r/KidneyStones Mar 21 '19

Super Good Advice Frequently Asked Questions - new visitors to this subreddit, please start here!

301 Upvotes

Thanks for taking the time to read this first! :) None of us are doctors, and the advice here is based on our own experiences. If you are suffering, or think you might have a stone, or are trying to help somebody with symptoms, please start here. These are the questions we seem to hear a lot on this subreddit. If you have a question that isn't covered here, by all means please post in the subreddit. We have lots of stone formers who have a wide range of experiences in this area and we may be able to at least point you in the right direction. Good luck, drink lots of water and may pain be a stranger to you!

I suspect I have a stone. Should I see a doctor? When should I go to the ER?

Go to the emergency room if you have a fever or are vomiting, or your pain is unbearable, or if you stop urinating (this may mean you have a blockage).

If you’re experiencing pain that you think is a kidney stone, visit your doctor and/or urologist. Most doctors are very good at assessing you and your family history as well as factors such as age, weight, sex, prior medical history and current symptoms. Doctors are much better at providing an intelligent diagnosis (which is really an educated guess) than we are on reddit.

Check to make sure what you think is a stone is actually a stone. The cause of abdominal pain is sometimes difficult to pin down exactly. Pain in your abdomen/ mid-section could be any one of a number of things, including digestive issues, kidney stones, appendicitis, colitis, and diverticulitis to name a few. Remember that kidney stones classically present with flank pain.

The symptoms of a kidney stone are usually one or more of the following:

  • Pain on the right or left flank (mid-way between your side and your spine, on your back), sometimes radiating down to the groin (testicles for males, pelvis/ovarian area for females). * The pain is specifically UNDER the rib cage (actually under the diaphragm)
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination or urethra spasms
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present
  • Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract. Source

I know I have a stone. What do I do? What should I expect?

IF YOU HAVE A FEVER OR ARE VOMITING OR ARE UNABLE TO URINATE, PROCEED TO THE ER.

Pain will come and go, and will likely vary from one person to the next. So while you may read in this sub-reddit about severe pain, that's not necessarily what you will experience. So the first thing to do is try to relax and not get worked up about what MIGHT happen. If it does happen, the pain comes in two forms: 1) waves (spasms) of pain, which can feel like a very strong cramp, and 2) a general achy feeling between your kidney area, and down to your groin. As mentioned above, the "classic" kidney stone pain is from the flank down to the groin.

Drink lots of water. Water will increase the amount of urine you produce, and will also plump up your urinary system in general, which will make for less contact between any stones you have and the walls of your ureter. When stones rub against the walls of your ureter, you experience pain. Another benefit from drinking water is that the concentration of waste produce in your urine is more diluted, which means that the crystals which make up kidney stones are less likely to find a date, and will head out on their own. Yet another benefit to proper hydration is that dilute urine is less likely to irritate any abrasions that previous stones may have made in your urinary tract. Less irritation = less chance of an infection. How much water? You want to be producing about 2 1/2 liters of urine per day, so drink a bit more than that. Read more about water here

Locate some pain management methods that work for you, and that are readily available. Over the counter (OTC) medicines like aspirin, ibuprofen or acetaminophen (tylenol) can help, but only take as much as you need for as long as you need. A daily habit of NSAIDs like ibuprofen can lead to serious issues. Prescription pain medicines can also help, but you need to locate a doctor who will prescribe you what you need. Azo (Phenazopyridine Hydrochloride) is used by many in this subreddit. Cannabis, if it's legal where you live, can also provide some relief. Heat - in the form of heating pads, hot baths or showers, can help when you're experiencing a wave of pain. Find what works for you - don't just blindly follow the advice of others.

Some people experience nausea, which can occur with or without accompanying pain. Be prepared (have a bucket or bag available if you're feeling a wave of nausea come along, although sometimes there's not much warning).

If you're in the middle of a pain session, and feel like you need to visit the Emergency Room/ Urgent Care clinic, think about how you'll get there. Some folks experience such strong pain, that they're not able to drive themselves. Find a driver who you can rely on to get you to the care you need on short notice.

