Kidney Stones

Symptoms

• Severe Flank or Back Pain: Intense pain in the side and back below the ribs that often comes in waves and fluctuates in intensity as the stone moves through the urinary tract.
• Pain Radiating to the Groin: Pain that spreads from the back or side into the lower abdomen and groin, shifting location as the stone travels down the ureter.
• Blood in the Urine: Urine that looks pink, red, or brown, or blood detected on testing, caused by the stone irritating the lining of the urinary tract.
• Nausea and Vomiting: Feeling sick to your stomach or vomiting, which commonly accompanies severe stone pain.
• Painful or Frequent Urination: Burning with urination, a persistent urge to go, or passing only small amounts at a time, especially once the stone nears the bladder.
• Cloudy or Foul-Smelling Urine: A possible sign that infection has developed along with the stone, which raises the urgency of getting evaluated.

When It's an Emergency

Go to the ER right away if you have severe pain in your back, side, or groin that you cannot get comfortable with, especially if it comes in waves and is joined by nausea or vomiting you cannot control. Kidney stone pain is among the most severe pain people experience, and IV medication in the ER can control it while imaging confirms what is happening.

Seek emergency care immediately if you have a fever and chills along with stone symptoms. A stone that blocks the kidney while infection builds behind it can lead to sepsis, and it is a true emergency that needs urgent diagnosis and often urgent drainage at a hospital.

Other red flags include blood in your urine with severe pain, difficulty or inability to urinate, or stone symptoms when you have only one working kidney, are pregnant, or have diabetes or a weakened immune system. When in doubt, it is safer to be evaluated than to try to ride out the pain at home.

When It's Not an Emergency

Not every kidney stone needs an emergency visit. If you have a known small stone, your pain is mild and controlled with over-the-counter medication, and you are drinking fluids, keeping them down, and urinating normally with no fever, it is often reasonable to follow the plan your doctor or urologist gave you.

A telemedicine visit or a call to your primary care doctor is a sensible first step for mild, intermittent discomfort, questions about a previously diagnosed stone, or follow-up on prevention. Many small stones pass on their own with time, fluids, and oral pain control.

The picture changes quickly if pain becomes severe or unrelenting, vomiting keeps you from holding down fluids, you develop a fever, or you stop passing urine. Any of those changes means stop waiting and come to the ER.

What Happens at Bellaire ER

At Bellaire ER, a board-certified emergency physician evaluates your pain, examines you, and gets testing started quickly, because uncontrolled stone pain should not wait. Urine testing checks for blood and signs of infection, and blood work assesses your kidney function and looks for evidence of infection.

CT scanning is the standard test for diagnosing kidney stones, and our CT scanner is on-site, so you get an answer in a single visit. Imaging shows the size and location of the stone and whether it is blocking the kidney, which is exactly what determines the right treatment.

Treatment typically starts with IV pain medication, anti-nausea medication, and fluids, and most stones ultimately pass on their own. If your stone is small, we control your symptoms and send you home with a clear plan, medication, and instructions for follow-up. If the stone is large, blocking the kidney, or accompanied by infection, we start antibiotics when needed and coordinate prompt urology care or hospital transfer for procedures such as lithotripsy or ureteroscopy.

Prevention

Drinking enough water throughout the day is the single most effective way to prevent kidney stones, because dilute urine makes it harder for crystals to form. Depending on the type of stone you have formed before, your doctor may also recommend limiting sodium, moderating animal protein, or adjusting how you get calcium and oxalate in your diet, and certain medications can help prevent recurrence. If you have had a stone once, you are at higher risk of another, so it is worth reviewing a prevention plan with your doctor or urologist.