- Do I have a kidney stone? Is it a kidney stone emergency?
- What is a kidney stone?
- Do I have a kidney stone?
- What is a kidney stone emergency?
- What kind of treatment is available for kidney stones?
- Do I Have Kidney Stones? Symptoms to Look for and When to See a Doctor
- When and How Soon to See a Doctor if You Suspect a Stone
- People With a History of Kidney Stones May Sometimes Forgo the Doctor
- Kidney Stones
- What Are Kidney Stones?
- What Are the Signs & Symptoms of Kidney Stones?
- What Causes Kidney Stones?
- How Are Kidney Stones Diagnosed?
- How Are Kidney Stones Treated?
- Can Kidney Stones Be Prevented?
- Where do kidney stones come from?
- Let kidney stones pass
- Take steps to bypass kidney stones
- What are Kidney Stones?
- Diet Changes
- 10 Signs Your Back Pain Could Be a Kidney Stone
- One of the symptoms of a kidney stone is back pain. But, how can you tell if it’s a kidney stone or just a simple backache? Read on for the telltale signs.
- Call for an Appointment(800) USC-CARE (800-872-2273)
Do I have a kidney stone? Is it a kidney stone emergency?
At Urology Austin, education is a crucial part of our service to patients. Making an appointment to diagnose certain conditions isn’t always advised, however, sometimes a kidney stone emergency exists and emergency care is the best option.
What is a kidney stone?
Kidney stones are a type of crystal that is formed by substances in urine. Kidney stones can cause pain, infection and even kidney damage. When a kidney stone forms, it may travel from the kidney down one of the ureters – thin tubes that carry urine from the kidney to the bladder.
The stones start small, but can grow large enough to fill the entire kidney if not detected early. Kidney stones are very common among both men and women, but children can also get them, although it is rare. Stones are especially common in southern states, like Texas, that have prolonged, warmer climates.
If you are experiencing pain and suspect that the source may be a kidney stone, please read the symptom checker below to decide your next step.
Do I have a kidney stone?
Here is a list of common symptoms associated with kidney stones:
- Severe pain – Many describe this pain as the worst they have ever experienced.
- Pain in flank and back – Kidney stones can cause excruciating pain in the flank (side of the body between the ribs and hip), and/or the back – Pain can start in the upper back and then migrate to the abdomen and groin.
- Changing positions doesn’t help – Kidney stone pain is primarily due to blockage of the urinary track, meaning you can’t alleviate it by moving or changing position.
- Pain accompanied by other symptoms – Nausea, vomiting, hematuria (blood in the urine), as well as fever are all common when someone is having a kidney stone episode.
- Pain comes in waves – The stone periodically blocks the urinary track as it makes its way out, meaning the pain often moves down the body.
What is a kidney stone emergency?
You may be experiencing a kidney stone emergency if the following apply:
- A fever above 101.5 degrees Fahrenheit.
- Burning during urination.
- Cloudy or foul smelling urine.
- Persistent nausea and vomiting.
- Intolerable pain.
- Certain medical conditions that can make passing a stone potentially more dangerous: having only one kidney, diabetes or decreased kidney function.
By themselves, these conditions may not be pointing to a kidney stone emergency. However, an evaluation is recommended. If you do suspect a kidney stone, a trip to an emergency room is advisable, especially if you are experiencing intense, uncontrollable pain. At the hospital, doctors can make the diagnosis and provide treatment for an active kidney stone. Imaging such as x-rays, or a CT scan, will confirm if a stone is present.
What kind of treatment is available for kidney stones?
Treatment options for kidney stones include:
- Allowing the stone to pass by itself.
- Using medications to help the stone pass.
- Surgery to treat or remove a stone.
Treatment options are based on the size of the kidney stone, and its location, within the urinary system. In general, stones less than 5 millimeters in size have a 50% chance of passing out of the body with conservative therapy alone. Kidney stones that are larger than 5 mm are often treated surgically.
If you don’t meet the criteria to go to the emergency room, but still suspect you might have a kidney stone, please contact us to make an appointment.
Do I Have Kidney Stones? Symptoms to Look for and When to See a Doctor
When and How Soon to See a Doctor if You Suspect a Stone
At the time of a first kidney stone attack, people often aren’t sure what is going on and need to be seen by a doctor to make sure the symptoms aren’t the result of a more serious problem, such as appendicitis, says Lieske.
