Kidney Stones and Dehydration in Arugam Bay: Why the Tropical Heat Raises Your Risk

We see more kidney stones in Arugam Bay than you’d expect for a small coastal town, and heat is almost always part of the story. Travelers arrive from cooler climates, spend all day in the sun surfing or sightseeing, and quietly run a fluid deficit for days without noticing — until a sudden, severe pain in the back or side sends them through our door. Kidney stones aren’t caused only by dehydration, but tropical heat is one of the biggest risk factors we see, and it’s one that’s entirely within your control.

Why the tropics raise your risk

A kidney stone forms when minerals and salts in your urine become concentrated enough to crystallise, usually calcium combining with oxalate. The single biggest factor that makes this more likely is simply not producing enough urine, which happens when you’re not drinking enough water relative to how much you’re sweating.

Arugam Bay stacks several things against you at once:

• Constant sweating. Heat and humidity mean you lose fluid all day, even lounging in the shade, let alone surfing.
• Long hours in the water. A two- or three-hour surf session doesn’t feel like exercise in the same way a gym session does, so people often forget to rehydrate afterward.
• Alcohol and caffeine in the evenings, both of which increase fluid loss through urine.
• Traveler’s diarrhoea or vomiting, which drains fluid fast on top of what the heat is already taking.
• A change in diet — more grilled fish, curry, and salt than usual, which can affect the mineral balance in urine for people who are already prone to stones.

None of this means a kidney stone is inevitable. It means the margin for error on hydration is smaller here than it is at home.

Symptoms

Kidney stones are notorious for how suddenly and severely they announce themselves. Watch for:

• Sudden, severe pain in the back or side, below the ribs, that comes in waves
• Pain that radiates toward the lower abdomen or groin as the stone moves
• Blood in the urine — sometimes visible, sometimes only picked up on a dipstick test
• Nausea and vomiting alongside the pain
• A frequent urge to urinate, or pain when urinating
• Restlessness — people with a kidney stone often can’t find a comfortable position, unlike someone with a stomach problem who tends to lie still

If the pain comes with fever and chills, that can mean the stone has caused an infection above it in the kidney, which is more urgent and needs treatment quickly.

What to do if you suspect a kidney stone

Come and see us. We can examine you, do a urine test to check for blood and rule out infection, and give you proper pain relief — the pain from a kidney stone is genuinely one of the worst pains people experience, and there’s no reason to try to tough it out with whatever’s in your first aid kit.

While you’re getting to us:

• Drink water if you can keep it down. Steady sips, not large gulps if you’re nauseated.
• Avoid more NSAIDs than the packet allows — ibuprofen can help with stone pain and is often what we use, but don’t self-dose beyond the recommended amount, especially if you’re dehydrated, since it can affect the kidneys further.
• Note what the pain is doing — where it started, whether it’s moved, whether you’ve seen blood in your urine. This helps us assess quickly.

Most stones under about 5mm pass on their own with pain control and good hydration, sometimes helped along with a medication that relaxes the ureter. Larger stones, or a stone blocking the kidney completely, may need referral to a hospital with urology facilities for further treatment. We’ll make that call together based on the size and position if imaging is needed, and we can arrange transport if a transfer is required.

Prevention while you’re traveling

• Aim for pale yellow urine as your daily check, the same marker we use for general dehydration. Dark urine or infrequent urination is your earliest warning sign.
• Carry a refillable water bottle everywhere, including into the water on longer surf sessions if you’re taking breaks on the beach.
• Rehydrate deliberately after surfing, not just when you happen to feel thirsty — thirst lags behind your actual fluid deficit in the heat.
• Match alcohol with water in the evenings, especially after a full day in the sun.
• If you’ve had kidney stones before, you’re at higher risk of another, and the tropical heat here makes that risk more relevant than it might be at home — be a little more disciplined about fluids than you would otherwise.

Related reading

• Dehydration in the Tropics: Oral Rehydration Salts and When You Need an IV Drip
• UTIs While Traveling in Sri Lanka: Prevention and Treatment
• Sun Protection and Heat Stroke

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This article is general health information and not a substitute for medical advice. If you have sudden, severe back or side pain, come in any time, day or night, or call 1990 for emergency transport.