How Expulsive Therapy Helps Pass Kidney Stones Naturally

In this blog, I break down everything you need to know about expulsive therapy, one of the most underutilized but effective options for passing kidney stones without surgery. I explain how both natural and medical expulsive therapies work, the mechanisms they target, and the real success rates based on stone size. If you’re trying to avoid costly or invasive procedures, this is a treatment option you need to know about.

Key Takeaways:

• Expulsive therapy is recommended by the AUA for stones <10mm

• It works by addressing spasms, swelling, pain, urine flow, and infection

• Natural options like Chanca Piedra and dandelion root can rival pharmaceuticals

• Passage rates increase by up to 65% with expulsive therapy

When it comes to kidney stones, expulsive therapy is one of the most overlooked tools in the treatment toolbox.

It’s often skipped in favor of more invasive options like surgery or shockwave lithotripsy, but that’s a mistake—because if your stone meets the right criteria, expulsive therapy can help you pass it naturally, without surgery, with less pain, and for a fraction of the cost.

Let me walk you through exactly how it works and why you should consider it first.

Where Expulsive Therapy Fits Among Kidney Stone Treatments

There are a handful of treatment options for kidney stones, ranging from least invasive to most invasive:

1. Do nothing (not recommended—you’ll likely suffer for longer)

2. Expulsive therapy

3. Shockwave lithotripsy

4. Ureteroscopy

5. Percutaneous nephrolithotomy (PCNL)

I strongly believe expulsive therapy is underused—especially in the United States. Despite the American Urological Association (AUA) recommending it for many cases, it’s used in only about 1% of kidney stone cases.

That number should be way higher.

What Expulsive Therapy Is Designed to Do

There are three main goals of expulsive therapy:

1. Avoid surgery – Kidney stone surgery is expensive. A trip to the ER and a procedure could cost $10,000–$20,000 or more depending on your insurance. Expulsive therapy is a fraction of the cost.

2. Shorten the time it takes to pass your stone – No one wants to be in pain for weeks or months.

3. Reduce the need for pain medication – Especially opioids, which doctors are increasingly hesitant to prescribe.

Whether you go with a medical or natural option, expulsive therapy aims to help you pass your stone faster and with less pain so you can avoid expensive, invasive procedures.

Who Is Expulsive Therapy For?

The AUA recommends expulsive therapy for uncomplicated kidney stones less than 10mm in size.

Uncomplicated means:

• No urine backup

• Pain is manageable

• No signs of kidney function loss

And yes, even a 10mm stone qualifies—despite how big that may seem. 

How Medical Expulsive Therapy Works

Medical expulsive therapy typically involves three to four different medications working together to help you pass the stone. Here's what they do:

1. Relax spasms in the ureter

• The ureter can spasm around the stone, locking it in place.

• Alpha blockers (like tamsulosin) are prescribed to calm those spasms.

2. Reduce swelling around the stone

• Swelling (edema) makes the ureter tighter.

• Doctors use corticosteroids or NSAIDs to reduce inflammation.

3. Improve urine flow

• Again, alpha blockers can help improve urine flow to push the stone along.

4. Manage pain

• Pain is usually managed with NSAIDs or opioids, depending on severity.

5. Prevent or treat infection

• If an infection is present, antibiotics are added to the mix.

So yes, you might end up taking several meds all at once. And that’s where problems can arise…

Side Effects of Medical Expulsive Therapy

Let’s talk side effects.

Alpha blockers can cause:

• Headache

• Dizziness

• Runny nose

• Sexual dysfunction in men

• Back pain

• Fatigue

• Diarrhea

• Skin rashes

That’s a long list—and many people understandably want to avoid that. 

Why I Prefer the Natural Expulsive Therapy Route

Natural expulsive therapy uses herbs and plant compounds to target the same problems, but with fewer or no side effects.

Here’s how natural remedies like those in Cleanse work:

1. Anti-spasmodic and anti-inflammatory effects

• Chanca Piedra, dandelion root, and apple cider vinegar can help reduce spasms and swelling in the ureter.

2. Improved urine flow

• Dandelion root is a natural diuretic that increases urine flow without depleting electrolytes.

3. Natural pain relief

• Chanca Piedra has shown 2–3x greater pain-relieving power than morphine, with none of the side effects.

4. Infection support

• If you’re prone to infection stones, grass-fed bovine colostrum is a powerful, natural immune booster.

If you suspect an active infection, you should still consult your doctor. But for ongoing support or prevention, natural options can be a great strategy.

How Effective Is Expulsive Therapy Really?

Here’s the data that really blew me away.

Let’s break down passage rates based on stone size:

That’s a 65% average increase in stone passage success when using expulsive therapy.

And keep in mind—most stones fall in the 5–9mm range, meaning expulsive therapy works for the majority of cases.

Why Expulsive Therapy Should Be Your First Option

Let’s put this in perspective.

• Medical expulsive therapy may cost $100+ for all the prescriptions

• Natural options like Cleanse might cost $80 or less for 2 bottles

• Shockwave lithotripsy or ureteroscopy can cost $10,000–$30,000+

And here’s the kicker—expulsive therapy has equal or better success rates for stones under 10mm.

That’s why I’m always baffled when I hear it’s being used in only 1% of cases. It works. It’s safe. And it’s recommended by the very organizations doctors rely on.

Final Thoughts: Ask Why You're Not Being Offered This First

If your stone is under 10mm, and your pain is manageable, and there’s no risk to kidney function—you should be offered expulsive therapy first.

If you’re not, ask your urologist:
“Why aren’t we trying expulsive therapy first?”

The odds are in your favor.
The cost is manageable.
And the outcome could save you from surgery.

So if you’re facing a kidney stone, remember: you have options—and expulsive therapy might just be the smartest first move you can make.