[Click! Health] Stones Increasing in Summer... Drink Plenty of Water to Prevent Urolithiasis

If you suddenly feel pain in your side and notice blood in your urine, you should suspect urolithiasis. Patients with urolithiasis need to be especially cautious during the summer, as cases tend to increase during this season. According to the Health Insurance Review and Assessment Service on the 16th, an analysis of the number of patients over the past five years by month showed that the number of urolithiasis patients was highest in the summer months (July to August), particularly in August. In January 2021, there were about 39,000 patients, which increased to approximately 46,000 in August of the same year. It is also known that urolithiasis patients are relatively more common in hot regions such as the Middle East and tropical areas.

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Professor Park Hyung-geun of the Department of Urology at Seoul Asan Medical Center explained, "When working in a hot environment or exercising intensely and sweating a lot, if fluid intake is insufficient, urine volume decreases and becomes concentrated," adding, "Fluid loss promotes the formation of stones, which is a major cause of urolithiasis." Therefore, it is important to drink enough fluids during the summer when sweating is heavy. Additionally, exposure to sunlight in summer activates vitamin D production, which affects calcium metabolism, and this factor is also known to increase the risk of stone formation.

The symptoms of urolithiasis vary depending on the location of the stone. Kidney stones usually cause no pain initially, but when fluid intake increases and urine volume rises, pain may occur in the flank area. In contrast, ureteral stones cause pain in the flank or the area near the ribs and spine, known as the costovertebral angle. Even a slight tap on the side can cause severe pain. In men, the pain often radiates to the bladder, scrotum, or testicles, while in women, it may spread to the vulva. When stones are located in the lower ureter, symptoms of bladder irritation such as frequent urination, urgency (inability to hold urine), and a feeling of incomplete emptying may appear.

Pain caused by stones occurs intermittently. It appears suddenly, disappears, and recurs repeatedly. More than 90% of urolithiasis patients show microscopic hematuria, and 5-10% may have visible blood in the urine. If acute flank pain is accompanied by hematuria, urolithiasis can be strongly suspected. Without proper treatment, pain may recur, or urinary tract infections caused by bacteria may develop. In severe cases, kidney function may deteriorate, leading to renal failure. If urolithiasis is accompanied by infection, serious complications such as pyelonephritis, sepsis, or malignant tumors may occur.

Treatment methods vary depending on the location and size of the stone. Stones smaller than 4-5 mm are naturally expelled in 60-80% of cases through increased fluid intake and medication. However, if the stone is 6 mm or larger or located in the upper ureter, the likelihood of natural expulsion is low, and shock wave lithotripsy is used to break the stone from outside the body, facilitating natural expulsion.

Since 30-50% of urolithiasis patients experience recurrence within five years, efforts to prevent recurrence are essential. It is important to control diet and maintain adequate hydration. The key to preventing urolithiasis is drinking about 2-3 liters of fluids daily. Increased diuresis from fluid intake shortens the time stones remain in the urine and dilutes the stone-forming substances. For example, when sugar is added to a cup of water, if there is too little water, the sugar does not fully dissolve and crystals form; but with enough water, the sugar dissolves properly and does not aggregate into crystals.

Patients with urolithiasis are sometimes advised by those around them to drink beer because alcohol has a diuretic effect that increases urine volume. If the stones are small, natural expulsion may be possible, so drinking beer might help with stone passage. However, alcohol consumption can cause dehydration, reducing urine volume and potentially causing the opposite effect, so long-term consumption is not advisable. Additionally, purines in beer are metabolized into uric acid in the body, and accumulation of uric acid can contribute to stone formation. Therefore, frequent hydration and exercise are better for naturally expelling urolithiasis than drinking beer.

Citrus fruits containing citric acid, such as lemons and oranges, are also good for preventing urolithiasis. It is recommended to reduce intake of salt, oxalate, and animal protein while consuming foods rich in citric acid. Restricting calcium intake can increase the risk of stone formation, so calcium should be consumed in appropriate amounts. For patients with frequent recurrences, visiting a hospital to address factors that promote urolithiasis?such as urinary retention (a condition where a significant amount of urine remains in the bladder after urination), infection, and decreased urine volume?is also a method of prevention.