Drug, shock waves can move kidney stones along

Q: Is there any way to make passing a kidney stone less painful? I went from uncomfortable to unbearable pain within a couple of hours.

The emergency-room doctors gave me narcotic pain relievers, but nothing to speed the stone out. If this ever happens again, I'd like something to help move the stone along.

A: If surgery is not necessary to remove the stone, there is one treatment that may be helpful. The same drug that is used to ease symptoms of prostate enlargement, Flomax (tamsulosin), may facilitate passage of kidney stones (Current Opinion in Urology, March 2008).

Shock-wave treatment (lithotripsy) is sometimes used to break kidney stones into smaller pieces. Flomax has been used in combination with lithotripsy to help smaller stones move. Not all studies show that the drug is effective, however, so you will need to discuss this approach with your urologist.

Q: I've been taking Fosamax for about 12 years. (I'm 45.) Last summer, I had acid reflux and pain. My doctor discovered I have Barrett's esophagus, a pre-malignant condition of the esophagus.

I hate to think I could have ended up with esophageal cancer. Could Fosamax have caused my esophagus problem? My doctors disagree.

In any event, no more Fosamax for me. I'd be very interested in any information you have on other approaches to osteoporosis.

A: Fosamax can be very irritating to the esophagus. Diane Wysowski, Ph.D., of the Food and Drug Administration has suggested that people with Barrett's esophagus should not take it (New England Journal of Medicine, Jan. 1, 2009). There don't seem to be enough data to determine if Fosamax, Actonel and Boniva actually increase the risk of esophageal cancer (New England Journal of Medicine, April 23, 2009). This is a controversial question.

We are sending you our Guide to Osteoporosis, which has a more complete discussion of risk factors, prevention and other treatments for this condition. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. U-92, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q: I am a 62-year-old male emergency-room nurse with a history of drinking six to eight alcoholic drinks a day for the past 30 years or so. My drinking is confined to the hours between 5 and 10 p.m. I drink because I like the buzz.