” hydration received 2000 ml of intravenous fluid over 2 hours while those given minimal hydration received only 20 ml of intravenous fluid an hour. Patients were then observed for four hours in the hospital.  Pain scores, amount of pain medications used, and chances of subsequent successful stone passage were compared. At the end of the study there were no significant differences between the two groups for any measure: pain scores, amount of pain medication, or success at stone passage.

Together, these results suggested that aggressively increasing your hydration during an acute stone episode is unfortunately not likely to help you pass your stone or reduce the pain you experience. However, drinking more fluids routinely as a kidneystoner is an important and effective strategy for stone prevention.

In contrast to these ineffective results involving fluid hydration during a stone episode, there is growing evidence that medications, on the other hand, can help during an acute stone episode. The most commonly used class of medications, known as alpha blockers, have been shown to reduce the pain experience during a stone episode, shorten the time to stone passage, and increase the chance of stone passage.

Image at top of post from Office.com

About Dr. Mike Nguyen

Mike M Nguyen, MD, MPH, is a urologist and an Associate Professor of Clinical Urology at the Keck School of Medicine of USC in Los Angeles, CA. He specializes in the treatment of kidney stones with both surgery and dietary prevention and the in the treatment of kidney and prostate cancer using the latest robotic surgical approaches. He sees patients at clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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11 Responses to Does drinking a lot of water help a stone pass faster?

  1. Joel DeClue Sr. says:

    I have not tackled this subject in any of my other posts, but as a patient, I do have an opinion.

    I have passed 100’s of stones and endured many, many procedures and stent placements and removals for large blocking stones over the last 28 years. I am not a medical professional nor can I offer any advice other than that based on my own experiences and my personal research.

    After passing 100’s of stones naturally, I do not believe that just drinking tons of water or fluids helps to pass kidney stones. If you continue to read, read it ALL, as partionally reading this can be both uninformative and, I believe, can leave you with some very unhealthy and bad advice.

    I know believe based on my own experiences that trying to force out a kidney stone rather than just wait for it to pass on it’s own is a very painful and grueling experience.

    It is my belief that in order to pass a kidney, unatturally, requires many things to occur. Please read very carefully becuase what I am describing is both extremely painful and can result in a blockage of your kidney. You must be prepared to have someone take you to an emergency room if you feel that something is wrong or the pain becomes to unbearable. I can only recommend the first part and think that if a kidney stone is small enough to pass and is in your ureter you should ABSOLUTELY let it then pass naturally.

    If you are not having pain from your kidney stone than just doung the first portion below can be helpful to pass it before it becomes to large, providing it is small enough to begin with.

    First, you must get the kidney stone to pass into your ureter if it has not already done so.

    In order to get a kidney stone into my ureter I try to be as active as possible, jumping jacks, pushups, stairs, jogging, etc. Also lying over pillows at the edge of the bed at my waist with head to the ground to get my kidney upside down and wiggling about in order to get the stone from lower or midpoles to the upper portion if your kidney where the ureter is.

    After it is in your ureter, assuming you can feel it due to mild to severe pain in your back flank than half the battle is won. As long as severe pain and cramping does not push it out then at this point I recommend letting it pass naturally.

    If I feel i must try to pass it by all neans necessary due to severe pain and possible blockage of the ureter and my kidney then I do the following. First, I wait until the pain is becoming severe after drinking fluids, if I am in a place and feel I can attend to get it to pass then now is the time. Otherwise, I lay off the fluids and take meds to try and relax my kidney, ureter and bladder and hope the pain will stop. I have found, that typically a stone in your ureter that does not move and allows urine to pass around it without any blocking will typically not result in further pain. I believe the pain occurs when it is moving and/or blocking the free flow of urine between your kidney and bladder.

    If I am prepared to deal with trying to force a stone out than their are two things you have to think about and they are contradictory. First the severe pain in your ureter from the stone can cuuse it to become stuck and sometimes even push it further back towards your kidney. So medications and other relaxations techniques to prevent that cramping is imperative. Second, when it is in this blocking position than you must drink lots of fluids so the act of urinating pushes the stone towards your bladder. However, it may or may not work. Massive pain in your back flank after knowing the stone is in your ureter is a result of the stone blood blocking or partially blocking urine. That will cause your kidney to swell with fluid and is usually, in my opinion, the most painful part of having a kidney stone.

