Kidney stone renal colic

Overview

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. Renal colic is the severe pain you feel when a kidney stone moves and blocks the tube (ureter) that carries urine from your kidney to your bladder. The pain often comes in waves and can be very intense.

Yes, kidney stones are quite common. Around 1 in 10 men and 1 in 20 women will get a kidney stone at some point in their lives. They are more common in adults aged 30 to 60.

Kidney stones affect people of all ages, but they are most common in adults. Men are more likely to get them than women. People with certain medical conditions, a family history of stones, or who are dehydrated are at higher risk.

Symptoms

Common symptoms

• Sudden, severe pain in your back or side, often on one side. The pain may spread to your lower belly or groin.
• Pain that comes in waves – it can be intense for a while, then ease up.
• Nausea or vomiting.
• Blood in your urine – it may look pink, red, or brown.
• Frequent need to urinate or pain when urinating.
• Urinating only a small amount at a time.

Symptoms in children

• Children may have belly pain instead of back or side pain.
• They may be irritable or cry a lot.
• Vomiting or fever can occur.
• Blood in the urine is common.

Symptoms in older adults

• Older adults may not have the typical severe pain. Instead, they might feel confusion, tiredness, or just not feel well.
• Pain may be less sharp and more of a dull ache.
• They may have trouble urinating or see blood in their urine.
• Infection signs like fever and chills are more concerning.

Causes

Main causes

• Kidney stones form when your urine has too many certain substances (like calcium, oxalate, or uric acid) and not enough fluid to dissolve them. These substances build up and form crystals, which then turn into stones.
• Not drinking enough water is the most common cause.
• Some medical conditions, such as gout, urinary tract infections, or metabolic disorders, can increase the chance of stone formation.

Risk factors

• Dehydration – not drinking enough fluids.
• Family history of kidney stones.
• Being overweight or obese.
• A diet high in salt, sugar, or animal protein.
• Certain medical conditions: hyperparathyroidism, gout, recurrent UTIs.
• Taking certain medications (talk to your doctor).

When to see a doctor

See a doctor urgently if:

• You have severe pain that is not relieved by rest or over-the-counter pain medicine.
• You have fever or chills along with the pain.
• You see blood in your urine.
• You cannot urinate at all.
• You are vomiting frequently and cannot keep fluids down.

Book a routine appointment if:

• You have had a kidney stone before and think you might have another one.
• You have mild pain that comes and goes.
• You notice small amounts of blood in your urine without severe pain.
• You have been diagnosed with a kidney stone and want to discuss prevention.

Diagnosis

Your doctor will ask about your symptoms, examine you, and likely order tests to confirm the stone and its size and location.

Tests that may be done

• CT scan (computed tomography) – a detailed scan that can find even small stones.
• Ultrasound – uses sound waves to see stones, especially in the kidney.
• X-ray of the kidneys and urinary tract (KUB).
• Urine tests to check for blood, infection, and crystals.
• Blood tests to check kidney function and look for high levels of minerals.

What to expect at your appointment

You may be asked to collect and strain your urine to catch the stone when it passes. Your doctor will explain the results and recommend next steps based on the size and location of the stone.

Treatment

Treatment depends on the size and location of the stone, your symptoms, and whether there are any complications. The main goals are to relieve pain, help the stone pass, and treat any infection or blockage.

Self-care at home

• Drink plenty of water (at least 2 to 3 litres per day) to flush the stone out, unless your doctor advises otherwise.
• Use over-the-counter pain relief as recommended by your pharmacist or doctor.
• Apply a heating pad to your back or side to ease muscle spasms.
• Rest until the pain improves.

Medical treatments

For more severe pain, your doctor may prescribe stronger pain medication. They may also prescribe a medicine that relaxes the muscles in the ureter (the tube connecting your kidney to your bladder). This helps the stone pass more easily.

When is surgery considered?

If the stone is too large to pass, is causing a blockage, or is infected, you may need a procedure to remove it. Options include shock wave lithotripsy (non-invasive sound waves) to break up the stone, or ureteroscopy (a thin telescope passed through the urethra and bladder) to remove the stone. Sometimes a small surgery called percutaneous nephrolithotomy is needed for very large stones.

Living with this condition

While waiting for a stone to pass, you may have occasional pain. Stay well-hydrated, follow your doctor's advice, and take pain medication as needed. Once the stone passes, most people feel better quickly.

Lifestyle tips

• Drink enough water throughout the day to keep your urine pale yellow.
• Reduce your salt intake – avoid processed foods and adding salt to meals.
• Limit high-oxalate foods like spinach, rhubarb, and nuts if your doctor suggests it.
• Eat a balanced diet with moderate amounts of animal protein.

Diet and exercise

Eating a healthy diet and staying active can help reduce the risk of future stones. Drink water before, during, and after exercise to stay hydrated. Talk to a dietitian for personalised advice.

Mental health and emotional wellbeing

The severe pain of renal colic can be frightening and stressful. You may worry about when the pain will return or about needing procedures. It is normal to feel anxious. Talk to your doctor or a counsellor if the worry affects your daily life.

Prevention

Yes, in many cases you can reduce your risk. The most important step is to drink enough fluid (mainly water) to keep your urine dilute. Depending on the type of stone you had, your doctor may also recommend dietary changes or medicines to prevent new stones from forming.

Vaccines

Vaccines do not prevent kidney stones.

Screening programmes

There is no routine screening for kidney stones. If you have had a stone, your doctor may check your urine and blood periodically to look for risk factors.

Complications

If left untreated

• Severe pain that may not go away.
• Urinary tract infection that spreads to the kidney (pyelonephritis).
• Kidney damage or scarring if the stone blocks urine flow for a long time.
• Sepsis – a life-threatening response to infection.

Long-term outlook

Most kidney stones pass with minimal treatment. With proper care, the pain usually goes away once the stone is out. Even if you need a procedure, the outlook is excellent. By making lifestyle changes, you can greatly reduce the chance of getting another stone.

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