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A patient story, myths debunked, and stone-sized video content.
- fever and chills
- urine that smells bad or looks cloudy
The kidney stone starts to hurt when it causes irritation or blockage. This builds rapidly to extreme pain. In most cases, kidney stones pass without causing damage-but usually not without causing a lot of pain. Pain relievers may be the only treatment needed for small stones. Other treatment may be needed, especially for those stones that cause lasting symptoms or other complications. In severe cases, however, surgery may be required.
Types Of Kidney Stones
- Calcium stones are the most common type of kidney stones. They are usually made of calcium and oxalate , but are sometimes made of calcium and phosphate.
- Uric acid stones form when your urine is often too acidic. Uric acid can form stones by itself or with calcium.
- Struvite stones can happen when you have certain types of urinary tract infections in which bacteria make ammonia that builds up in your urine. Struvite stones are made of magnesium, ammonium and phosphate.
- Cystine stones are made of a chemical that your body makes naturally, called cystine. Cystine stones are very rare, and happen in people who have a genetic disorder that causes cystine to leak from the kidneys into the urine.
Kidney stones can be as small as a grain of sand or as largesometimes larger thana pearl. They can stay in your kidneys or travel through your ureters , and out of your body with your urine. When a kidney stone moves through your ureters and out your urethra with your urine, it is called passing a kidney stone. A kidney stone can also get stuck in your urinary tract and block urine from getting through. When you pass a kidney stone or a large kidney stone blocks the flow of your urine, it can be very painful.
Treatment For Kidney Stones
Most kidney stones can be treated without surgery. Ninety per cent of stones pass by themselves within three to six weeks. In this situation, the only treatment required is pain relief. However, pain can be so severe that hospital admission and very strong pain-relieving medication may be needed. Always seek immediate medical attention if you are suffering strong pain.
Small stones in the kidney do not usually cause problems, so there is often no need to remove them. A doctor specialising in the treatment of kidney stones is the best person to advise you on treatment.
If a stone doesnt pass and blocks urine flow or causes bleeding or an infection, then it may need to be removed. New surgical techniques have reduced hospital stay time to as little as 48 hours. Treatments include:
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Whats The Urinary Tract How Does It Work
Your urinary tract is vital to your body because it gets rid of waste and extra fluid. Its made up of both your kidneys, two ureters, your bladder and your urethra. Each organ has an important job :
- Kidneys: Your fist-sized, bean-shaped kidneys are located on either side of your spine, below your rib cage. Each day they filter 120 to 150 quarts of your blood to remove waste and balance fluids. Your kidneys make one to two quarts of urine every day.
- Ureters: After your kidney creates urine, the liquid travels through the tube-shaped ureter to the bladder. There is one ureter per kidney. Kidney stones can pass through the ureters or, if theyre too big, get stuck in them. You may require surgery if the stone is too large.
- Bladder: Between your hip bones is your bladder, an organ that stores urine. It stretches to hold about one and a half to two cups.
- Urethra: Like a ureter, your urethra is a tube through which urine passes. Its the final stop of the urinary tract where your urine leaves your body. This is called urination.
Kidney Stones: Treatment And Prevention
LEONARDO FERREIRA FONTENELLE, MD, MPH, PhD, Universidade Vila Velha Medical School, Vila Velha, Espírito Santo, Brazil
THIAGO DIAS SARTI, MD, MPH, PhD, Health Sciences Center of Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
Am Fam Physician. 2019 Apr 15 99:490-496.
Patient information: A handout on this topic is available at .
The prevalence of nephrolithiasis is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010.1,2 Worldwide, it is also increasing in Europe and is even higher in the hot-climate stone belt extending from the southeastern United States to northern Australia.3,4 Table 1 lists the incidence of different types of kidney stones among children and adults in developed countries.38 Most are of noninfectious etiology and are associated with low fluid intake, hot climate, and certain comorbidities and risk factors .1,4,911 Increasing exposure to these risk factors may explain the rising incidence of kidney stones and their prevalence in men, non-Hispanic whites, and persons with low socioeconomic status.1,3,4,9 The annual incidence of kidney stones is about eight cases per 1,000 adults and peaks around midlife in developed countries.3
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What Does The Treatment Involve
You will be positioned on an operating table. A soft, water-filled cushion may be placed on your abdomen or behind your kidney. The body is positioned so that the stone can be targeted precisely with the shock wave. In an older method, the patient is placed in a tub of lukewarm water. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes.
Sometimes, doctors insert a tube via the bladder and thread it up to the kidney just prior to SWL. These tubes are used when the ureter is blocked, when there is a risk of infection and in patients with intolerable pain or reduced kidney function.