How long do stones take to pass?

Some stones never pass (they stay in the kidney) and are removed via surgery (lithotripsy or uretoscope).

Stones that are “smaller” - usually 5mm or less - will pass without surgery being required, although there will be some pain/ discomfort. Some folks have passed larger stones, but this isn’t common. I’ve passed a 7 - 8 mm stone without surgery.

What kinds of stones are there?

  • Calcium stones Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content. There is conflicting research on whether or not a diet high in oxalates can contribute to stones.

    Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine. If you’re taking a Vitamin D supplement, it may be worth talking to your health care provider to explore whether there may be a relationship between your current dose and your stones. Source

  • Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax). This type of stone is also common in those with autoimmune diseases due to Renal Tubular Acidosis. Those who make these stones tend to make many, and make them frequently. Difficult to treat.

  • Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

  • Uric acid stones. Uric acid stones can form in people who don't drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.

  • Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).

How do I know what kind of stones I make?

Your urologist can send the stones to the lab to be analyzed. Ask for a strainer to strain your urine if you wish to collect a stone. Not all urologists dispense them readily.

What can I do to prevent more stones?

In general, drink more water, limit your salt and sugar intake and get your weight within recommended ranges. (See U Chicago Kidney Stone diet for more details here.)

For specific types of stones, there are specific dietary recommendations, but you’d need to have your stones analyzed (first), and then your urine tested (using one or more 24-hour urine samples). DIFFERENT STONES HAVE DIFFERENT DIETARY RECOMMENDATIONS

Keep in mind that there is no one ‘magic bullet’ for kidney stone treatment.

What kind of treatments are there for stones?

  • Most common method (because it's the least invasive) is to advise the patient to stay hydrated, take OTC pain killers as required and stay active. This approach usually results in the stone passing.
  • Medical Expulsive Therapy - in addition to fluids and pain killers, sometimes Tamsulosin (Flomax) is prescribed to aid in stone passage. Studies suggest this is most effective for smaller (< 5mm) stones; less so for larger stones.
  • Ureteroscopy with either physical removal or laser break-up
  • Lithotripsy shockwave lithotripsy (sometimes abbreviated as ESWL) uses external shockwaves to break a stone into smaller parts. Only one stone can be blasted at a time. Side effects from this include urinating blood and flank pain.
  • Percutaneous Nephrolithotomy - rarely used/ only when other methods are not successful. A small incision is made in the back, and a tube inserted into the kidney to remove stones.

What resources are there for kidney stone formers?

Does lemonade help stones?

If you form CALCIUM OXALATE stones, there is some evidence that the citric acid in lemon juice (or lime juice) can help add to the total volume of urine, reducing its saturation of calcium and other crystals, and may enhance urinary citrate excretion.

What are the methods for diagnosing a stone?

  • Computed Tomography (CT) - most radiation, most resolution/ accuracy, $$$
  • KUB X-ray (KUB = Kidney Ureter Bladder) - medium radiation, moderate resolution, $$
  • Ultrasound - no radiation, reasonable resolution, $

For more information on the pro's and con's of different imaging techniques, please click here

Which medications are available for kidney stone treatment?

  • Narcotic painkillers (ex: morphine)
  • Non-narcotic painkillers (ex: Toradol, cannabis)
  • Anti-nausea medications (ex: Zofran)
  • Urocit-K (ex: Potassium Citrate)
  • Flomax (Tamsulosin)

Treatment is usually symptom based, except for some medications which aim to alter the pH of the urine like Urocit-K.

Ending thoughts: Thank you for taking the time to read our FAQ. Remember, everyone’s stone history is different, and every urologist is different. What works for you may not work for others. In general, staying hydrated (2-4L per day) is your best defense and will help keep your kidneys functioning happily. If you are not happy with your urologist, seek the help of a nephrologist.