As a general rule, you need to seek medical attention if you experience any of the following symptoms:
- Severe pain that makes sitting still or getting comfortable impossible
- Pain with nausea and vomiting
- Pain with fever and chills
- Blood in the urine
- Difficulty passing urine
- A strong need to urinate
- A burning sensation while urinating
If you can’t see your doctor that day, head to the ER.
“If stone pain and fever develop, go directly to the ER,” says Timothy F. Lesser, MD, a urologist at Torrance Memorial Medical Center in Torrance, California. A kidney stone with a urinary tract infection (UTI) may cause sepsis and must be treated immediately. (9)
If urine is trapped behind a kidney stone that is blocking the ureter, the urine can become infected, says Seth K. Bechis, MD, a urologist at UC San Diego Health in San Diego. This, in turn, can cause an infection of the kidney tissue or result in the infection spreading to the bloodstream, causing sepsis, he explains.
Additionally, over time stones can become infected and harbor bacteria, causing urinary tract infections, adds Dr. Bechis. Some people who have a history of recurrent UTIs are found to have a large stone that continuously sheds bacteria into the urine. When doctors suspect that someone has a kidney stone with a UTI, they place a tube in the ureter or kidney to drain the backed up, infected urine, says Bechis. In addition, antibiotics are given to treat infection. (10)
While men are more prone to kidney stones than women, women are more likely to get UTIs, says Lieske. “So it’s not surprising that women are also more likely to get a urinary infection associated with their kidney stones,” he says.
People With a History of Kidney Stones May Sometimes Forgo the Doctor
While infection with kidney stones is a medical emergency, some people with a history of kidney stones may not always need to see a doctor, says Lieske. After an initial consultation with their physician, people who recognize their symptoms may be able to have pain medication on hand, so they can try passing the stone at home, he explains. Your doctor will likely have you drink plenty of water to help flush the stone out of your urinary tract.
Whether to use this approach “really depends on how severe the pain is and how comfortable people are with this strategy,” says Lieske. “Anecdotally, it seems that patients may have less severe pain the more kidney stone attacks they have had over the years, although this is certainly not universally true.”
Ibuprofen (Advil, Motrin) can help with kidney stone pain, while a drug called tamsulosin (Flomax) may help relieve discomfort and enable you to pass the stone, notes Marchalik.
Fortunately, doctors can help you make prevention plans so you can avoid repeatedly developing stones.
- Larger text sizeLarge text sizeRegular text size
What Are Kidney Stones?
Kidney stones happen when minerals form crystals inside the kidneys. Then they get bigger and become kidney stones. Kidney stones can move into the urinary tract. There, they can cause problems like pain and blood in the urine (pee). Some stones also can block the flow of pee.
Most kidney stones pass out of the body without causing any damage. Pain medicine and plenty of fluids help most people with kidney stones get better.
What Are the Signs & Symptoms of Kidney Stones?
Usually, kidney stones don’t cause symptoms until they move around in the kidney or pass into the ureter (the muscular tube that connects the kidney to the bladder). Small stones can pass out of the body with little or no pain.
Larger stones in the urinary system may get stuck and cause symptoms like:
- pain, which usually:
- starts in the side or back
- spreads to the lower belly and groin as the stones move through the urinary tract
- comes and goes in waves
- blood in the pee (hematuria)
- nausea and vomiting
- needing to pee often or urgently
- fever or chills (signs of a possible infection)
Sometimes, a stone that’s too big to move can create a backup of pee. This can make one or both kidneys swell, causing pain in the side and back. If it’s not treated, it may cause long-term kidney damage.
What Causes Kidney Stones?
Most teens who get kidney stones have a health condition that increases their risk for them. These include:
- some medicines
- special diets, like a ketogenic diet that is sometimes used to prevent seizures
- problems with how the urinary tract is formed
- metabolic disorders (problems with how the body breaks down and uses food)
- other kidney conditions
- conditions that affect the thyroid or parathyroid gland
- some urinary tract infections (UTIs)
Other things that can make a kidney stone more likely are:
- not drinking enough water
- eating too much salt
- not having enough citric acid (the acid in citrus fruits such as oranges) in the urine
- having too much calcium in the urine
Kidney stones mostly affect adults. But kids and teens can get them.
