Laxatives And Kidney Stones: Safe Or Not?

Kidney stones are small, hard lumps of mineral and uric acid salts that form in the body. They can be caused by dehydration, a high-salt diet, or certain medical conditions. While laxative abuse is associated with kidney stones, it is not clear whether taking a laxative with a kidney stone is safe. In one case, a patient with idiopathic hypercalciuria and an eating disorder was found to have nephrolithiasis associated with laxative abuse. However, it is recommended that you consult with a physician before taking any over-the-counter medication, especially if you have kidney disease.

Laxative abuse and kidney stones

Laxative abuse, eating disorders, and kidney stones are interconnected, as evidenced by case reports and literature reviews. While kidney stones are listed as a complication of eating disorders, there have been very few reported cases of this occurrence. However, in one case, a patient with idiopathic hypercalciuria developed nephrolithiasis due to laxative abuse, which resulted in low urine volume and high supersaturation of calcium oxalate and phosphate. This combination of factors increased their risk of kidney stone formation.

Laxative abuse can lead to kidney stones, including calcium oxalate or ammonium urate stones. Chronic laxative abuse can cause intestinal losses of potassium and bicarbonate, which can contribute to hypokalemic metabolic acidosis. Additionally, laxatives can result in kidney stone formation and may yield false-positive urinary acidification test results.

The relationship between laxative abuse and kidney stones is complex and varies with individual cases. In some instances, laxative abuse may mimic distal renal tubular acidosis (dRTA), leading to non-anion gap metabolic acidosis with hypokalemia and impaired urinary acidification. However, further investigation and kidney biopsy may be necessary to distinguish between dRTA and laxative abuse as the underlying cause.

It is important to note that kidney stones can impact bowel function and lead to digestive issues such as irritable bowel syndrome (IBS), bowel obstruction, diarrhea, and constipation. Treating kidney stones with certain medications can also increase the risk of constipation. Therefore, it is crucial to consult a physician before taking any over-the-counter medications, including laxatives, especially if you have kidney stones or kidney disease.

Laxatives and kidney disease

Constipation is a common problem for people with chronic kidney disease. This is due to several factors, including the side effects of other medications such as iron and calcium tablets, and the dietary restrictions that are often necessary for kidney disease patients.

Laxatives can be used to treat constipation in patients with kidney disease, but it is important to be cautious and consult a doctor before taking any over-the-counter medication. Some laxatives may not be safe for those with kidney disease, as they can cause fluid imbalance or hypermagnesemia. For example, magnesium-containing products should be avoided as they can accumulate in patients with kidney disease.

Safe laxatives for those with kidney disease include PEG3350 (Restoralax, Miralax), PEG3350 with Lytes (PEGLyte, GoLytely), Bisacodyl (Dulcolax), Senna (Senokot), and Lactulose. Docusate (Colace) is also safe but may not be very effective.

Lifestyle and dietary changes are recommended for kidney disease patients experiencing constipation. Increasing fluid intake and consuming more fibre can help to soften stools and promote regular bowel movements. However, those with advanced chronic kidney disease may need to limit their fibre intake to prevent hyperkalemia.

Pharmacological treatments are often necessary to treat constipation in patients with chronic kidney disease. Bulk-forming laxatives, osmotic laxatives, and stimulant laxatives are all available options. Lubiprostone, a chloride channel activator, has been shown to be safe and effective for patients with kidney disease. Linaclotide and plecanatide, which are guanylate cyclase-C agonists, also appear safe for these patients due to their very limited systemic absorption. Tenapanor, an NHE3 inhibitor, is another option that provides the additional benefit of reducing hyperphosphatemia. Prucalopride, a selective 5-HT4 receptor agonist, may also be prescribed but at a reduced dose for those with impaired renal function.

In summary, constipation is a common issue for those with kidney disease, and there are several safe and effective laxative options available. However, it is important to consult a doctor before taking any new medication, as some laxatives may be unsafe for those with kidney disease, and lifestyle and dietary changes may also be necessary to manage constipation.