    So will that urine back-pressure push out the stone? Possibly, but more than likely it can result in just moving the stone enough to allow urine to pass or maybe even put you in the hospital with a blocked kidney.

    Out of many attempts the first part in getting a kidney stone to my ureter has worked well. I then believe in passing it naturally after that. Drinking plenty of fluids, but don’t over do it and stay active.

    As regards to the second part, it has rarely worked for me. In fact only one case I am aware of.

    I thought I was passing a 9mm round x 12mm in length stone. Turned out to be two shoved together. Anyway, these were in my ureter for almost four months and causing regular pain. A day and a half before my wedding, I took pain meds, moved around a lot doing the kidney stone boogie and when I started feeling pain in my kidney I drank water by the gallons, and was in absolute agony the whole while highly medicated. I drank water for 18 straight hours and then stopped from both pain and exhaustion. Finally I slept about 3-4 hours before getting ready and walking down aisle.

    I passed those stones about 2 hours after we said our “I do’s”.

    I believe what I did was rash, stupid, dangerous and a terrible idea after the fact.

    So, after all of that! Fluids and getting a passable kidney stone into your ureter is, I believe, possible, healthy and one thing you should do to pass a stone. The second is let it pass through your ureter naturally. Lastly, if you know it is in your bladder and not passing, do the same things you would to get it from your kidney to ureter, that usually works for me to get it all the way out.

  2. CS says:

    My first kidney stone was 7 years ago. The pain was so bad all I could do is pace the floor. Sitting, standing or lying down did nothing as the pain was the same. Forget sleeping. After 4 days of this agonizing pain I decided to try to flush it out after reading online about drinking a lot of water. I used water and cranberry juice 100%. I bought the biggest bottle i could find in the grocery store. I drink this until it was all gone which took about 30 minutes. After that, I started drinking bottle water until I had to go to the bathroom. I held it for as long as I could to the point of almost peeing on myself to make sure when I let it go that there would be a major rush of urine and so much that needed to come out that maybe the stone would be carried out with it. It worked. It was very painful and felt like someone stuck a cattle prod ( very strong shocker ) right between my legs under the scrotum. I guess it was the stone going through the prostate. It hurt so bad I jumped and peed all over the floor. I have to say it worked for me and it was not fun but it sure beat the unbearable pain 24 hours a day. The stone was large and jagged which explained the agonizing pain and was such a relief when it plopped out into the screen the doc gave me. All the pain was immediately gone. Now 5 years later I am at that crossroads again. This time the stone got stuck in the ureter. Very painful, I woke up and went to the bathroom normally like always and in the middle of urinating I felt the shock and severe pain in my penis. It made me jump again because i was not expecting it. It hurt very bad and there was obviously not enough urine left to flush it out. The next 2 times I went, same thing. Shock and pain. I could feel it was stuck in there so i remembered what I did with the first stone I had and tried that again. After 2 gallons of water and cranberry juice drank over a period of about 45 minutes I could not hold it. I had to go so bad I was dancing all the way in the bathroom and could still feel it stuck in there. There was so much fluid built up from holding it so long when I let it go the stone just popped right out. Another large one but this time I felt no pain when it came out. I am a believer on this method and it has worked for me twice now. Everyone is different and every body does not react the same but it worked for me maybe it will work for some of you also.

  3. Tom says:

    The last time I went to the ER with kidney stones they gave me Hydro Codone to take 1 a day. Every other time I’ve been (usually have a stone every 2-4 years) I was given a prescription of the same meds to take 1 every 4 hrs. and enough to last a few weeks. So when I was only given enough to last a week at 1 a day, that was ridiculous. Luckily I had some left over from other times I had kidney stone else I would have been in bad shape having to deal with the full level of pain for the week it took to pass the three stones.

  4. Kirsten says:

    I was told yesterday at the ER that I had a small kidney stone that had traveled down and was almost to the bladder. I was given hydro codone with acetaminophen. I am supposed to take it every 8 hours based on pain and drink lots of water. I take the mess but still experience pain, is there anything else I can take and how long should it take to pass the kidney stone at this point?

    It’s my first one, hopefully last.