Some types of kidney stones run in families, so having a relative with kidney stones can make a person more likely to get them. Teens who have had kidney stones before are more likely to get them again.
How Are Kidney Stones Diagnosed?
The doctor will ask about:
- the symptoms and how long they’ve been going on
- your diet
- whether you could be dehydrated
- whether there’s a family history of kidney stones, or urinary or kidney problems
The doctor will do an exam and probably order:
- blood tests
- urine tests
- kidney function tests
- imaging tests, such as ultrasounds, X-rays, or CT scans. These can show a stone’s exact size and location. This helps doctors decide on the best treatment.
How Are Kidney Stones Treated?
Treatment depends on the type of kidney stone and its size. Some people only need to drink a lot of water and take pain medicines to pass a kidney stone. Those with larger stones may need surgery or other treatments to help remove the stones.
There are different types of stones. A stone that passes in pee and is caught in a strainer can be tested to see what type it is. Knowing that can help doctors find the cause and offer advice how to treat it and prevent other stones.
To help pass a small stone, drink plenty of water and take medicine to ease the pain. Often, over-the-counter medicines such as ibuprofen and acetaminophen are enough. But sometimes, doctors prescribe pain medicine.
The doctor might ask you to strain your pee for a few days to collect the kidney stones. Examining them can help the doctor decide if you need more treatment.
Teens whose kidney stones block the urinary tract or cause severe pain or dehydration may need care in a hospital. They might get intravenous (IV) fluids and pain medicine to help the stones pass and treat dehydration.
Large stones rarely pass on their own. To get rid of large stones and stones that are damaging the kidneys, doctors can do a procedure to break up the stone. This lets the smaller pieces pass on their own or be removed with a scope or surgery.
Can Kidney Stones Be Prevented?
It’s not always possible to prevent some types of kidney stones.
But anyone who’s had kidney stones should:
- Drink a lot of liquids (water is best) throughout the day. Avoid dark sodas, soft drinks, and sports drinks. If their pee is almost clear, that’s a sign they’re drinking enough. Ask your doctor how much you should drink.
- Limit the salt and protein in their diet.
If dietary changes don’t prevent kidney stones, medicines can help. Depending on the type of kidney stone you had, the doctor can prescribe treatments or medicines to lower the levels of crystal-forming substances in the pee.
Doctors will keep an eye on teens who have had kidney stones and try to prevent new ones. The doctor might have you use a 24-hour urine collection test. This measures the volume of pee within a 24-hour period and checks what’s in it.
Kidney stones aren’t usually a worry for most teens, though it’s always a good idea to eat healthy foods and drink enough fluids to avoid dehydration.
Reviewed by: Robert S. Mathias, MD Date reviewed: November 2019
If you’ve ever passed a kidney stone, you probably would not wish it on your worst enemy, and you’ll do anything to avoid it again. “Kidney stones are more common in men than in women, and in about half of people who have had one, kidney stones strike again within 10 to 15 years without preventive measures,” says Dr. Brian Eisner, co-director of the Kidney Stone Program at Harvard-affiliated Massachusetts General Hospital.
Where do kidney stones come from?
Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into “stones.” About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.
After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain (pain in one side of the body between the stomach and the back), sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin.
“If you experience any of these symptoms, see your primary care physician,” says Dr. Eisner. “He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number.”
Let kidney stones pass
Stones typically take several weeks to a few months to pass, depending on the number of stones and their size. Over-the-counter pain medications, like ibuprofen (Advil, Motrin IB), acetaminophen (Tylenol), or naproxen (Aleve), can help you endure the discomfort until the stones pass. Your doctor also may prescribe an alpha blocker, which relaxes the muscles in your ureter and helps pass stones quicker and with less pain.
If the pain becomes too severe, or if they are too large to pass, they can be surgically removed with a procedure called a ureteroscopy. Here, a small endoscope (a device with a miniature video camera and tools at the end of a long tube) is passed into the bladder and up the ureter while you are under general anesthesia. A laser breaks up the stones, and then the fragments are removed.
Take steps to bypass kidney stones
Even though kidney stones can be common and recur once you’ve had them, there are simple ways to help prevent them. Here are some strategies that can help:
1. Drink enough water. A 2015 meta-analysis from the National Kidney Foundation found that people who produced 2 to 2.5 liters of urine daily were 50% less likely to develop kidney stones than those who produced less. It takes about 8 to 10 8-ounce glasses (about 2 liters total) of water daily to produce that amount.
