Kidney Stones

What should I do if I have a kidney stone?

In many cases kidney stones are very painful and it is likely that you will be aware of the stone. The stone normally passes from the body without any need for medical intervention. However, in some instances this is not the case and you should see a doctor if you experience any of the following symptoms:

Severe pain in your lower back
A high temperature
Chills
Blood in the urine
Unpleasant smelling urine
Cloudy urine
Vomiting
Burning sensation when you urinate

What is a kidney stone?

It is a solid mass which forms in the kidneys and can remain there or travel outside of the kidneys via the urinary tract. They are made from substances found in the urine and can be very painful. This is especially the case if they are large and the passage of urine is blocked. Smaller stones may pass without much pain but if a stone gets dislodged in the bladder, urethra or ureter, this can be problematic and medical help is normally required.

Are there different types of kidney stone?

Yes. Kidney stones vary in size and shape and there are four main kinds of kidney stone, including:

The main type of kidney stone is made largely of calcium. It is formed when calcium is left behind as a waste product.
Stones known as struvites may form following a urinary infection and contain magnesium and ammonia.
Uric acid stones form as a result of overly acidic urine. Recurrence of these stones can be a sign of too much meat consumption.
Cystine stones are the least common type of kidney stone. Cystine is an important substance which is present in the nerves and muscles. The stones tend to run in families and they are formed when cystine accumulates in the urine.

What do they look like?

Kidney stones vary in appearance: some are smaller than grains of rice while others are much larger. It is possible for stones to be as large as golf balls. Kidney stones are normally yellow or brown in colour and can be either jagged or smooth in texture.

How can the doctor help me?

If a stone cannot be passed it may be necessary for a doctor to remove the stone. In the past surgery was the only option, but doctors now use a range of techniques to remove problematic kidney stones. Treatment options include:

Shockwaves: shockwaves can be used to break larger kidney stones into smaller fragments, which can be passed through the urinary system. Shockwaves are applied directly to the stone via a machine, of which there are two types: one which works when the patient is sat in water and one that works as the patient lies on a bed or table. The latter is known as extracorporeal shockwave lithotripsy or ESWL; lithotripsy is the Greek word for crushing stones.

Tunnel surgery: this is where an incision is made in the lower back and a special instrument is used to tunnel down to the stone within the kidney and remove it. The medical name for this procedure is percutaneous nephrolithotomy.

Ureteroscope: an ureteroscope is a long, thin wire-like instrument which is inserted into the urethra, passed up into the bladder and directed to the exact location of the stone. The ureteroscope is fitted with a camera to show the location of the stone and a cage which is used to extract the stone.

Your doctor will advise you about which method is the best option based on your individual circumstances and the size and location of the stone.

How will the doctor diagnose the type of kidney stone I have?

Your doctor will test the stone to determine what type of stone it is. This may involve testing it once it has been passed or carrying out blood or urine tests to establish the cause. The test results will allow your doctor to provide advice on how to avoid the condition in the future.

Why is the type of stone important?

The treatment your doctor advises may depend on the category of stone. If you have a struvite stone, for example, medication to prevent calcium stones will not be effective, while dietary changes may not have any impact on uric stones.

How can I reduce the risk of stones in the future?

It may not be possible to prevent kidney stones, but there are steps you can take to reduce the risk of getting another one, including:

Drinking plenty of water; aim for at least 2 litres or 12 glasses of water per day. This will help to flush out the substances which may cause kidney stones. Water also helps to keep you hydrated and is essential for many important processes in the body. Drinking other drinks can help you to stay hydrated, though water is always the best option.
Limit the amount of caffeine you consume as drinks such as tea, coffee and cola cause the body to lose fluid.
Keep an eye on your meat intake if you have had a uric acid stone. It is likely that the doctor will advise you to eat less meat to reduce the risk of getting another stone.
Follow your doctor's instructions, and they may also advise you to begin taking medication.

Points to remember

Most stones pass from the body without any problems.
You should visit your doctor if you experience severe back pain or lingering pain in the side.
Visit your doctor if you notice blood in your urine.
Drink plenty of water every day.
Follow your doctor's advice.
Try to keep the stone you pass so that your doctor can determine what type of stone it is. This will help them to advise you on how to avoid the condition in the future.