Reviewed By: Pramod Kerkar, MD, FFARCSI

Kidney stones can occur in one or both kidneys and quite common in people aged from 30 to 60 years. It is seen more in men than in women. Kidney stones are formed when the amount of water in urine is reducing therefore the salts and mineral tends to stick together and form stones.

Should I Go to The ER for Kidney Stones?

If you have symptoms such as high fever with chills and rigors with severe loin pain, loin pain that does not answer the usual pain medication, previous episodes of stones, blood in the urine, cloudy or foul smelling urine, reduced urine output, nausea and vomiting preventing to drink fluids, then it is best that you present to the emergency room. In the hospital, pain medication will be given to relieve the kidney stone pain. Then further examination and investigations can be carried out to diagnose the condition. After the diagnosis the doctor will discuss with you the treatment options for kidney stones.

When to Actually Go to The ER?

If you have below symptoms of kidney stones its best you present yourself to the emergency room (ER). Pain medications can be given to relieve the pain then necessary investigations can be carried out and proper treatment can be given according to the diagnosis.

  • Fever with severe loin pain
  • Pain that does not answer the usual pain medication
  • Previous episodes of stones
  • Blood in the urine
  • If the urine output is reduced
  • Cloudy or foul smelling urine
  • Severe nausea and vomiting preventing drinking fluids

Symptoms of Kidney Stones

Most of the kidney stones will not cause any symptom even if these stones are quite large. It can increase in size for years without any symptoms. Most of the people will present when complications such as infection occur.

  • Pain
    • In the front or back just below the ribs on the side of the kidney stone. It is called renal pain.
    • Can be a continuous dull ache or be sharp and very severe.
    • The pain usually remains as a dull ache with varying intensity throughout the day.
    • Nausea and vomiting can be present when the pain is severe.
    • Blood in the urine - sometimes.
  • Symptoms of infection
    • High fever with chills and rigors.
    • Severe loin pain that does not answer usual pain medication.
    • Painful desire to pass urine but only small volumes passed.
    • Nausea, vomiting.

If the kidney stone is in the ureter – severe pain, the worst pain you have experienced. Pain starts in the loin radiates down towards the genitals. This is called loin to groin pain. This pain is typical of a stone in the ureter trying to travel down. Pain comes periodically (colicky pain). This is how you differentiate kidney and ureteric stones.

  • Investigations
    • Non-contrast CT Scan of the Abdomen and Pelvis: It’s quick and painless and helps to identify
    • If you have a kidney stone or any other stone in the urinary tract
    • If the symptoms are caused by other disease such as appendicitis, pancreatitis, cholecystitis
    • The location, size and number of kidney stones
    • Density of the kidney stone
  • How much obstruction it causes
    • X-ray of kidney, ureter, bladder (KUB): It is a quick and painless investigation. It also shows the location, size and amount of stones in the kidney. But the problem is it only shows calcium containing stones, from that also some calcium containing stones will not be seen.
    • Ultrasound KUB - stones are identified as an abnormal radiographic density. It is useful in identifying kidney stones in pregnant women as radiation exposure form X-ray and CT scan is harmful to the baby. Stones not seen in x-ray can be seen in ultrasound scan but small stones (<5mm) will be difficult to identify.
    • By identifying the above details about the stones, the doctor can plan out the kidney stones treatment options and discuss it with you which treatment method you would like to proceed.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 18, 2018

This article does not provide medical advice. See disclaimer

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