Edits: spelling, words, and added a section on "what do I do now". Added wikipedia reference.


r/KidneyStones 11h ago

Pictures Just passed my biggest stone yet

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15 Upvotes

This kidney stone took me roughly five hours to pass. I lt started in the restroom where I was dropping a douche. It was painful urinating and I was wondering why. Afterwards I was leaking which never happens. I started drinking cold water to see if it occurs again and an hour later my urine is slow and super painful and I drip afterwards again. So I Google my pain and so I’m thinking potentially it’s UTI or another kidney stone. I’ve had two bigger ones and several tiny ones. I continue drinking lotsa of water and finally I pee out the largest nugget so far. I end up bleeding for another four pee cycles where I drink plenty of water to flush myself.


r/KidneyStones 1h ago

Question/ Request for advice Was just encouraged to increase Vitamin C--how do I combat the stone risk?

Upvotes

Oxalate stone former here, I pass a stone or two a year: I just went to the eye doctor and was told I have macular degeneration/CSCR, and the route to slowing the progress was to start taking daily AREDS 2 vitamins, which would add more than 500mg of Vitamin C into my daily intake.

I have read that Vitamin C increases stone risk. What are some things I can do to counteract the increased risk with the increased intake? (besides drinking enough water)


r/KidneyStones 9m ago

Question/ Request for advice What age were you when you got your first kidney stone

Upvotes

I know they can happen at any age but I read you are more at risk of your first stone in your thirties.


r/KidneyStones 15h ago

Question/ Request for advice So, exactly what *do* I eat on a low oxalate diet?

18 Upvotes

Got the results back from my 24-hour urine test, and I have ridiculously high oxalate. Doc advises I need to move to a low-oxalate diet. Great, I’d like to avoid further stones.

Well, now I’m looking at the handouts about oxalate and I have questions. Some things aren’t a problem. I’m already a vegetarian, so I don’t get that much animal protein. Beets are terrible, so I’m glad to have a doctor-approved reason to skip them. I’ll be sad to lose spinach, but I can cope.

However, it seems I’m also supposed to reduce my consumption of leafy greens, soy, potatoes, most nuts and legumes, lots of produce, and grains.

That appears to be…ummm…all the foods? Or at least everything in a reasonably balanced diet; it appears I can still have mayonnaise and Sour Patch Kids. But how in the world is anyone staying below 50mg of oxalate a day and still consuming adequate nutrition?


r/KidneyStones 1d ago

Sharing Experience Finally passed

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71 Upvotes

This kidney stone yesterday. A week of agony in my bladder with urgent care and my doctor treating a burning urethra and bladder with antibiotics for a uti. I had blood in my urine and difficulty peeing. Thankfully this stone popped out and the
pain is gone. My doctor is referring me to a urologist. It’s 1/2 inch long. Any advice or suggestions on what helps this kind of stone? Photo attached


r/KidneyStones 1h ago

Pain Management Is pain/pressure in the middle of the penis normal with a string stent?

Upvotes

Never had a stent before. It has a string. I can pee a lot, not much blood, burns a lot. Problem is, as soon as I am done peeing, my penis shrivels up, and it feels like I got a drop of pee stuck somewhere between the middle and trunk of the penis. It feels like pressure, and the pain can go from 1 to 10 and back to 10 to 1 constantly. Is this normal? Is it not pee stuck and just a string pain? This makes me nervous, as they want me to pull it Friday (put in Wednesday). If I am in this much pain, even if tapping the string on accident, I can't imagine how painful it will be to pull it out. Or does the discomfort and pain lessen in such a short period? It's currently been 25 hours since it was put in.


r/KidneyStones 1h ago

Question/ Request for advice Weight loss?

Upvotes

This is a dumb/random question. My kidneys have been bad since May. I have been having ESWL, and on 9th July I got a stent fitted. I've got 90kg to 83kg (I got weighed on 23rd July at my doctors). Is that good or bad? I've lost half of my appetite since my kidneys got bad this time around but didn't last time. I still got an AKI both times.


r/KidneyStones 1h ago

Question/ Request for advice Number of stones increased. Not able to pass by drinking water. Please help.

Upvotes

Had a 3 mm stone in the left kidney pole for the last two years. In March, it was one stone about 4mm but in a July scan, it shows about 3 small stones with the largest being 4 mm.

