Ask a Doc: How will I know if I have kidney stones?

Ask a Doc: How will I know if I have kidney stones?

David M. Weiner, MD, Urologist at St. Luke's and Roosevelt Hospitals

Answer: Kidney stones can present in a variety of ways, but typical involve severe pain and the inability to find a comfortable position. There may be associated nausea and vomiting or blood present in the urine. The degree of pain may be variable and the absence of severe pain does not rule out the presence of a kidney stone. In fact, with the frequent use of radiographic studies in medicine, many kidney stones are now discovered incidentally. Other common conditions that often mimic kidney stones include: musculoskeletal pain, gastrointestinal pain, gallstones, and ovarian or testicular pain.

Q: What does a kidney stone attack feel like?

Answer: A kidney stone attack will likely cause the patient to have severe pain in the abdominal or flank area (near your back and sides, below your ribs where your kidneys sit). The pain may radiate to the groin region and be associated with a frequent urge to urinate.

It is often very difficult to find a comfortable position and patients may writhe in pain. Nausea, vomiting and bloating of the abdomen often occur. There may be visible blood in the urine.

Q. What are the risk factors for kidney stones?

Answer:

  • Dehydration is one of the most common causes of kidney stones. It may seem like a lot, but it’s important to drink 8 to 10 glasses of fluid a day, preferably water. You know you’re drinking enough fluids if your urine is clear in color as opposed to having a darker, concentrated appearance.
  • Certain metabolic conditions such as hyperparathyroidism, which raises the levels of calcium in the blood and urine, can trigger kidney stones to form.
  • Nutrition also can contribute to kidney stones. A diet high in protein, sodium, calcium, vitamin D, and high-oxalate foods like chocolate, baked beans, potatoes and bran cereal can increase the risk for kidney stones in some patients.
  • Genetics, such as race, gender and family history can put you at higher risk. Caucasian men have a higher risk for kidney stones starting in their 40s, and women’s risk begins climbing in their 50s. You could also be at increased risk if you have recurring urinary tract infections, Crohn’s disease or a physical change in your kidneys or urinary tract.  

Q. When should I call the doctor?

Answer: If you’re running a fever, have the chills or have intractable pain it is advisable to seek immediate medical attention.

Q. How are kidney stones diagnosed?

Answer: Some urine tests can suggest the presence of kidney stones by demonstrating the presence of blood in the urine. The most precise test for diagnosing a kidney stone is a CT scan, but ultrasound and plain radiographic x-ray imaging are often utilized.

Q. What treatments can I get if I have kidney stones?

Answer: The most common option used for smaller kidney stones is the wait-and-see approach. Sometimes, it can be as simple as taking pain medication and keeping well-hydrated to allow a chance for the stone to pass spontaneously. The choice to pursue treatment is often at the discretion of the patient.

If the problem becomes an emergency or your pain becomes too intense to tolerate, there are several options to manage the stones:

  • Shockwave therapy (also known as Extracoprporeal Shock Wave Lithotripsy or ESWL) involves sending a shock wave to the kidney stone from outside the body under X-ray guidance. The shock wave breaks up the kidney stone into smaller pieces allowing them to pass through the urinary tract more easily.
  • Ureteroscopy is a method whereby a camera is inserted into the urinary tract through the patient’s urethra (no incision is necessary) and the stone may be directly visualized and broken with a laser or removed with a small basket.
  • Prescription medications can also assist you in passing a kidney stone. Alpha-blockers and anti-inflammatory medications, for example, may relax the walls of the ureter (the tube between the kidney and the bladder where stones typically become stuck) so a stone can pass more easily.

If you have kidney stone symptoms, talk to your doctor. Find a physician by calling 1-855-411-LWNY (5969) or visiting chpnyc.org.

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