    Thanks

  5. Jean says:

    I have kidney stone 3cm was sent home on narcotic pain meds, anti nausea meds and flomax. This was on a Wednesday. Thursday and Friday I felt okay and was able to eat little solid food. Since Friday night I am constantly nauseated and have to struggle to keep down fluids. Nausea pills seem to be doing nothing. I can tolerate a little applesauce. I have a bout of loose stools every morning. Saturday was horrible, pain, vomiting all day into evening. I feel so weak and know I’m getting dehydrated. Is this the normal routine while waiting to pass a stone. I feel awful. Thanks

    • Jean says:

      What happens if you cannot keep a lot of fluids down because of constant nausea? No one seems to address the nausea just the pain.

    • Glenn says:

      I’m guessing you mean 3mm.

      I’m taking Tamsulosin (flomax), percocet (narcotic pain med), and Ondansetron (anti-nausea) all prescribed by the ER. Saw my PCP the next day and he also prescribed Ketorolac (NSAID pain med) indicating it may help more than the percocet. Hard for me to tell. So far the biggest pain relief has been jumping into a hot bath. Seems to pull the pain and nausea down for me or could be coincidence. I had tried a heating pad, but it didn’t help nearly as much.

      I’ve been drinking tons of water and it doesn’t seem to have an effect.

    • Joel DeClue Sr. says:

      First, I am not a Doctor or medical professional. I am only a patient whom has passed 100’s of stones and endured numerous procedures relating to kidney stones over 28 years.

      Going along with what Glenn said, is this a 3mm that would be passable or is this truly a 3cm stone in your kidney?

      A 3mm stone can pass through your system and depending on the individual the reaction to the passing of a stone of that size can be all the way from minimal pain to what you are describing, in addition to how you personally react to the medications prescribed.

      If it is truly a 3cm stone and it is not in your kidney, rather in your ureter, bladder or urethra you need to see a Urologist immediately! If it is in your kidney then it has most likely moved to the upper pole/region of your kidney where it can constantly obstruct the ureter but not pass into it due to the large size of the stone. That can also describe your symptoms as many people react very differently to both kidney stones and the medication you are taking. For example, I tolerate pain meds and rarely or ever become nauseous due to pain or meds. However, a large stone constantly obstructing the ureter causes bouts of unbearable pain and in many instances periods of cramping and pain that well exceeds the pain medication.

      In either case, I believe you need to see a Urologist if not an ER immediately. Either to have it removed or to have a stent placed between your bladder and kidney which will keep the stone from moving up against the ureter and blocking your kidney from draining properly. A stent is a pliable tube with circular perferated ends. This stent keeps the opening to your ureter from being blocked while allowing urine to pass through the end and the perforations down to your bladder. Typically the majority of pain, serious debilitating pain, is a result of your kidney not draining properly and swelling as a result. This stent is a temporary measure that allows a Urologist time to schedule and perform a procedure to have the stone removed.

      When I visit an ER, I always have them medicate me asap, as they can monitor and provide you with many more pain relieving options than you can be prescribed to take at home. Additionally, I insist they bring in an on-call Urologist to place a stent if needed rather than allow them to place a drainage tube externally and into your kidney resulting in an open procedure unless they can absolutely provide you no alternative. Also, I have never had an on-call Urologist offer to or perform any procedure to remove the stone, only place a stent so it can be removed at a later date.

      Personally I have turned down drainage tubes numerous times and have received stents even if it means waiting much longer. The stent has either been placed while in the hospital or the following day or two by having a Urologist force it into their schedule as an emergency out-patient procedure. I have only been able to get a Urologist to schedule a procedure to remove the stone within a day or so three times, every other time I was forced to have the stent placed first if I could not wait longer.

      Again, I am a patient and these are my opinions and thoughts. I am not a medical professional and can not offer valid medical advice as a result.

  6. Pedro says:

    Hi. I currently have one stone (7mm by 4mm) stuck in the abdominal-pelvic transtition, right near the iliac blood vessels. I experienced very light pain one week ago in the lowe abdomen but it has since disappeared. My physician says I should not drink many liquids because he says it won’t help. But my question is, does drinking many liquids cause any possible injury to the kidney? I still urinate easily, have no fever and no blood in the urine (this is my 4th experience, the least painful of all, but with the largest stone so far). I really want to know whether I can take a chance on the flooding of the system or not. Will it cause a colic? But won’t the colic make the stone move forward? Thank you

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