(Updated July 2020) Ouch! These hurt. This is one condition that’s far more common in men than women. In fact, some compare the pain of a kidney stone to childbirth; it can be that intense.
There are genetic factors and dietary factors for kidney stones. The process of developing a kidney stone or having renal colic (a cramping pain) occurs when the calcium oxalate or similar stone develops in the kidney and moves into the ureter (thin pipe) and eventually passes to the urinary bladder. Final step–passing it through the urethra to the outside. Multiple steps can hurt– most commonly movement of the irregularly shaped stone into or through the ureter. Also painful is when the stone gets stuck, stops moving, and pressure builds up behind the stone. Fluid can even back up to the kidney (hydro-nephrosis).
Back to treatment: if this is your first, you may need to speak to or see your doctor or an urgent care doctor or emergency room in order to be diagnosed. Typically it’s low back or flank pain initially, moving toward the abdomen on one side. The pain is intense, crampy, sharp and can come on quickly and then take a break after a while. Sometimes blood can be found in the urine on dipstick testing or even a pink visible tinge. If a diagnosis is made, fluids are used to flush the stone through– oral fluids or intravenous fluids.
Pain control, usually with pain killing medication is next. Don’t worry, this won’t lead to addiction, but for a brief period, strong medication is often needed. This could include morphine injectable (emergency room), shots of toradol (injectable anti- inflammatory), oral hydrocodone (norco), etc.
Recently, flomax (tamsulosin) has been added to the treatment protocol to add in ureteral relaxation and therefore stone passage. This medication is also used with enlarged prostate issues.
If possible, get a urinary strainer, or pee through cheesecloth into a container with the goal of capturing the stone. Your physician can send it to a lab to be tested for content. The type of stone determined can help the doctor guide you to dietary changes that may reduce but, unfortunately, not eliminate, the risks of future stone development. There is a different diet advised depending on what kind of stone you pass.
Sometimes imaging is helpful. CT scan shows the stone best, location, and size, but does involved x-ray radiation. Ultrasound can be helpful after passage to see if others are present in the kidney, although treatment might not change as a result of this knowledge.
Another preventive point: stay hydrated in hot weather; although excessive water is not necessarily good either.
This is something you hope you don’t get and you hope you are close to a pharmacy, physician, or urgent care if you get a severe attack. Be sure to be diagnosed; flank and abdominal pain can have other causes that might require a different treatment.