After the procedure, you will usually stay for about an hour then be allowed to return home if all goes well. You will be asked to drink plenty of liquid, strain your urine through a filter to capture the stone pieces for testing, and you may need to take antibiotics and painkillers. Some studies have reported stones may come out better if certain drugs are used after SWL.
How Do Health Care Professionals Treat Kidney Stones
Health care professionals usually treat kidney stones based on their size, location, and what type they are.
Small kidney stones may pass through your urinary tract without treatment. If youre able to pass a kidney stone, a health care professional may ask you to catch the kidney stone in a special container. A health care professional will send the kidney stone to a lab to find out what type it is. A health care professional may advise you to drink plenty of liquids if you are able to help move a kidney stone along. The health care professional also may prescribe pain medicine.
Larger kidney stones or kidney stones that block your urinary tract or cause great pain may need urgent treatment. If you are vomiting and dehydrated, you may need to go to the hospital and get fluids through an IV.
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Prescription Medication For Severe Pain
If the stone is causing severe pain, the urologist may choose to prescribe a narcotic. Providers may also inject patients with Ketorolac , a more powerful anti-inflammatory medication. If the patient becomes severely dehydrated due to vomiting or the inability to drink enough liquids, the urologist may decide to give IV fluids and pain medications.
When Can Swl Be Used
SWL works better with some stones than others. Very large stones cannot be treated this way. The size and shape of stone, where it is lodged in your urinary tract, your health, and your kidneys’ health will be part of the decision to use it. Stones that are smaller than 2 cm in diameter are the best size for SWL. The treatment might not be effective in very large ones.
SWL is more appropriate for some people than others. Because x-rays and shock waves are needed in SWL, pregnant women with stones are not treated this way. People with bleeding disorders, infections, severe skeletal abnormalities, or who are morbidly obese also not usually good candidates for SWL. lf your kidneys have other abnormalities, your doctor may decide you should have a different treatment. lf you have a cardiac pacemaker, a cardiologist will decide if you can have SWL.
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How Long Does It Take To Pass A Kidney Stone
The amount of time it can take for you to pass a kidney stone is different from anothers. A stone thats smaller than 4 mm may pass within one to two weeks. A stone thats larger than 4 mm could take about two to three weeks to completely pass.
Once the stone reaches the bladder, it typically passes within a few days, but may take longer, especially in an older man with a large prostate. However, pain may subside even if the stone is still in the ureter, so its important to follow up with your healthcare provider if you dont pass the stone within four to six weeks.
Keeping Kidney Stone Pain Under Control
If you are experiencing the intense discomfort of kidney stones , pain control is a top priority. A 2018 analysis of multiple randomized trials looked at different pain relief medicines given to people treated in the emergency department for acute renal colic. It compared nonsteroidal anti-inflammatory drugs with paracetamol or opioids. The study found NSAIDs offered effective pain relief with fewer side effects than paracetamol or opioids. NSAIDs directly inhibit the synthesis of prostaglandins, which decreases activation of pain receptors and reduces renal blood flow and ureteral contractions.
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Does The Patient Need Anesthesia
Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesia–either local, regional or general–is used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.
How Successful Are These Treatments
In short dubious at best. There have been many reports of people using these natural methods, but the efficacy is unsubstantiated. Some people report success, but none of these treatments are based in scientific fact. For every anecdotal success story posted online, there are hundreds more stories of failures . So, what natural remedies DO work?
4. Lab Grade Chanca Piedra
Lab grade chanca piedra has shown high rates of success in kidney stone treatment. This herbal remedy breaks down and prevents the development of new kidney stones. The clinical benefits of all-natural Chanca Piedra are related to ureteral relaxation and to a putative reduction of the excretion of urinary crystallization promoters such as calcium. It first grabbed the attention of the scientific community in a 2002 study on rodents which demonstrated it slowed or halted kidney stone growth. Further studies indicated lab grade Chanca Piedra actually interferes with the process that would normally cause stones to form.
Professor Dr. Nestor Schor speaking about his research on lab grade Chanca Piedra:
Treatment with Phyllanthus niruri strongly inhibited the growth of the stones and reduced the number of stones
These results show that Phyllanthus niruri has an inhibitory effect on crystal growth
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Why You Get Stones
Part of preventing stones is finding out why you get them. Your health care provider will perform tests to find out what is causing this. After finding out why you get stones, your health care provider will give you tips to help stop them from coming back.
Some of the tests he or she may do are listed below.
Medical and Dietary History
Your health care provider will ask questions about your personal and family medical history. He or she may ask if:
- Have you had more than one stone before?
- Has anyone in your family had stones?