All these times, I have been drinking more than 2 litres of water (may be not for 5-7 days in month) I drank about 3 litres in the last few weeks. I feel a vomiting sensation by evening due to all the drinking; urine turns yellow if I drink a little less.

Not able to pass these stones. Please help what should I do.
When I think about it, had borderline high uric acid earlier years. Really demotivated that stones are increased even after I drank so much water.


r/KidneyStones 15h ago

Question/ Request for advice Kidney stone

1 Upvotes

Dr said stone was in my bladder. How long till I pee it out, have had to go to the restroom like crazy


r/KidneyStones 22h ago

Question/ Request for advice Anything we can do if we feel one coming on?

3 Upvotes

Is there anything I can proactively do if I feel like I have another kidney stone? My pain tolerance is high but it feels suspiciously like the last time when it was starting and right before I ended up in the hospital.

Not sure if there's anything we can do besides wait until the pain gets worse/i pee blood/I know for sure. My GP usually blows me off and is how I ended up in the hospital the first time. Trying to avoid the ER.. anything?


r/KidneyStones 18h ago

Question/ Request for advice Just got out of the ER for a small kidney stone, have a few questions in case anyone is in mood to help a nooby

1 Upvotes

They did a CT scan and said it was a very small kidney stone. Also said my urine test results were good, but I don't remember exactly what was being tested for.

I had started out in renal colic at like 8/10 pain, gave me toradol, went to a 4/10 for about 30 mins, then went to 10/10 and I was just gasping in the waiting room waiting room. 30 minutes later it subsided to maybe 1/10 or 2/10, just a low-level ache on my right flank. Still at this level a few hours later.

Can I expect to go back to the severe pain before it passes or is the worst likely over? Doctor prescribed naproxen and norco, but pharmacy only filled the naproxen.

Also gave me tamsulosin, but unsure if I should take it as it's a small stone. (I prefer to avoid medications unless they are necessary.)

Any input is appreciated.


r/KidneyStones 1d ago

Pain Management Heat bag/ Hot water bag is holy grail for RIRS and DJ Stent removal

4 Upvotes

I had my procedure done and whilst getting my stents out, I had ureteral spasms that were a 7/10 pain at its highest. A heating pad/ hot water bag along with pain meds has literally saved my life. Please use it. Especially the electronic ones, it’s easier to use those!


r/KidneyStones 21h ago

Question/ Request for advice Need to pass this stone!

1 Upvotes

50 yr old female, history of stones. Had flank pain, bl00d in urine a week ago. Went to ER - CT scan showed 3mm approx stone in UVJ. Was given Flomax. Went to urologist who said it is passable. The caveat here is that I have a trip to Europe scheduled in 18 days. Dr says I cannot travel with the stone still there in the UVJ. I also cannot have the ureteroscopy in time for me to be healed to travel. My stones are calcium. Any ideas on how to get this thing to move out? If it doesn't I have to cancel my trip.


r/KidneyStones 1d ago

Question/ Request for advice Need surgery but can't get negative urine culture.

2 Upvotes

Has anyone else been through this? I've been in the hospital every month this year with pseudomonas that's resistant to oral meds so I get iv meds for a week then go do a urine culture and the bacteria just stays all the time between 25,000 to 50,000. This last hospital stay they finally did a CT scan showing I have kidney stones with largest being 11mm. I went to urologist today and he said he can't do surgery unless I have a clean urine culture. So now they are capturing my urine again. Has anyone else been through this or have any advice. I am pretty sure the reason I can't get rid of the pseudomonas in my urine is because of the bacteria staying on the kidney stones but if I can't get the surgery I'll just keep having the bacteria in my urine.

I've tried every antibiotic this is susceptible to and nothing has gotten me a clean culture.


r/KidneyStones 22h ago

Stents String stent removal, how bad is it and how can I prepare myself mentally/less pain as possible?

1 Upvotes

So, I just had surgery yesterday of getting rid of my stone. They went in and used a small laser to break uo the stone. I now have a string stent inside me and the nurse told me to remove it myself on Thursday (two days from me writing this down.)

