First, I would want to exclude an anatomical abnormality. They can cause obstruction and predispose to stone formation. This can be done with a CT scan or intravenous urogram.
Metabolic abnormalities and dietary imbalance can also cause recurrent stones.
- Excessive oxalate can predispose to calcium oxalate stones. Foods like beets, spinach, chocolate and kale are high in oxalate.
- Excess uric acid in the urine (hyperuricemia) can lead to recurrent uric acid stones. This is the case for patients with gout or uric acid rich diet
- Citrate is an inhibitor of stone formation. Low levels in the urine predispose to stone formation. Foods high in citric acid such as lemons and limes can help boost the level of citrate in the urine. Thus, it will help to reduce stone formation.
Metabolic or dietary causes of recurrent stones can be diagnosed with blood tests and 24 hour urine collections. Dietary changes and/or medications can then be tailored to treat the problem.