- Do you have a medical condition that may increase your chance of having stones, like frequent diarrhea, gout or diabetes?
Knowing your eating habits is also helpful. You may be eating foods that are known to raise the risk of stones. You may also be eating too few foods that protect against stones or not drinking enough fluids.
Understanding your medical, family and dietary history helps your health care provider find out how likely you are to form more stones.
Blood and Urine Tests
Imaging Tests
When a health care provider sees you for the first time and you have had stones before, he or she may want to see recent X-rays or order a new X-ray. They will do this to see if there are any stones in your urinary tract. Imaging tests may be repeated over time to check for stone growth. You may also need this test if you are having pain, hematuria or recurrent infections.
Stone Analysis
Are There Any Possible Complications
Complications from kidney stones are uncommon. Rarely, a large stone can completely block the urine passing down one of the tubes draining urine from the kidney. This may lead to infection or even damage to the kidney.
This is now very uncommon because X-rays or scans will usually detect any blockage so that large stones can be removed before they cause any damage to your kidneys.
Further reading and references
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Medical Therapy For Kidney Stones
Most evidence suggests that stones less than 10 mm in diameter have a reasonable chance of passing through the urinary tract spontaneously. You may be offered medical expulsive therapy using an alpha blocker medication, such as tamsulosin. Its important to understand that this is an off-label use of the drug. Rarely, tamsulosin causes a condition called intraoperative floppy iris syndrome that can complicate cataract surgery.
Not all experts feel MET is worthwhile, and its use remains controversial. Discuss your options with your doctor or a urologist.
What Makes Stones More Likely
You are more likely to form a stone if your urine is concentrated. For example, if you exercise vigorously, if you live in a hot climate or if you work in a hot environment when you may lose more fluid as sweat and less as urine.
You are also more prone to develop kidney stones if you have:
- An abnormal kidney – for example, with scars or cysts on it.
- A close relative who has had a kidney stone.
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Alternate Remedies For Kidney Stones
Increasingly, more people are interested in attempting at-home treatments for kidney stones to decrease the use of medicines, procedures and surgeries. A number of alternative remedies have been acknowledged for the treatment of kidney stones. We will present these below and discuss their likelihood of success.
1. Lemon Juice and Olive Oil
Sounds awful, doesnt it? Some people do claim success in mixing a concoction of lemon juice and olive oil to help dissolve kidney stones as a home remedy. Proponents of this method claim that at the first notice of symptoms, mix five ounces of olive oil with five ounces of lemon juice. Drink this combination straight and then drink a glass of water. Repeat the process again in the late afternoon. Be sure to drink plenty of water as well through the day as well as extra lemon juice, if possible. Continue this treatment regimen for several days until the stone passes. It is thought that the lemon juice could help break down the kidney stones and the olive oil would aid in lubrication to pass the stone more easily. Extra-virgin olive oil is thought to be the best olive oil ingredient to use because it is the thickest and healthiest.
Warning: Lemons are very acidic and can destroy tooth enamel and contribute to heartburn or ulcers.
Our patient surveying indicates some success in a very limited number of kidney stone patients. We give it 2 out of 5 stars.
2. Apple Cider Vinegar
3. Coke and Asparagus
We give this remedy 1 out of 5 stars.
What Can Be Done To Rule Out Or Confirm An Underlying Cause
Kidney stones are common and they are not caused by any known underlying disease for most people. However, some tests may be recommended to rule out an underlying problem. In particular, tests are more likely to be advised if:
- You have repeated kidney stones.
- You have symptoms of an underlying condition.
- You have a family history of a particular condition.
- A stone forms in a child or young person.
You may be asked to catch a stone so that it can be analysed. This will help to find out if there may be an underlying cause for the kidney stone. To catch a stone, you will need to pass urine through gauze, a tea strainer or a filter such as a coffee filter.
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How Are Kidney Stones Diagnosed
Your healthcare provider will discuss your medical history and possibly order some tests. These tests include:
- Imaging tests: An X-ray, CT scan and ultrasound will help your healthcare provider see the size, shape, location and number of your kidney stones. These tests help your provider decide what treatment you need.
- Blood test: A blood test will reveal how well your kidneys are functioning, check for infection and look for biochemical problems that may lead to kidney stones.
- Urine test: This test also looks for signs of infection and examines the levels of the substances that form kidney stones.
What Can The Patient Expect After Treatment
The recovery time is usually fairly brief. After treatment, the patient can get up to walk almost at once, Many people can fully resume daily activities within one to two days. Special diets are not required, but drinking plenty of water helps the stone fragments pass. For several weeks, you may pass stone fragments.
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