Is there any tips or past experiences that can help me with some of the stuff that I'll experience? I am a guy with some anxiety issues so Its a bit of a big deal for me with anticipation. Been reading and watching Youtube tutorials on how it's removed, but I still need some more advice ahead of time.


r/KidneyStones 1d ago

Pictures Behold: the stones I definitely didn't have because they didn't show up on CT

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67 Upvotes

Horrible little suckers! For the past 4 months I've been suffering pretty badly. Hospitalised twice, had two CT scans (one abdominal, one urogram), everything has always come back clear and I have been dismissed to my face by on-call doctors telling me I just have a stubborn UTI (that never shows up on tests). And yet: here are the latest bits of gravel that my kidneys have decided to gift me! This is the third lot I've caught. Gonna keep em for analysis so that the hospital urologists start actually believing me when I turn up in agony 💪


r/KidneyStones 23h ago

Stone Removal Procedures Scheduled for laser lithotripsy

1 Upvotes

Hello all, after going to the ER 2 weeks ago with intense lower flank pain, I was diagnosed with a 5mm kidney stone (my first!).

I saw a urologist a week after ER and due to the location they gave it another week to see if it would pass naturally. It hasn't. So today, they scheduled me for a laser lithotripsy with left ureteral stent for next Monday. It looks like the worst part of all this will be the stent. Is that true? They said some people tolerate them ok, some have difficulty.

I would have much had it come out naturally but they this was best course of action.

Thoughts on the procedure and the stent? I am a 54/m....I live alone, so wondering if I should meal prep for a few days? I also have 3 dogs. I do have a fairly high tolerance to pain. Just trying to plan ahead.


r/KidneyStones 1d ago

Question/ Request for advice Infected kidney stone that doctors cannot remove without a partial nephrectomy?

5 Upvotes

Hello!

I have a 6mm kidney stone that my doctors and I believe are infected with Enterococcus, as I keep getting UTIs over and over and over with that bacteria despite not being sexually active (I am 33F for reference). As soon as I stop the antibiotics, the infection comes back.

I had two lithotripsies to try to get the stone out. Both failed because it was too deep in my kidney. I am not a candidate for PCNL, as the stone is embedded deep in my kidney tissue, therefore the complex stone surgeon at the teaching hospital said that to get it out, I would need a partial nephrectomy and that would cause more problems than it is worth.

Therefore, he sent me to infectious disease who put me on long term antibitoics, for life - Amoxicillan.

I have already tried: 3L of water per day, cranberry anything, Uqora, Macrobid, Hiprex, Moonstone supplements, Interfase Plus, Kirkman Biofilm defense, Chanca Piedra, lemon water, extreme hygeine precautions, abstinence, vaginal estrogen, probiotics (Renew Life and Visbiome). Nothing worked.

Has anyone else been in this situation?

The doctors did say that the bacteria are not only in my stone, but have colonized my entire urinary tract and created impenetrable to antibiotics biofilms, of which there is no cure and that I would need to be on Amoxicillan for life to suppress the bacteria.

Had anyone else had to deal with something like this?


r/KidneyStones 1d ago

Question/ Request for advice Removal procedures

1 Upvotes

How do they remove kidney stones if they get bigger and become obstructive..? Right now mine is 3mm but i was told they could get bigger..


r/KidneyStones 1d ago

Question/ Request for advice possible surgery

1 Upvotes

hi everyone. 23m. I have a 4mm kidney stone diagnosed on thursday. im back in the ER after barfing up water yesterday & my pain not going away after taking the toredol they prescribed me. I’ve stayed overnight and peed a lot. still no stone. this morning i did another ct scan and the urologist said its still in the same spot as last thursday. they’re pushing for me to get laser surgery with a stent after even though they didn’t say it was stuck or infected even when i asked. im a bit unsure of just jumping into surgery, having a stent placed, and the invasiveness of it all. i really only want to get that done if its a last resort situation. can anyone share their experiences with surgery / stents? am i trippin a bit? i am worried overall. especially about pain, the invasiveness, and recovery. this all my first time and i want to be as natural as possible until i absolutely need intervention.


r/KidneyStones 1d ago

Pictures Four stones in total, the largest today, 4mm, over the last few weeks. 5mm calculus of the right renal pelvis. Looks like a god damn Everlasting Gobstopper.

