Consult the Urology Department at SSM Hospital

Kidney stones are a common urinary system problem that can cause anything from mild discomfort to severe, sudden pain. They develop when certain minerals and salts in the urine become concentrated and form hard crystals inside the kidneys. Some small kidney stones may pass naturally without causing major symptoms, while larger stones can become lodged in the urinary tract and require medical treatment.

Recognising the symptoms of kidney stones early can help you seek appropriate medical evaluation and treatment. Ignoring persistent or severe symptoms may sometimes allow complications such as urinary obstruction or infection to develop.

If you experience severe pain, fever, difficulty passing urine, blood in the urine, or other concerning symptoms, consult a healthcare professional promptly.

What Are Kidney Stones?

Kidney stones are solid deposits that form inside the kidneys from substances present in urine. Their size can range from very small particles to larger stones that may interfere with the normal flow of urine.

A stone may remain inside the kidney without causing symptoms. However, when it moves into the ureter—the narrow tube connecting the kidney to the bladder—it can cause significant pain and other urinary symptoms.

The symptoms depend on factors such as the stone's size, location and whether it is blocking the urinary tract.

1. Sudden and Severe Pain

One of the most recognised symptoms of a kidney stone is intense pain. Kidney stone pain may begin suddenly and can fluctuate in severity.

The pain commonly occurs in the:

• Side of the abdomen
• Lower back
• Flank area
• Lower abdomen
• Groin

The location of the pain can change as the stone moves through the urinary tract. Some people describe the pain as coming in waves, with periods when it becomes particularly intense.

Severe or unexplained abdominal, back or flank pain should not automatically be assumed to be a kidney stone because several other medical conditions can cause similar symptoms.

2. Pain That Moves Toward the Groin

As a kidney stone travels from the kidney through the ureter, pain may move from the side or back toward the lower abdomen and groin.

This changing pain pattern can occur because the stone is moving through the urinary tract.

If you experience sudden severe pain that travels from your back or side toward the groin, medical assessment can help determine the underlying cause.

3. Blood in the Urine

Blood in the urine, medically known as hematuria, can occur when a kidney stone irritates or causes minor injury to the lining of the urinary tract.

The urine may appear:

• Pink
• Red
• Brownish
• Tea-coloured

Sometimes blood may only be detected through urine testing and may not be visible to the naked eye.

Blood in the urine should not automatically be attributed to kidney stones. Other urinary and kidney conditions can also cause hematuria, so professional evaluation is important.

4. Pain or Burning While Urinating

A kidney stone can cause discomfort or burning during urination, particularly when the stone has moved closer to the bladder.

You may experience a sensation of:

• Burning while passing urine
• Pain during urination
• Discomfort in the lower abdomen

These symptoms can also occur with urinary tract infections and other urinary conditions. If burning or painful urination persists, medical evaluation is advisable.

5. Frequent Urge to Urinate

A kidney stone located near the lower part of the urinary tract can sometimes create a frequent or urgent need to urinate.

You may feel that you need to use the bathroom repeatedly, even when only a small amount of urine is produced.

Frequent urination can have many causes, including urinary infections and other bladder conditions, so it should be assessed in context with other symptoms.

6. Nausea and Vomiting

Kidney stone pain can be accompanied by nausea and vomiting. Severe pain can trigger a response from the nervous system that affects the digestive system.

If intense flank or abdominal pain is accompanied by repeated vomiting, medical attention may be necessary, particularly if you are unable to keep fluids down.

Persistent vomiting can also increase the risk of dehydration.

7. Difficulty Passing Urine

A larger stone may partially or completely obstruct the flow of urine. This can lead to difficulty passing urine or a significant reduction in urine output.

Difficulty urinating should not be ignored, particularly when accompanied by severe pain or other urinary symptoms.

A urinary obstruction may require prompt medical assessment.

8. Fever and Chills

Fever and chills are warning signs that require particular attention.

A kidney stone can sometimes occur alongside a urinary tract infection. If urine flow is blocked while an infection is present, the situation can become serious.