2. Skip high-oxalate foods. Such foods, which include spinach, beets, and almonds, obviously raise oxalate levels in the body. However, moderate amounts of low-oxalate foods, such as chocolate and berries, are okay.
3. Enjoy some lemons. Citrate, a salt in citric acid, binds to calcium and helps block stone formation. “Studies have shown that drinking ½ cup of lemon juice concentrate diluted in water each day, or the juice of two lemons, can increase urine citrate and likely reduce kidney stone risk,” says Dr. Eisner.
4. Watch the sodium. A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. Federal guidelines suggest limiting total daily sodium intake to 2,300 milligrams (mg). If sodium has contributed to kidney stones in the past, try to reduce your daily sodium to 1,500 mg.
5. Cut back on animal protein. Eating too much animal protein, such as meat, eggs, and seafood, boosts the level of uric acid. If you’re prone to stones, limit your daily meat intake to a quantity that is no bigger than a pack of playing cards.
What are Kidney Stones?
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no “one-size-fits-all” diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form. Below are some tips.
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts (about ten 10-ounce glasses). This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But it’s best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces (2.5 liters) of urine daily.
Health care providers recommend people who form cystine stones drink more liquid than other stone formers. Usually 4 liters of liquid is advised to reduce cystine levels in your urine.
Reduce the amount of salt in your diet.
This tip is for people with high sodium intake and high urine calcium or cystine. Sodium can cause both urine calcium and cystine to be too high. Your health care provider may advise you to avoid foods that have a lot of salt. The Centers for Disease Control (CDC) and other health groups advise not eating more than 2,300 mg of salt per day. The following foods are high in salt and should be eaten in moderation:
- Cheese (all types)
- Most frozen foods and meats, including salty cured meats, deli meats (cold cuts), hot dogs, bratwurst and sausages
- Canned soups and vegetables
- Breads, bagels, rolls and baked goods
- Salty snacks, like chips and pretzels
- Bottled salad dressings and certain breakfast cereals
- Pickles and olives
- Casseroles, other “mixed” foods, pizza and lasagna
- Canned and bottled sauces
- Certain condiments, table salt and some spice blends
Eat the recommended amount of calcium.
If you take calcium supplements, make sure you aren’t getting too much calcium. On the other hand make sure you aren’t getting too little calcium either. Talk with your health care provider or dietitian about whether you need supplements. Good sources of calcium to choose from often are those low in salt. Eating calcium-rich foods or beverages with meals every day is a good habit. There are many non-dairy sources of calcium, such as calcium-fortified non-dairy milks. There are good choices, especially if you avoid dairy.
You can usually get enough calcium from your diet without supplements if you eat three-to-four servings of calcium-rich food. Many foods and beverages have calcium in them. Some foods and beverages that might be easy to include on a daily basis with meals are:
Eat plenty of fruits and vegetables.
Eating at least five servings of fruits and vegetables daily is recommended for all people who form kidney stones. Eating fruits and vegetables give you potassium, fiber, magnesium, antioxidants, phytate and citrate, all of which may help keep stones from forming.
A serving means one piece of fruit or one potato or one cup of raw vegetables. For cooked vegetables, a serving is ½ cup. If you are worried you may not be eating the right amount of fruits and vegetables, talk to your health care provider about what will be best for you.
Eat foods with low oxalate levels.
This recommendation is for patients with high urine oxalate. Eating calcium-rich foods (see table above) with meals can often control the oxalate level in your urine. Urinary oxalate is controlled because eating calcium lowers the oxalate level in your body. But if doing that does not control your urine oxalate, you may be asked to eat less of certain high-oxalate foods. Nearly all plant foods have oxalate, but a few foods contain a lot of it. These include spinach, rhubarb and almonds. It is usually not necessary to completely stop eating foods that contain oxalate. This needs to be determined individually and depends on why your oxalate levels are high in the first place.
Eat less meat.
If you make cystine or calcium oxalate stones and your urine uric acid is high, your health care provider may tell you to eat less animal protein.
If your health care provider thinks your diet is increasing your risk for stones, he or she will tell you to eat less meat, fish, seafood, poultry, pork, lamb, mutton and game meat than you eat now. This might mean eating these foods once or twice rather than two or three times a day, fewer times during the week, or eating smaller portions when you do eat them. The amount to limit depends on how much you eat now and how much your diet is affecting your uric acid levels.