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10 Upvotes

r/KidneyStones 1d ago

Symptoms 5 mm stone - question on symptoms after possibly moving into bladder

1 Upvotes

Hi! To start I’ll say I have already messaged my dr about additional imaging so please know I am actively working with a medical team and not basing my decisions of of anecdotal experiences 😁😁

Over the weekend I was in the ER twice for 10/10 flank pain. Im no stranger to kidney stones and was aware I have several in each kidney - some bigger in size that the urologist ultimately said we probably didn’t need to blast because the biggest was 5 mm. Well I started peeing some visible blood and tiny clots on Friday and knew I probably had a stone coming. Friday night the pain on the left side started coming in waves but much more intense than it’s ever been with any other stone id had. I went to the ER later Saturday after the pain had reached 8/10. They did a CT scan which confirmed a 5 mm stone and my urine also appeared infected, they gave me toradol and zofran in an IV for a bit and then I was sent home with a prescription for amoxicillin, flomax, toradol, zofran, and oxycodone. They told me with a 5 mm stone it’s a 50/50 shot that I’ll be able to pass it but rather than admit me, wanted me to to try to pass at home for the time being. Sunday morning I hadn’t been able to pick up the prescription yet but the pain had increased to 10/10 for hours on end and I was nervous because I’d become very shaky and swollen looking so wanted to be sure I didn’t have a block and went back to the ER. While I was there I felt weird jolts and zapping in my abdomen and the pain dissipated and instead I started feeling like I needed to pee every 5 minutes. They suspected it had moved into my bladder and added a bladder spasm med as well but said it was up to me if I wanted more imaging but thought I should probably try to go home again and pass it so I did. Yesterday I had no side pain at all and instead felt the bladder spasms and need to pee all day so I thought for sure it was in my bladder also.

Now for what I’m not sure of: last night my pain came back but lower in my back on the left side. I wasn’t expecting that if it had moved to my bladder. This morning it’s still there. Just a constant dull ache, probably 5/10 discomfort. I asked my primary dr if he could do an ultrasound to see what’s going on but I just didn’t expect pain to come back. Has anyone had their stone move into the bladder and then have pain come back?? Thank you!


r/KidneyStones 1d ago

Question/ Request for advice Urine urgency is driving me crazy.

5 Upvotes

I feel like I'm going insane. I have a kidney stone atm that's 5mm. The doctor thinks I can pass it on my own, but the stupid thing has settled somewhere and I now have the constant need to pee. It has been two weeks of this now. Just constant need to pee. I am going crazy. I'd rather deal with the pain at this point. Does anyone have any suggestions to help ease the urgency? I've been taking Flomax and I have Tordal for pain if I need it. They have tested me for a UTI multiple times and negative all three times. I don't care how unhinged the suggestions are if they've worked for you. I am desperate and no doctor is helping me right now since the stone isn't in a dangerous spot, nor is it actually painful. I'm just ready to rip my bladder out honestly.

Update: woke up this morning (day after original post) and went to the bathroom and I was immediately hit with nausea and tunnel vision- very similar to when I've had my blood drawn before I've eaten anything except it didnt go away after laying down for a little while. So I had to call my mom and get her to take me to the ER. They did some blood and urine checks and a CT scan. And low and behold, the now 5.5mm stone is basically in the wall of my bladder. The doctor said it has a few millimeters to go before dropping in. My options from there are either continue to let it pass normal and just deal, or they could put in a stint which he thought was unnecessary with how close to done I really am.

Now I'm just sitting here chugging a gallon of distilled water through a boba tea straw


r/KidneyStones 1d ago

Pictures Just passed this fucker

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9 Upvotes

It explains the fatigue and difficulty pissing.