Kidney stones are hard deposits made up of minerals and salts that form inside your kidneys. They develop when your urine contains more crystal-forming substances than the fluid in your urine can dilute. Passing a kidney stone can produce severe pain. Small stones may go undetected and pass out of the body in the urine without causing symptoms. However, larger stones may get stuck in the urinary tract and block the flow of urine, causing extreme pain. While some kidney stones require surgical removal, there are several methods you can try at home to help break up or pass a kidney stone without surgery.
What causes kidney stones?
There are several factors that can increase your risk of developing kidney stones:
- Dehydration – Not drinking enough fluids increases the concentration of stone-forming minerals in your urine.
- Family history – Some people are more genetically predisposed to developing kidney stones.
- Diet – Eating a lot of sodium, animal protein, sugar, and high oxalate foods can increase your risk.
- Obesity – High body weight increases the excretion of urinary constituents that may form stones.
- Certain medical conditions like hyperparathyroidism, inflammatory bowel disease, and gout can also increase your risk.
- Some medications – Drugs like diuretics, antacids with calcium, and medications containing calcium.
What are the symptoms of kidney stones?
Common symptoms of kidney stones include:
- Severe pain in the side and back, below the ribs
- Pain that radiates to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pain on urination
- Urgent need to urinate
- Urinating more often than usual
- Fever and chills (if an infection is also present)
- Nausea and vomiting
- Blood in your urine
When should you see a doctor for kidney stones?
You should seek medical attention if you experience the following:
- Severe pain that isn’t relieved with pain medications
- Fever and chills
- Blood in your urine
- Difficulty passing urine
- Nausea and vomiting that prevents you from keeping down fluids
- Symptoms lasting more than 48 hours
Seeking prompt medical care is crucial because some kidney stones won’t pass on their own and may require procedures or surgery for removal. Delaying treatment can allow stones to grow larger and cause complications like infection and kidney damage.
How are kidney stones diagnosed?
Your doctor will start by asking about your symptoms and medical history. Diagnostic tests used to confirm kidney stones include:
- Blood tests – To assess kidney function and check for signs of infection.
- Urinalysis – Microscopic exam of your urine to look for red blood cells, white blood cells, and crystals.
- Imaging tests – Ultrasound, CT scan or MRI to visualize your urinary tract.
- Urine culture – To identify any bacteria in your urine if infection is suspected.
Finding out the location and size of your kidney stone can help determine the best treatment approach.
How can you break up a kidney stone without surgery?
Several non-surgical treatment options are available to break up or facilitate the passage of kidney stones. Common methods include:
1. Increase your fluid intake
Drinking more fluids, especially water, dilutes your urine and increases urine volume. This can help flush out small stones from your kidneys. Try to drink at least 2 to 3 liters of fluids daily when passing a stone.
2. Take medications
- Pain relievers – Over-the-counter painkillers like ibuprofen, naproxen or acetaminophen can relieve discomfort.
- Alpha blockers – Help relax the muscles of your urinary tract to ease passing of stones.
- Calcium channel blockers – Prevent calcium buildup that contributes to certain stones.
- Oral steroids – Help reduce swelling around stones to facilitate their passage.
3. Try lithotripsy
Lithotripsy uses ultrasound shock waves directed at the stone from outside your body to break it up into smaller fragments that can pass more easily. It doesn’t require any incisions. Lithotripsy works best for stones in your kidney or upper urinary tract.
4. Use ureteroscopy
Your doctor inserts a thin, lighted instrument called a ureteroscope through your urethra and bladder into your ureter. Special tools can capture the stone or break it into pieces that can then be removed or passed naturally.
5. Try laser stone fragmentation
Laser energy transmitted through a ureteroscope breaks up the stone. The laser doesn’t cut or burn the surrounding tissue. This method works well for larger stones.
6. Get extracorporeal shock wave lithotripsy (ESWL)
This technique uses external shock waves to break up stones in your kidney or upper urinary tract. The remaining fragments pass out through your urine.
7. Use percutaneous nephrolithotomy
Your surgeon makes a small incision in your back and creates a tunnel directly into your kidney through which instruments can be inserted to break up and remove larger stones.
How can you prevent kidney stones from recurring?
Making certain dietary and lifestyle changes can lower your risk of developing new kidney stones in the future:
- Drink plenty of fluids, especially water.
- Limit sodium intake to reduce stone-forming calcium excretion.
- Reduce consumption of animal proteins.
- Eat less oxalate-rich foods like spinach, rhubarb, nuts, wheat bran and chocolate.
- Get enough calcium, but not excessive amounts.
- Maintain a healthy weight.
- Take medications if prescribed to prevent stones.
When is surgery necessary to remove kidney stones?
Surgery may be required in cases where:
- Stones are very large and less likely to pass naturally.
- Stones are blocking the flow of urine and causing severe pain or infection.
- Other procedures have failed to break up or remove the stones.
- Stones are located in positions that are difficult to reach.
Common surgical procedures include:
- Percutaneous nephrolithotomy – Kidney stones are removed directly through a small incision in your back.
- Ureteroscopy – A ureteroscope inserted through the urethra and bladder allows removal of stones from your ureter.
- Laser lithotripsy – Laser energy delivered through a ureteroscope breaks up larger stones.
- Open surgery – Rarely needed, involves making an abdominal incision to directly access stones.
Conclusion
While passing kidney stones can be extremely painful, there are several effective methods you can try without surgery. Home remedies like drinking more fluids help flush out smaller stones. Medications can ease discomfort and facilitate stone passage. Procedures like lithotripsy, ureteroscopy and laser lithotripsy use technology to break stones into passable pieces. Making dietary and lifestyle changes is key to preventing new kidney stones. However, surgery may still be required for very large, obstructing, or difficult to reach stones that don’t respond to other treatments.