kidney stone when to seek care

Overview

Kidney stones are hard, tiny stones that form inside your kidneys. They can cause pain when they move through your urinary tract, but many pass on their own and most are treatable.

Yes, kidney stones are common. About 1 in 10 people will experience one during their lifetime. They are most often seen in adults, and your risk goes up after age 30.

Anyone can get a kidney stone, but they are more common in men, people with a family history, and those with certain health conditions like diabetes or obesity.

Symptoms

Common symptoms

• Severe pain in your side or back, often below your ribs
• Pain that spreads to your lower belly or groin
• Pain that comes and goes and is very intense
• Pain or burning when you urinate
• Pink, red, or brown urine
• Needing to urinate more often or suddenly
• Nausea or vomiting

Symptoms in children

• Children may complain of a painful belly that comes and goes.
• You might see blood in their urine, or they may have pain when urinating.
• Very young children may just cry, be fussy, or have a fever, so tell your pediatrician if something seems off.

Symptoms in older adults

• Older adults may not have the same sharp pain. Instead, they might feel confused, tired, or generally unwell.
• They may have a urinary tract infection that unmasks the stone, so fever and discomfort can be signs.
• If you notice changes in an older person's behavior along with belly or back pain, get medical help.

Causes

Main causes

• Your urine may have too many crystal-forming substances, like calcium, oxalate, or uric acid, and not enough fluid to wash them out.
• A lack of natural substances in urine that usually prevent crystals from sticking together.
• A urinary tract infection can also lead to a special type of stone called a struvite stone.

Risk factors

• Not drinking enough water
• A diet high in salt, sugar, or foods rich in oxalate
• Being overweight or obese
• A family history of kidney stones
• Certain medical conditions, including some that cause diarrhea or affect your kidney or hormone function
• Taking some medications, though this is less common

When to see a doctor

See a doctor urgently if:

• If you have pain that is getting worse or will not ease up, see a doctor the same day.
• If you have a fever or chills with your symptoms, seek medical care promptly.
• If you feel too sick to eat or drink, call your healthcare team.

Book a routine appointment if:

• If you have been diagnosed with a small stone before and are having mild symptoms, book a routine appointment.
• If you notice blood in your urine but have no other symptoms, make an appointment to get it checked.
• If you have frequent urinary tract infections, talk to your doctor about whether a stone could be the cause.

Diagnosis

Your doctor will start by asking about your symptoms and examining you. If a kidney stone is suspected, they will likely order imaging tests to see the stone and its size and location.

Tests that may be done

• A urine test to check for blood or signs of infection.
• A blood test to check your kidney function and look for substances that can form stones.
• An imaging test, such as a CT scan, ultrasound, or X-ray, to locate the stone.

What to expect at your appointment

You may be asked to urinate through a strainer so that if you pass a stone, it can be collected and sent to a lab. This helps your doctor understand what type of stone it is and plan the best way to prevent future ones.

Treatment

Treatment for kidney stones depends on how big the stone is, where it is, and whether it is blocking urine or causing an infection. Many small stones pass on their own with home care. Larger stones may need a procedure done in a hospital.

Self-care at home

• Drink plenty of water and other fluids so your urine stays light yellow.
• Move around gently; this may help the stone move along.
• Use pain relief that your doctor or pharmacist recommends for you, and always follow the directions.
• Rest when you need to, and try placing a warm cloth or heating pad on the painful area if it helps.

Medical treatments

If your stone does not pass on its own, a specialist may suggest treatments to help. These can include sound waves to break the stone into smaller pieces (called lithotripsy), a thin tube to drain a blocked kidney, or surgery to remove the stone. Your doctor will explain the options and recommend what is best for your case.

When is surgery considered?

Surgery is usually considered when a stone is too large to pass, is blocking urine, causing repeated infections, or is not helped by other treatments. Most procedures are minimally invasive, meaning shorter recovery.

Living with this condition

While you are passing a stone, focus on staying comfortable and hydrated. Keep a note of your pain and any changes, and contact your doctor if anything gets worse.

Lifestyle tips

• Drink enough fluids every day, especially in hot weather.
• Cut back on salt in your meals.
• If your doctor advises, limit foods high in oxalate, like spinach, rhubarb, and nuts.
• Do not stop eating calcium foods like milk or yogurt; getting calcium from food can actually help prevent stones.

Diet and exercise

A balanced diet and regular exercise help you stay a healthy weight, which lowers your risk. Sudden changes, like very high-protein or very low-carb diets, can increase the risk of stones, so talk to your doctor before changing how you eat.

Mental health and emotional wellbeing

Dealing with severe pain can be stressful and exhausting. It is normal to feel anxious or upset. Let yourself rest, and talk about your feelings with someone you trust. If you need extra support, a mental health professional can help.

Prevention

Yes, kidney stones can often be prevented. Drinking enough water is the top way. Your doctor can also help you understand what caused your stone, which makes it easier to prevent another one.

Screening programmes

If you have had kidney stones in the past, your doctor may suggest regular check-ups to monitor your kidney health and catch new stones early.

Complications

If left untreated

• A stone can block the flow of urine, causing the kidney to swell with fluid (a condition called hydronephrosis).
• Bacteria can get trapped behind a blocked stone, leading to a kidney infection that could become serious.
• Over time, repeated stones or long-term blockages can damage your kidney function.

Long-term outlook

The outlook for kidney stones is very good. With the right treatment, most people pass the stone or have it removed without long-term damage. Afterward, small changes in diet and fluid intake can strongly reduce your chance of getting another stone. You have good reason to be hopeful.

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