Ask an expert: Can the occasional tipple cause kidney stones?

It is well known that excessive consumption of alcoholic drinks can have negative consequences for our health but can a few glasses of wine every now and then seriously increase your risk of conditions such as kidney stones? We invited leading consultant urologist Mr Anthony Blacker to offer expert insight on the causes of kidney stones and how they are treated. The renowned specialist also gives valuable lifestyle advice on which foods and drinks to avoid to help maintain a healthy kidney and prevent stones from developing.

What are kidney stones?

Kidney stones are solid bits of material that grow from some of the chemical constituents within urine. There are different types of kidney stone, each being made of various chemicals but all types originate from the urine. It's the concentration of the urine that predisposes people to getting them so diluting it is the best way of avoiding all types of stones.

Who gets kidney stones?

Kidney stones are relatively common; around six per cent of the population in the United Kingdom will get stones. Someone who has had a kidney stone before is also more likely to get another one. They can be detected coincidentally when performing a scan or because they are causing pain. Initially, pain is often felt in the back on one side or the other before it moves around to the front and down into the groin. Providing they're treated, kidney stones don't usually cause much harm but they are painful and can cause discomfort.

What foods and drinks can help to avoid kidney stones?

The principal piece of advice that I give people to try and avoid kidney stones is to drink more water. Water is very good at diluting the urine and drinks such as tea and coffee can also improve stone risks. Even alcoholic drinks like beer and wine can be helpful, not because of their alcohol content, but because people tend to drink them in the evenings. Typically, we concentrate our wee overnight so that we don't have to get up to pee during the night. Unfortunately, that concentration is what forms kidney stones.

To avoid that, drinking fluid in the evenings protects you against forming stones. And so, although alcoholic drinks can dehydrate you, they can be part of the fluids that you drink to pre hydrate you before bed. Of course, it would be even better to substitute your alcoholic drink for water, squash or decaffeinated tea or coffee. Spirits, such as whiskey or vodka, dehydrate to an extent where there is no benefit from in taking them as a fluid making them definitely bad for stones. If your urine is looking yellow first thing in the morning, that's a suggestion that you probably have concentrated wee and should have been drinking more overnight.

Other drinks which raise the risk of developing stones are those which include sugar or too much vitamin C, such as fruit juices. Just about all fruit juices, such as cranberry, grapefruit, apple and orange juices can cause kidney stones if they are drunk in excess. Provided they are sugar-free, fizzy drinks don’t increase your risk of kidney stones.

Salt isn’t known to definitely cause stones, but its consumption certainly does cause other health problems so it's very sensible to avoid eating it or adding it to food. Dairy products, such as milk, cheese and yoghurts are good for you and help to protect against kidney stones.

Can kidney stones go away on their own?

Following lifestyle advice should help you to avoid getting kidney stones but there are treatment options available if you're unlucky enough to develop them. Lots of stones will pass through by themselves if they're small enough to do so. Equally some stones in the kidney may remain there for many years without causing any problems or requiring treatment.

How are kidney stones removed?

When stones do require treatment, we can offer lithotripsy for smaller stones, particularly if there's a concern about them. Lithotripsy is also known as ESWL or Extracorporeal Shockwave Lithotripsy. This involves lying on a couch with a jelly pad on your back, over the kidney area where the stone is so that it can be precisely located using ultrasound so the surgeon can target the shockwave therapy accurately. It is transmitted into your back through the jelly pad to focus down onto the stone and is delivered at about one a second for three thousand shocks.

This breaks up the stone and the fragments can then pass naturally through the urine. This treatment can also be used for ureteric stones where the stone has moved out of the kidney into the ureter. The alternative way of treating stones in the ureter is look directly at the stone using a ureteroscope and apply a laser. This treatment is performed under general anaesthetic and the telescope is passed through the urethra and bladder, up to the ureter and the stone. It is also possible to treat stones within the kidney stones using this method. Fragments can be pulled out but only if they're small enough to do. If they are very small, they are left in to be passed spontaneously with the urine.

The other approach in treating kidney stones a surgical procedure that gives directly through the side using a minimally-invasive keyhole technique called PCNL or percutaneous nephrolithotomy. In this procedure, a hole is drilled into the kidney where a tube is then inserted, allowing the surgeon to drill out the stone and suck out the fragments. This treatment tends to be reserved for the most difficult to access or largest stones, particularly stones bigger than two centimetres in maximum dimension.

It is important to remember that most stones will actually pass by themselves and will not require any treatment. Therefore a diagnosis of a stone doesn't necessarily mean that treatment will be needed. Drinking plenty of water will help to keep your kidney healthy and should mean you avoid developing kidney stones all together.

If you are seeking treatment for kidney stones and wish to book a consultation with Mr Blacker, you can do so by visiting his Top Doctors profile.