Kidney Stones Common Painful Preventable

Overview

A kidney stone is a small, hard lump made from minerals and salts that builds up inside a kidney. Stones can be as tiny as a grain of sand or as big as a pea, and sometimes larger. They usually cause no trouble while they sit in the kidney. The pain starts when a stone moves into the narrow tube that carries urine from the kidney down to the bladder. This tube is called the ureter (say: yoo-REE-ter). The stone scrapes and blocks the flow of urine, and that is what hurts so much.

Yes. Kidney stones are one of the most common reasons people go to an emergency department with severe tummy or back pain. They are becoming more common worldwide, partly because of diet and how much water people drink.

They most often affect adults between about 30 and 60 years old. Men get them slightly more often than women, but women are catching up. You are more likely to get one if you have had one before, if a close family member has had them, if you live in a hot climate or sweat a lot, or if you do not drink enough fluids.

Symptoms

Common symptoms

• Sharp, severe pain in your side or back, just below your ribs
• Pain that spreads down towards your lower belly and groin
• Pain that comes in waves and can make you double over
• Pain that shifts position as the stone moves
• Not being able to get comfortable, or needing to keep moving
• Blood in your urine, which may look pink, red or brown
• Cloudy or smelly urine
• Feeling sick or being sick
• Needing to pee more often, or a burning feeling when you pee
• Feeling generally unwell, restless or sweaty

Symptoms in children

• Vague tummy or side pain rather than a clear 'stone' pain
• Being unusually fussy or unsettled
• Vomiting or poor feeding
• Blood in the urine, or nappies that look pink or dark
• Burning or straining when peeing, or new bedwetting
• Stones are much less common in children, so other causes are checked first

Symptoms in older adults

• Pain may be less dramatic and easier to miss
• Sudden confusion or a general feeling of being unwell
• New urine infection symptoms, or urine that smells strongly
• Feeling weak, dizzy or unsteady, sometimes leading to a fall
• Loss of appetite or feeling sick without obvious cause
• Because symptoms can be vague, older adults sometimes need tests earlier

Causes

Main causes

• Urine that is too concentrated. When you do not drink enough, the minerals in urine become packed together and can form crystals that stick and grow into a stone.
• A diet high in salt. Too much salt makes your kidneys release more calcium into your urine, and calcium is a common building block of stones.
• Not getting enough calcium from food. This can sound odd, but eating normal amounts of calcium-rich food actually helps protect against stones. Cutting calcium out can raise your risk.
• Too much animal protein (meat, fish, eggs) can raise the chance of some types of stone.
• Some medical conditions, such as repeated urine infections, gout, bowel problems, or hormone conditions that affect calcium.
• Some medicines and very high doses of certain vitamin supplements can increase stone risk. Ask your doctor or pharmacist if you are unsure.

Risk factors

• Having had a kidney stone before — this is the strongest risk factor
• A close family member with kidney stones
• Not drinking enough fluid, especially in hot weather or with physical work
• A diet high in salt or processed food
• Being overweight
• Being male, and being aged roughly 30 to 60
• Certain long-term gut conditions, or surgery for weight loss
• Problems with the shape of the urinary tract that make urine flow poorly
• Taking some prescribed medicines long term

When to see a doctor

See a doctor urgently if:

• Pain is severe, or you also have a temperature, shivering or feel very unwell — get help the same day or call your local emergency number if you feel seriously ill
• You cannot pass urine at all
• You see blood in your urine
• You are vomiting and cannot keep fluids down
• You are pregnant and have pain or urinary symptoms
• You have only one kidney and have stone-type pain

Book a routine appointment if:

• You have had a stone before and want advice on lowering your risk
• You have had mild or on-off pain in your side or back
• You have had blood in your urine, even once and even if it has stopped
• You have repeated urine infections
• You have a family history of stones and want to know what to do

Diagnosis

A doctor will usually start by asking about your pain — where it is, how it moves, and how bad it gets — and about your urine, your health history and any medicines you take. They will often test a urine sample on the spot. If a stone is suspected, you may be sent for a scan. You may also be given pain relief while tests are arranged.

Tests that may be done

• A urine test to look for blood, infection and crystals
• Blood tests to check kidney function and levels of minerals such as calcium
• An imaging scan — often an ultrasound first, or a CT scan, which shows stones clearly
• A pregnancy test where relevant, before any scan
• If you pass a stone, it may be sent to a lab to find out what type it is — this guides prevention advice

What to expect at your appointment

Tests are quick and usually painless apart from the urine sample. You may be given a strainer to pee through so you can catch the stone if it comes out — try to do this, because knowing the stone type helps your doctor give you the right advice. Most people are sent home with pain relief and clear instructions on when to come back.