Home remedies for kidney stones

Kidney stones are a common health problem, with about 12% of men and 5% of women in the United States developing them during their lifetime. Passing these stones can be incredibly painful, and unfortunately, people who have had kidney stones are more likely to get them again. Here are some home remedies that may help:

• Stay hydrated: Drinking plenty of fluids can help pass kidney stones and prevent new ones from forming. Aim for about 2 liters of urine output daily. Water is the best option, but you can also drink ginger ale, lemon-lime sodas, and fruit juices.
• Increase your citric acid intake: Citric acid may help prevent calcium oxalate kidney stones by binding with calcium in the urine and preventing stone formation and enlargement. Eat more citrus fruits, such as grapefruit, oranges, lemons, or limes, or add lemon or lime juice to your water.
• Limit foods high in oxalates: A high oxalate intake may increase oxalate excretion in urine, which can be problematic for people prone to forming calcium oxalate crystals. Foods high in oxalate include leafy greens, fruits, vegetables, and cocoa. However, a strict low-oxalate diet is no longer recommended for all stone-forming individuals. Consult a healthcare provider or dietitian before limiting your intake of oxalate-rich foods.
• Get enough calcium: Contrary to popular belief, decreasing your calcium intake does not reduce your risk of forming calcium-containing stones. A diet high in calcium has been associated with a decreased risk of stone formation. Dairy products like milk, cheese, and yogurt are good dietary sources of calcium.
• Increase your magnesium intake: Magnesium is an important mineral with several health benefits, and some studies suggest it may help prevent calcium oxalate kidney stone formation. Avocados, legumes, and tofu are good dietary sources of magnesium.
• Eat less animal protein: A diet high in animal protein sources, such as meat, fish, and dairy, is associated with a higher risk of kidney stones. Plant-based protein sources are a better option.
• Apple cider vinegar: Apple cider vinegar contains acetic acid, which helps dissolve kidney stones and may reduce the formation of new ones. Add 2 tablespoons of apple cider vinegar to 6 to 8 ounces of drinking water, and avoid consuming more than one 8-ounce glass per day.
• Celery juice: Celery is used in some traditional medicines as a kidney stone remedy, and a study found that female participants with kidney stones ate less celery than those without kidney stones. Blend one or more celery stalks with water and drink the juice, but check with a doctor first as celery can interact with other medications.
• Pomegranate juice: Pomegranate juice contains antioxidants, which may help keep the kidneys healthy, although the National Kidney Foundation notes that it does not affect kidney stone prevention.
• Kidney bean broth: Kidney bean broth is a traditional Indian dish that some people claim can improve urinary and kidney health, although there is little evidence to support this.
• Dandelion: Parts of the dandelion plant may help eliminate waste, increase urine output, and improve digestion, and a study showed that it is effective in preventing kidney stones in lab samples. However, human studies are needed to determine its safety and effectiveness.
• Wheatgrass: Wheatgrass may increase urine flow to help pass kidney stones, and it contains nutrients that help cleanse the kidneys. Start with a small amount and gradually increase to the recommended serving to prevent side effects.
• Horsetail: Horsetail is used as a diuretic to increase urine flow and has antibacterial and antioxidant properties that could aid in overall urinary health. However, the National Kidney Foundation notes that horsetail may be unsafe for people with kidney disease.

It is important to note that some of these remedies may interact with certain medications or supplements, so it is always best to consult a doctor before trying any home remedies, especially if you have any chronic conditions or are pregnant or breastfeeding.

Dietary changes to prevent kidney stones

Kidney stones are small, hard lumps of mineral and uric acid salts that form in the body. They can be extremely painful to pass and can cause digestive issues like irritable bowel syndrome (IBS) and bowel obstruction, as well as diarrhea or constipation. Making dietary changes can help prevent kidney stones. Here are some recommendations:

