Each year, more than half a million people will flock to emergency rooms to treat a kidney stone. Although kidney stones are not always an emergency, they’re more common than you might think, with an estimated 1 in 10 people developing an issue with one over the course of their lives.
Kidney stones usually result from a buildup of certain minerals that clump together inside the kidney. You may not feel anything at all if the stone is small enough, but larger kidney stones can cause a lot of pain when passing through the urinary tract. Some symptoms include sharp pain on one side around the middle of your back, nausea or vomiting, and blood in the urine.
When you are met with sudden harsh abdominal pain or other symptoms, it can be difficult to determine the exact cause at that moment and even more difficult to decide if your pain or other symptoms are enough to merit a visit to the ER. So, when are kidney stones an emergency? Read on to learn more.
What is a kidney stone?
A kidney stone is an irregularly shaped solid mass or crystal formed from undissolved chemicals in the urine. They can range in size from a grain of sand to a golf ball, but most are around the size of a chickpea.
Urine has different types of waste dissolved in it. When there is too little liquid in the urine and too much waste, crystals can form. These crystals can draw other elements (calcium, oxalate, urate, cystine, xanthine, and phosphate) to form a solid mass that will continue to get larger unless it is passed out of the body in the urine. Normally, the kidney acts as the body’s master chemist and eliminates these chemicals if your body is well-hydrated. But, if the body lacks enough liquid to help the kidney function properly, stones will form.
The main causes of kidney stones are:
Dehydration
Dehydration is caused by not consuming enough fluid, or losing more fluid than you take in (example: excessive sweating from overexercising). This is the primary cause of kidney stones, since this reduces the volume of urine and keeps the kidneys from flushing out waste properly.
Dietary Factors
Those who consume high amounts of animal protein, sodium, and sugar are at an increased risk for kidney stones. But it’s not just your food choices that have an impact — taking excessive amounts of vitamin D supplements or not consuming enough calcium may lead to the development of oxalate kidney stones.
Medical Conditions
Certain medical conditions change the body’s metabolic state, and this can increase the risk of forming kidney stones. Inflammatory bowel disease, gout, hyperparathyroidism, obesity, weight loss surgery, and some kidney diseases make the body more likely to form kidney stones.
Urinary Tract Infections
Struvite stones are a common type of kidney stone that develop in tandem with urinary tract infections.
How to tell if you have a kidney stone
Kidney stones can remain in your body for years without you knowing. As long as the stones stay within your kidney, you usually will not feel any pain or symptoms. Pain typically starts when they begin their path out of the kidney and into the ureter, the tube connecting the kidney to the bladder. This pain can go from mild to extreme very quickly, depending on the size of the stone being passed. If the stone gets lodged in the ureter, expect the following symptoms:
- Sharp, severe pain in the side and back, below the ribs
- Pain radiating to the lower abdomen and groin
- Waves of pain that fluctuate in intensity (caused by spasms in the ureter)
- Burning sensation while urinating
Other signs a kidney stone is present include:
- Urine discoloration (pink, red, or brown)
- Cloudy or foul-smelling urine
- A persistent urge to urinate, urinating more often than expected and in small amounts
- Nausea and vomiting
- Fever and chills (if an infection has developed)
The anatomy of the urinary tract is different in men and women, so the location and severity of the pain will differ for each as a kidney stone passes. Men will feel dull, achy or throbbing pain in their abdomen, lower back or groin as the stone passes through the very narrow ureter. Some have likened this pain to going into labor. Women may compare pain from kidney stones to that of menstrual cramps, ranging from mild, dull aches to intense, wincing pain like labor.
When to go to the ER for kidney stones
So you’re in pain–a lot of pain. But how can you tell when to go to the ER for kidney stones? You should immediately seek emergency care if you are experiencing any of the following symptoms:
- High fever (above 101.5 degrees Fahrenheit)
- Blood in the urine
- Cloudy or foul-smelling urine
- Difficulty urinating
- Severe pain that keeps you from being able to sit still or find a comfortable position
- Pain in conjunction with nausea and vomiting
- Pain in conjunction with fever and chills
- Certain medical conditions that make passing a stone more dangerous, like diabetes or decreased kidney function
Once you’ve arrived at an emergency care facility, the providers will use a blood test, urine test or imaging such as CT or x-rays to confirm if a stone is present. They will also verify the size to determine the best course of ER treatment for kidney stones.
Small kidney stones
Small stones (less than 5mm in size) with minor symptoms can usually pass through the urinary tract without invasive treatment, though there may be some discomfort. In general, it is safe to wait between 4 and 6 weeks for a small kidney stone to pass. To help the safe passage of the stone, your doctor will recommend a course of treatment including the following:
- Drinking plenty of water — around 2 to 3 quarts per day (enough to produce clear urine)
- Over-the-counter pain medications such as Tylenol or stronger painkillers if the pain is severe
- Prescription medications such as alpha-blockers help the stones pass by relaxing the ureter
Larger kidney stones
Kidney stones larger than 5mm are considered too big to pass safely on their own because they can cause bleeding, kidney damage, or ongoing urinary tract infections. Treatment for larger stones can be more extensive, including:
- Extracorporeal Shock Wave Lithotripsy (ESWL) – Using soundwaves to break up the stones into smaller, passable pieces
- Surgery to remove very large stones from the kidney
- Using a scope to remove smaller stones from the kidney
- Parathyroid gland surgery – for those with kidney stones caused by parathyroidism
How to prevent kidney stones
Although kidney stones are fairly common, there are plenty of lifestyle changes you can make to prevent them from developing.
Hydration, hydration, hydration
The benefits of hydration are many. Drinking fluids is especially important to maintaining kidney health by allowing them to properly flush waste out of the body. Drink at least 3 quarts of liquid (mostly water) a day to produce enough urine. If you exercise frequently or live in a hot, dry climate, you may need to drink even more.
Avoid sodium
Consuming a lot of sodium can cause you to lose more calcium in your urine. Calcium and sodium are transported the same way in your kidneys, so if you eat foods high in salt, it will kick the calcium out of the transport. This can increase your risk of developing another kidney stone, so it’s best to avoid salty foods.
Eat fewer stone-forming foods
If you tend to form calcium oxalate kidney stones, it is best to restrict foods rich in oxalates like beets, rhubarb, okra, spinach, sweet potatoes, nuts, tea, chocolate, black pepper, and soy products.
Less animal protein, more plant protein
Eating too much animal protein like poultry, red meat, eggs, or seafood increases the amount of uric acid in the kidneys, which heightens the risk of kidney stones forming. Diets high in protein reduce urinary citrate, the chemical that prevents stones from solidifying. If you are prone to stones, you should limit your animal protein intake and try consuming more plant-based proteins, like legumes.
Get your calcium through food
Dietary calcium (calcium in food) does not increase the risk of stones forming. Unless your doctor tells you otherwise, continue eating calcium rich foods like yogurt, milk and cheese. Dietary calcium combined with foods rich in oxalates are a great combination to prevent kidney stones. Ask your doctor before taking calcium supplements, since these have been linked to higher risks of kidney stones forming.
Fast & effective ER treatment for kidney stones
If you or a loved one has any symptoms from kidney stones listed above, seek immediate medical attention. You can always count on us! We are open 24 hours a day, 365 days a year, so we’re always ready to provide you with exceptional care. Find your nearest Neighbors Emergency Center location.