What is a kidney stone?
Kidney stones are stones that form in your kidneys. Some stones may not cause any symptoms, so you may have kidney stones without being aware of it. But if the stone gets stuck, it can be extremely painful.
The kidneys are connected to the bladder by a tube called the ureter. When a stone gets stuck, it often occurs where the tube narrows, between the kidney and ureter or between the ureter and the bladder.
You usually feel the pain in your side or back. It is usually sudden, sharp, and comes in waves. Often, the pain makes it hard to sit still (unlike pain that worsens with movement).
Most common symptoms of kidney stones
Pro Tip
Pain is usually sudden, intermittent—comes in waves—and makes you not want to sit still. Pain is often accompanied by nausea or vomiting, as well as urinary symptoms such as frequency, urgency, and hematuria (blood in urine). Women often describe the pain as being similar to labor pains. —Dr. Chandra Manuelpillai
Intense pain is the most common symptom. The location of pain depends on where the stone is lodged. The most common place is the sides of the torso. But pain can also be in the back just below the rib cage where the kidneys lie, or in the groin. This pain may even radiate into the upper legs and/or genital region.
You may also have blood in your urine, pain with urination, urinary frequency, urgency, nausea/vomiting, and/or difficulty or inability to urinate.
Main symptoms
- Sudden, sharp pain that comes in waves
- Hematuria (red discoloration/blood in urine)
Other symptoms you may have
- Nausea/vomiting
- An urgent and frequent need to urinate
- Pain or difficulty when urinating
- Urine that smells bad or looks cloudy
- Abdominal pain
- Groin pain including pain in genitalia (vagina, testicle, or penis)
What are the main causes of kidney stones?
The cause for stone formation varies, but is likely due to crystallization of the components of urine. Most kidney stones are calcium stones, but there are also uric acid, struvite (a mineral), and rarely cystine stones or a combination of more than one type.
Calcium stones form when there is a large amount of calcium in urine due to diet, medications, or medical conditions such as hyperparathyroidism (overactive parathyroid) or gout (a form of arthritis).
Uric acid stones form more frequently in acidic urine. Chronic diarrhea, gout, diabetes, obesity make urine acidic. Some urinary tract infections, depending on the bacteria, can cause struvite stones.
Dr. Rx
Even though most common kidney stones are caused by calcium, it does not mean you should stop eating calcium-rich foods. It may have the opposite effect. Instead, testing the stone, as well as insight from a dietician, may help. It is important to get individualized recommendations because multiple factors go into stone formation so every stone is different. —Dr. Manuelpillai
Kidney stone treatment
Most kidney stone pain and symptoms can be managed by your doctor or urgent care.
But if you have severe pain, inability to urinate, or fever, as well as continued nausea and vomiting, go to the ER.
Treatment is often based on the size and location of the kidney stone. Also your past medical history, including having had kidney stones before. If your doctor thinks you’ll be able to pass the stone on your own, treatment is aimed at pain control while the stone is moving through. You may also get medication to help it move through.
In some cases, you may need to be seen by a urologist. They can monitor you to make sure the stone passes. They can also do imaging, like an ultrasound, to try to locate the stone and see how big it is.
You may be given a urine strainer. You’ll be asked to try to catch your passed stone to confirm it has been released and to save it for testing. Testing helps figure out what kind of stone it was and the best plan to prevent it from recurring.
You may need a procedure or surgery to break up the stone (shock wave lithotripsy), remove the stone (percutaneous nephrolithotomy, cystoscopy, ureteroscopy), or place a stent (tube) in the ureter to widen it, allowing the stone to pass through.
Medication
- To control pain, take over-the-counter ibuprofen or acetaminophen. If you need more pain relief, your doctor may prescribe opiates for short-term use.
- Medications to reduce nausea.
- Expulsive therapy causes the muscle of the ureter to relax, increasing the flow of urine and helping move the stone through. One example is the prescription drug, Flomax.
How long does it take to pass a kidney stone?
Unfortunately, it isn’t really possible to predict how long it will take to pass a stone. The smaller the stone and the further down the pathway from the kidney the more likely it will pass faster.
After the stone passes, you may want to follow up with your doctor to see if there is anything you can do to prevent more stones.
What makes you more likely to have kidney stones?
Pro Tip
There have been multiple studies trying to determine what causes kidney stones, but unfortunately we are still not totally sure. The one recommendation almost all physicians will recommend is drink plenty of fluids, preferably water. However, no matter what you do, you can decrease your risk but not completely prevent kidney stones from forming. —Dr. Manuelpillai
Many things may increase your risk of kidney stones including diet, underlying medical conditions, family history, the shape or your kidneys and ureters, and certain medications. Also, anything that can make urine more concentrated (ie, dehydration, poor fluid intake, excessive exercising).
Some medical conditions that can lead to kidney stones include inflammatory bowel disease, frequent urinary tract infections, hyperparathyroidism, sarcoidosis, cancer, and gastric bypass. Also, once you’ve had a kidney stone, you are more likely to have another one.
Prevention
It's common to get more kidney stones once you have them. But you can reduce the risk. Preventing kidney stones depends on what is causing the stones.
If your doctor thinks the stone formed because of dehydration or diet, preventing dehydration by increasing your fluid intake and/or changing diet should prevent future stone formation.
If the stones are caused by an underlying medical condition, treating that condition will hopefully prevent the stones from coming back.
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