• Drink plenty of fluids: Water is the best option, but coffee and lemonade are also good choices. Aim for 2-3 quarts or 8-12 cups per day to ensure you're producing enough urine. Fluids help flush out minerals and other substances that contribute to kidney stone formation.
• Limit sodium intake: Sodium increases the amount of calcium in your urine, which can trigger kidney stones. It's found in salt, as well as many canned, packaged, and fast foods, condiments, seasonings, and meats. Aim for less than 2,300 mg per day.
• Consume calcium-rich foods: Calcium-rich foods can help prevent calcium oxalate stones by combining with oxalate in your intestines and reducing the risk of stone formation. Good sources include dairy products, soy products, beans, seeds, fortified tofu, and some green vegetables like kale and broccoli. Aim for 1,000-1,200 mg of calcium per day.
• Limit animal protein: Eating animal protein may increase your chances of developing kidney stones. Limit your intake of beef, chicken, pork, organ meats, milk, cheese, and other dairy products. However, ensure you're still getting enough protein by replacing some animal protein with plant-based sources like beans, dried peas, lentils, and peanuts.
• Eat more fruits and vegetables: A diet rich in fruits and vegetables can help prevent kidney stones by increasing urinary citrate, a natural acid that prevents calcium bits from sticking together in the urine.
• Be cautious with vitamin C supplements: While vitamin C is beneficial, high doses of 1,000 mg or more per day have been linked to an increased risk of kidney stones in men. It's best to get your vitamin C from food sources.
• Monitor your oxalate intake: High levels of oxalate in the urine can contribute to kidney stone formation. Oxalate is found in many healthy foods like spinach, beets, nuts, wheat germ, rhubarb, and soy. Instead of eliminating these foods, focus on eating a varied diet, drinking extra water, or pairing oxalate-rich foods with dairy.
• Avoid certain activities that cause excessive sweating: Activities like saunas, hot yoga, and heavy exercise can lead to dehydration and reduced urine production, creating an environment conducive to kidney stone formation.

It's important to note that these are general recommendations, and individual needs may vary. Consult a healthcare professional or a registered dietitian for personalized advice and to determine the specific type of kidney stones you have, as diet changes can be individualized based on the type of stone.

Medication to help pass kidney stones

Kidney stones are small, hard lumps of mineral and uric acid salts that form in the body. They can vary in size, ranging from as small as a grain of rice to as large as a golf ball. The exact cause of this condition is not always clear, but certain factors may increase the risk of kidney stone formation. These include a family history of kidney stones, a diet high in salt or protein, and medical conditions such as gout or hyperparathyroidism.

Most kidney stones are small and will pass out of the body through urine without the need for medical intervention. Staying hydrated by drinking plenty of water is essential for passing kidney stones and preventing their formation. However, larger kidney stones may require medical treatment to facilitate their passage. Here are some medications and procedures that can help:

• Pain relievers: Pain medications such as ibuprofen or diclofenac can be taken to manage the pain associated with passing a kidney stone.
• Alpha-blockers: Alpha-blockers, such as tamsulosin, can be prescribed to relax the muscles in the lower part of the bladder, making it easier for kidney stones to pass. They are particularly recommended for stones larger than 5 mm and have been shown to increase the likelihood of stone passage. However, it is important to note that alpha-blockers are not specifically approved for treating kidney stones.
• Calcium channel blockers: Calcium channel blockers, such as nifedipine, can also be used to relax the ureter and facilitate stone passage. Like alpha-blockers, they are not specifically approved for this use.
• Extracorporeal shock wave lithotripsy (ESWL): For stones that are too large to pass naturally, ESWL can be used. This procedure employs high-energy sound waves to break up the stones into smaller fragments that can then be flushed out in the urine.
• Ureteroscopy: In this procedure, a ureteroscope is inserted into the urethra and advanced up into the urinary tract. The stone is then broken up using a laser or mechanical means and either flushed out or removed using the endoscope. This method is typically used for stones larger than 10 mm in diameter.
• Percutaneous nephrolithotomy (PCNL): PCNL is a surgical procedure where an endoscope is inserted through a small incision in the back to reach the kidney or renal pelvis. The kidney stones are then broken up using a laser or mechanical means and removed using tiny forceps. This approach is generally used for stones greater than 10 mm in diameter.

It is important to consult with a healthcare professional to determine the most appropriate treatment option for kidney stones, as the choice of medication or procedure will depend on the size, location, and composition of the stones, as well as the patient's medical history and overall health.

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