Q: I’ve had about 20 kidney stones over the years, with shockwave treatment three times.
My urologist put me on a diuretic, HCTZ, which flushed my kidneys. Since I started taking it, I have not had a single kidney stone.
A: Thank you for sharing your experience. Urologist Fredric Coe agrees that thiazide diuretics such as hydrochlorothiazide (HCTZ), chlorthalidone or indapamide can reduce the chance of kidney stones. Researchers have found that low-dose thiazides work as well as high doses to prevent development of kidney stones (Canadian Journal of Health and Disease, July 15, 2018).
Dr. Coe recommends some diet and lifestyle changes as well. Drinking plenty of fluids and avoiding foods rich in oxalate can help. These include peanuts, rhubarb, spinach, beets, chocolate and sweet potatoes.
You can learn more about kidney stones from our recent free podcast on the topic. It is Show 1148: What Can You Do About Kidney Stones? at www.PeoplesPharmacy.com.
Q: I was given a Medrol Dosepak for a rash that developed following gallbladder surgery. I was highly allergic to the glue used to seal the incision.
I picked up the prescription in the evening and took the pills before going to bed. That was the biggest mistake of my life! The severe adverse reactions began the next day and did not slow down for months. Five years later, I still suffer from the aftereffects of this steroid.
I had every side effect imaginable: insomnia, severe fatigue, muscle weakness that interfered with walking, muscle spasms, shooting pains all over my body, high blood pressure, anxiety, increased blood sugar levels, depression, heart palpitations, ulcer, sprained ankle and tendonitis in my foot. Why don’t doctors warn you about adverse effects?
A: Methylprednisolone (Medrol) is a powerful corticosteroid. The Dosepak you received provides a loading dose that is gradually tapered over several days.
Doctors often prescribe a short course of treatment with drugs like prednisone or methylprednisolone to treat serious inflammation. This kind of “burst” dosing is used for rashes, back pain, sinusitis, bronchitis and a range of allergic reactions.
Many health professionals assume that such steroid treatment is very safe. But the reactions you describe are not uncommon. Researchers from Taiwan report that even a short course of treatment with corticosteroids can lead to bleeding ulcers, sepsis and heart failure (Annals of Internal Medicine, Sept. 1, 2020). Doctors should warn about potential steroid side effects, even when such drugs are prescribed for short periods of time.
Q: I had complained to my gastroenterologist about having lots of gas. He asked if I chew sugarless gum — I responded yes. I did not know that sugarless gum contains sorbitol, which can cause gas.
A: Sorbitol, maltitol, mannitol, xylitol and other “sugar alcohols” are sweet but not as caloric as sugar. Consequently, they may be used instead of sugar in certain diet desserts, candies or chewing gum. Because our bodies don’t absorb these compounds, they provide fodder for our intestinal bacteria to create gas or diarrhea. While most people can tolerate such foods in moderation, some are more sensitive and should avoid them.
We discuss causes and treatments for gas and other gastrointestinal woes in our eGuide to Overcoming Digestive Disorders. This online resource is located in the Health eGuides section at www.PeoplesPharmacy.com.