Have you ever had a kidney stone? It’s no fun- am I right? Unfortunately, kidney stones are a common complication after weight loss surgery due a host of reasons and is a popular topic I discuss in my bariatric support groups. In this blog post, we’ll discuss the risk factors of developing kidney stones after surgery, important measures to prevent the development of kidney stones, and what to do if you are trying to pass one.
Weight Loss Surgery And The Risk of Kidney Stones
After weight loss surgery- especially rerouting procedures like the Roux en Y or Duodenal Switch, you are at a higher risk of developing kidney stones.
Why? Your intestines are responsible for helping you absorb calcium, uric acid, and other minerals. After weight loss surgery, the newly created intestinal detour affects the absorption and reabsorption of these elements. As a result, the checks-and-balances of calcium and uric acid are altered, leading to the development of kidney stones.
Unfortunately, if you’re currently battling a kidney stone now, or have had any in the past, you’re already at a higher risk of getting them again.
How Can You Help Prevent Kidney Stones?
As we always discuss in the bariatric support community- drink, drink, drink (water). Staying hydrated is the most important preventive measure you can make to prevent the development of kidney stones.
Also depending on where you live- ie: somewhere warm- be extra intentional about drinking back the water you lose from the hotter temperature and heat.
Dehydration is one of the biggest risk factors for developing kidney stones.
Aim to drink two to three liters a day.
To help you increase your water intake, you can check out my tips on how to drink more water throughout the day. Also, be sure to grab my FREE Water Habit Tracker from the Healthy Habit Workbook!
Avoid these food/ drink items, as they can worsen your chances of building stones. Think of anything dark colored:
- Dark chocolate
- Dark leafy vegetables
Reminder: If you’ve had weight loss surgery, it’s important not to have anything carbonated to avoid swallowing a lot of air that could cause pressure and swelling on your stomach / pouch.
Prioritize these items instead (citrus):
While you’re drinking 2-3 L of water per day, add in some freshly squeeze citrus. I’m always a proponent of whole / clean foods, so try to avoid squirting anything into your water. These products are loaded with artificial ingredients and chemicals and can cause fully body inflammation when you have them often or as a regular part of your diet.
What Happens When You Do Have A Kidney Stone?
Depending on the size of the kidney stone- if it’s upwards of three millimeters- you will likely be able to pass it safely on your own.
As you urinate, you may notice the passage of fine-grain sand, or even the tiny stone itself.
Where Are The Most Common Places Where Kidney Stones Get Stuck?
There are 2 places that kidney stones typically get stuck: 1) as it leaves the kidney and begins to travel down the ureter(the path that connects your kidney to your bladder). You’ll feel this as upper back pain on one side typically. And 2) as the stone is trying to enter into the bladder.
Therefore, the most common places are exiting the kidney and entering in the bladder.
What Are The Treatments For Kidney Stones?
Kidney stones that stay put in the kidney don’t usually cause problems. Unless of course, they become very large and hard. These are typically identified on a CT scan of your abdomen. When they become larger in size, your Urologist will likely have to use shockwave therapy or perform a surgical procedure to fragment the stone for removal.
If you have a kidney stone that is stuck and is causing a blockage, your Urologist will need to insert a stent (in the operating room), in order for urine to have an open lane to empty around the stone. Your Urologist will also remove your stone with a special “basket” instrument / laser. The stent will be removed a few weeks after the procedure (in the office).
However, if your kidney stone is only a few millimeters in diameter, you’ll likely be able to pass it on your own with thorough hydration and medications.
What Should You Take For Pain?
When it comes to over the counter pain medication- Tylenol is pretty safe. That is, assuming you don’t have significant liver disease.
You do NOT want to take Toradol.
Toradol is a nonsteroidal anti-inflammatory drug (NSAID), which is a category of medications that includes Aspirin, Ibuprofen, Motrin or Aleve.
You CANNOT take those medications for the rest of your life after you’ve had weight loss surgery.
These medications can cause ulcers to form along the incision lines and connections of your surgery. Ulcers can cause leaks to happen- causing significant pain and re-operation to repair.
Again, avoid taking these medications unless instructed to do so by your medical providers:
Side note about Toradol:
If you’re suffering from a kidney stone and you go into the emergency room, they will liking giving you Toradol as a first line pain medication. It is very important to tell them that you’ve had weight loss surgery, and that you can’t have this kind of medication. They’ll still be able to address your pain needs with Tylenol and other kinds of stronger pain medication.
Aside from pain medication, you will likely be given a medication called Flomax or Tamsulosin. This medication helps to dilate the tubing system that carries your urine, giving your kidney stone more room to pass.
Another medication that they might give you is Pyridium, which is an orange dye (in pill form) and will discolor your urine. It can also stain contact lenses, so be sure to wear glasses while taking this medication.
Pyridium helps to lubricate and soothe the entire pathway from your kidneys into your bladder to prevent spasms.
Analyzing Your Stones
If you have been diagnosed with having a kidney stone, and are having pain from the “passing” component, be sure to speak with your primary care provider or Urologist about straining your urine. As you go to the bathroom, be sure to use a strainer to catch any stones or stone fragments that pass.
From there, you can send them over to your doctor to be analyzed. Once the type of stone is identified, specific dietary measures can be put into place to help prevent that specific type of stone from forming in the future.
IMPORTANT: Enlist the assistance of a Urologist to more specifically address your kidney stone needs.
Don’t forget to pay attention to what you can control in order to lower your risk of forming kidney stones:
- Water intake: at least 2 liters.
- Add citrus: whole fruit versions like lemon or lime.
- Avoid dark things: colas, coffee, tea, dark chocolate.
- Do not take Toradol (or any NSAID medication) for pain IF you’ve had weight loss surgery.
- Tylenol is okay. Other stronger medications may need to be prescribed in addition to Pyridium and Flomax
- Save your stone to send it for analysis
Kidney stones are a common complication after weight loss surgery but can be prevented with appropriate lifestyle modifications. Download this FREE INFO SHEET on kidney stones to learn more!