This topic is about managing recurrent uric-acid kidney stones for someone who has an ileostomy. The person is looking for ways to handle or prevent these painful stones without relying heavily on medication. Here are some helpful insights and advice shared by others who have faced similar challenges:

1. Hydration is crucial:
- Drink plenty of water, aiming for 8-10 glasses or at least 3 liters daily.
- People with ileostomies tend to lose more fluids, which can strain the kidneys and increase the risk of stone formation.

2. Lemon water and citrate sources:
- A daily glass of water with fresh lemon juice is recommended by some urologists and has been effective for some without the need for medication.
- Potassium-citrate (Urocit-K) may be prescribed if urine pH is low, combined with high fluid intake to prevent stones.

3. Experiences with allopurinol:
- Many have lived stone-free for years on allopurinol and suggest not fearing the medication.
- Some found allopurinol alone insufficient but effective when combined with Urocit-K.
- Others take allopurinol for gout and have not experienced kidney stones since starting it.

4. Dietary adjustments:
- Reduce high-purine foods like red meat, organ meats, and shellfish.
- Focus on vegetables, fruits, whole grains, and low-fat dairy to lower acid load and stone risk.
- High-protein diets can increase uric-acid levels, so aim for foods that help alkalinize urine.

5. Supplements and other aids:
- Cranberry extract capsules (not juice) have helped some remain stone-free for decades.

6. Kidney monitoring cautions:
- Chronic dehydration after an ileostomy can lead to kidney damage; aggressive hydration is advised.
- Early specialist referral and 24-hour urine testing are important for monitoring kidney health.

7. General themes:
- Aim to raise urine pH through citrate or lemon juice, or medication if needed.
- Maintain a high urine volume.
- Consider a detailed metabolic work-up (24-hour urine test) before deciding on a treatment plan.
- Discuss lifestyle and dietary approaches with a knowledgeable doctor or nutritionist if you wish to limit medications.