Changing your diet and increasing fluids may not be enough to prevent stones from forming. Your health care provider may give you medications to take to help with this. The type of stone and the urine abnormalities you have will help your health care provider decide if you need medicine and which medicine is best. Common medications include:
are for patients who have calcium stones and high levels of calcium in their urine. Thiazides lower urine calcium by helping the kidney take calcium out of the urine and put it back in the blood stream. When taking thiazides, you need to limit how much salt you take in, as these medications work best when urine sodium is low.
is for patients with calcium stones and low urinary citrate, and for those with uric acid and cystine stones. Potassium citrate makes the urine less acidic or more alkaline (basic). This helps prevent cystine and uric acid stones. It also raises the citrate level in the urine, helping to prevent calcium stones.
is frequently prescribed for gout, which is caused by high uric acid in the blood. Allopurinol not only lowers the level of uric acid in the blood but also in the urine, so it may also be prescribed to help prevent calcium and uric acid stones.
Acetohydroxamic acid (AHA)
is for patients who produce struvite or infection stones. These stones form because of repeated urinary tract infections (UTI). AHA makes the urine unfavorable for struvite stones to form. The best way to prevent stuvite stones is to prevent repeated UTIs caused by specific types of bacteria and to completely remove the stones with surgery.
Cystine-binding thiol drugs
are used only for patients who form cystine stones. These medications (d-penicillamine or tiopronin) bind to cystine in the urine and form a compound that is less likely than cystine to crystallize in the urine. This drug is used when other measures fail, such as raising fluid intake, reducing salt intake or using potassium citrate.
should be used carefully as some can increase your risk of forming kidney stones. Your health care provider and a dietitian may be good sources of information about over-the-counter nutritional supplements.
10 Signs Your Back Pain Could Be a Kidney Stone
One of the symptoms of a kidney stone is back pain. But, how can you tell if it’s a kidney stone or just a simple backache? Read on for the telltale signs.
Your back is achy, yet you don’t remember hurting it, and that painkiller doesn’t seem to be helping. Could it be a kidney stone? Possibly, and almost definitely, if you have these other symptoms:
1. Pain on one side of your lower back or on the sides, underneath your ribs
General back pain, on the other hand, can be felt anywhere on your back. So if the pain is in your middle back or shoulders, chances are, it’s not a kidney stone.
2. Pain that comes and goes in waves and changes in intensity
As the kidney stone moves through your urinary tract, you’ll feel pain differently. With a backache, the pain is usually constant.
Call for an Appointment
(800) USC-CARE (800-872-2273)
“Kidney stone pain typically starts high up, near the kidney, migrates toward the abdomen and then eventually moves down toward the groin as the stone moves further down the ureter,” says Mike Nguyen, MD, a urologist at Keck Medicine of USC and associate professor of clinical urology at the Keck School of Medicine of USC.
3. Pain that doesn’t go away, when you move
If it’s a backache, a change of position may momentarily alleviate the pain. With kidney stones, the pain won’t disappear when you move, and some positions may even make it worse.
4. Severe pain
Backache pain can range from mild to severe, while kidney stone pain is almost always severe. Kidney stones are rumored to be as painful as childbirth.
“Kidney stone pain is typically severe and can be sharp or dull,” Nguyen says. “It usually occurs suddenly, without any provoking events.”
5. Blood in your urine
Kidney stones can cause your urine to be pink, red or brown.
7. More frequent urination
Kidney stones can make you feel like you need to urinate more, and when you do go, you may only go a little.
“When a stone is almost ready to come out into the bladder, patients may feel the urge to urinate,” Nguyen adds.
8. Foul-smelling urine
10. Fever and chills, along with your back pain
This could also mean that you have a urinary tract infection.
If you have any of these symptoms, along with your back pain, you should call your doctor right away.
“If your pain is unbearable, is associated with fevers or chills, or you have nausea and vomiting that is preventing you from keeping down fluids or medications, you should seek immediate medical attention,” Nguyen says.
by Anne Fritz
If you’re in the Los Angeles area and are looking for exceptional care, the experts at USC Urology at Keck Medicine can help. Schedule an appointment or call (800) USC-CARE (800-872-2273).