Seek prompt medical attention if kidney-stone-like symptoms occur together with:

• Fever
• Chills
• Feeling unusually weak or unwell
• Severe pain
• Vomiting

Do not rely on pain medication alone when these warning signs are present.

9. Cloudy or Unusual-Smelling Urine

Cloudy urine or urine with an unusual smell can sometimes occur with urinary infections. Although these symptoms are not specific to kidney stones, they may be important when they occur alongside pain, fever or urinary difficulties.

A urine examination can help healthcare professionals evaluate possible infection or other urinary problems.

When Should You Seek Medical Attention?

Not every kidney stone requires emergency treatment, but certain symptoms should prompt urgent medical evaluation.

Seek immediate medical attention for symptoms such as:

• Severe or unbearable pain
• Fever or chills with urinary symptoms
• Difficulty passing urine
• Very little or no urine production
• Repeated vomiting
• Significant blood in the urine
• Severe weakness or feeling seriously unwell

These symptoms can indicate complications or another medical condition requiring prompt assessment.

What Causes Kidney Stones?

Kidney stones can develop when certain substances in urine become highly concentrated and form crystals. Several factors may increase the likelihood of stone formation.

These can include:

• Not drinking enough fluids
• Certain dietary patterns
• Family history of kidney stones
• Previous kidney stones
• Certain medical conditions
• Some medications
• Certain metabolic factors

The type of kidney stone can also vary. Calcium stones are common, while other types include uric acid, struvite and cystine stones.

Can Kidney Stones Pass Naturally?

Some smaller kidney stones can pass through the urinary tract without a procedure. However, whether a stone will pass naturally depends on factors such as its size, location and the individual's circumstances.

A healthcare professional may recommend observation, medication, hydration guidance or another treatment approach depending on the situation.

Larger stones or stones causing significant obstruction, persistent symptoms or complications may require a procedure.

How Are Kidney Stones Diagnosed?

When kidney stones are suspected, a healthcare professional may consider the patient's symptoms and medical history along with appropriate investigations.

Depending on the situation, evaluation may involve:

• Physical examination
• Urine testing
• Blood tests
• Ultrasound
• CT imaging
• Other diagnostic tests when appropriate

Imaging can help identify the location and size of a stone and determine whether there is urinary obstruction.

Kidney Stone Treatment

Treatment depends on the stone's size, location, symptoms and the patient's overall health.

Possible approaches may include:

Observation and Hydration

Small stones that are likely to pass naturally may sometimes be managed with observation and appropriate fluid intake, as advised by a healthcare professional.

Medication

Doctors may prescribe medication to manage pain or, in selected cases, help facilitate stone passage. The choice of medication depends on the patient's individual circumstances.

Shock Wave Treatment

Certain kidney stones may be treated using shock waves to break the stone into smaller fragments that can pass through the urinary tract.

Ureteroscopy

During ureteroscopy, a specialised instrument can be passed through the urinary tract to locate and treat a stone. Depending on the situation, the stone may be removed or broken into smaller pieces.

Other Procedures

Larger or complex stones may require other specialised procedures. The appropriate treatment should be determined by a qualified urologist after evaluation.

How Can You Reduce the Risk of Kidney Stones?

Adequate hydration is one of the important measures for reducing the risk of kidney stone formation. However, prevention depends on the type of stone and individual risk factors.

General preventive measures may include:

• Drinking adequate fluids
• Following a balanced diet
• Maintaining a healthy body weight
• Following medical advice regarding dietary changes
• Taking prescribed medications correctly
• Completing recommended follow-up testing

People who have previously had kidney stones may benefit from discussing prevention strategies with a healthcare professional.

Don't Ignore Persistent Urinary Symptoms

Kidney stones can sometimes begin with symptoms that appear manageable but become more intense as the stone moves or causes obstruction. Severe pain, blood in the urine, urinary difficulty, fever, chills and persistent vomiting are symptoms that should receive appropriate medical attention.

Early evaluation can help determine whether the symptoms are caused by a kidney stone or another urinary or abdominal condition.

If you experience severe flank pain, blood in the urine, fever with urinary symptoms, difficulty passing urine or repeated vomiting, seek medical attention promptly rather than waiting for the symptoms to resolve on their own.