Treatment

Treatment depends on the size of the stone, where it is, and how much pain or blockage it is causing. Most small stones pass on their own. The main job in the meantime is controlling pain and making sure you stay hydrated. Larger stones, or ones causing a blockage or infection, may need a procedure.

Self-care at home

• Drink water steadily through the day — aim to keep your urine pale and not dark yellow
• Take pain relief as advised by your doctor or pharmacist. Ask them what is suitable for you, especially if you have kidney problems or other conditions
• Use a strainer to catch the stone if you can — your doctor can give you one, or you can pee through clean gauze
• Keep gently active if you feel able — light movement is fine and may help
• A warm bath or a heat pack on your back can help you feel more comfortable while you wait
• Note down how bad the pain is, when it happens and whether you can keep fluids down — this helps your doctor judge how you are doing

Medical treatments

Doctors can prescribe stronger pain relief if you need it, and in some cases a medicine that helps relax the tube the stone is stuck in so it can pass more easily. Some stones can be broken up using painless sound waves directed from outside the body, and the tiny pieces then pass in your urine. Other stones are removed with a small camera passed through the water pipe (the urethra) — you would be asleep or numbed for this. Sometimes a small soft tube is left in place for a while to keep urine flowing. Your medical team will explain which option suits your stone, and why.

When is surgery considered?

A procedure is usually considered when a stone is too big to pass, when it is blocking the kidney, when there is an infection behind the blockage, when pain cannot be controlled, or when there is a risk of damage to the kidney. If you have a blockage with a temperature or infection, treatment is urgent — this is why fever with stone pain matters so much.

Living with this condition

While you wait for a stone to pass, plan around the pain. Keep water within reach, take pain relief early rather than waiting until the pain is unbearable, and have someone to call if you need help. Many people find the uncertainty hard — not knowing when the pain will hit. Keeping a simple note of symptoms can give you a sense of control and gives your doctor useful information.

Lifestyle tips

• Carry a water bottle and sip through the day, especially in hot weather or when exercising
• Cut back on salt — check labels on bread, sauces, cheese and ready meals, which are common hidden sources
• Eat calcium-rich foods as normal rather than avoiding them, unless your doctor advises otherwise
• Eat plenty of fruit and vegetables
• Keep meat, fish and eggs to normal portions rather than very large amounts at every meal
• Keep to a healthy weight — steady, gradual changes are better than crash diets
• If you have had a stone, ask your doctor whether your urine or blood should be checked again

Diet and exercise

For most people, the biggest dietary change is fluid and salt. Aim for urine that looks pale straw-coloured rather than dark. Regular movement — walking, swimming, cycling, whatever you enjoy — supports a healthy weight, which lowers stone risk. If you have had a specific stone type identified, your doctor or a dietitian can give you more tailored food advice, because different stones need slightly different approaches.

Mental health and emotional wellbeing

Kidney stone pain can be frightening, and the suddenness of it can leave people anxious about when the next attack will come. It is very normal to feel shaken afterwards, and to worry about it happening again. Sleep can be disrupted, and work or caring duties can be affected. These feelings usually settle as you recover and get a clear plan. If anxiety, low mood or worry is lasting more than a few weeks or getting in the way of daily life, tell your doctor — support is available and it helps.

Prevention

Often, yes. Most stones can be made less likely with simple, steady changes — mainly drinking more water, eating less salt and keeping to a healthy weight. If you have had a stone, your chance of another one is higher, so prevention advice matters even more. Ask your doctor for a plan that fits you.

Vaccines

There is no vaccine that prevents kidney stones. Staying up to date with other routine vaccinations is still worthwhile, as infections can make you unwell and dehydrated.

Screening programmes

There is no routine screening test for kidney stones in people with no symptoms. Testing is offered when you have symptoms, or when you have had stones before and your doctor wants to check how you are doing.

Complications

If left untreated

• A stone can block the flow of urine and cause a build-up of pressure in the kidney
• A blocked kidney can become infected, which is serious and needs urgent treatment
• Repeated blockage or infection can, over time, damage kidney function
• Ongoing pain and repeated episodes can affect sleep, work and mood
• Stones often come back — roughly half of people who have one will have another within about 5 to 10 years without prevention steps

Long-term outlook

The outlook is good for most people. Most stones pass, procedures for larger stones are well established and effective, and simple changes lower the chance of another stone. Having a stone is painful and disruptive, but it is a very treatable problem — and with the right advice, many people go on to have far fewer, or no more, stones.

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