For most individuals, the acute onset of kidney stones occurs when the stone enters the ureter and causes severe pain.  Surprisingly, initial treatment can be simply water and and analgesics.

A kidney stone is defined as a hard, rock-like mass made of minerals in the kidney.  But, to those who have had the unfortunate experience of passing a large kidney stone, the definition is just one word:  agony.

Stones develop from chemicals filtered by the kidneys, such as calcium, uric acid and cystine. When other chemicals, such as citrate and magnesium, don't provide sufficient balance, crystals are formed and then clump together on the inner surfaces of the kidney.

It's not unusual to be symptom free but still have kidney stones.  It's only when a stone of significant size breaks loose and begins to work its way down the ureter that you experience pain.   The onset of pain is usually sudden and dramatic, typically in the area of the kidney or in the lower abdomen. It may radiate to the groin.  The severity of pain depends on the size of stone and how much of a blockage it creates.  Other symptoms may accompany the pain such as:

• Nausea and vomiting
• Blood in the urine
• Frequent urge to urinate
• Burning sensation during urination
• Fever (when infection is present)

Since most kidney stones will pass without intervention, treatment is usually ‘‘wait and watch'' while the patient takes pain medications and aggressively hydrates, drinking at least 2 to 3 quarts of liquid per day.  In some cases, a doctor may prescribe antibiotics to fight infection, an antispasmodic to relax the ureter or diuretics to prevent urine from staying in the kidney. 

While small stones can pass through the body within hours or a few days, larger stones can take several weeks.  During that time, the patient is usually asked to strain their urine to catch the stone.  Its chemical make-up can be analyzed to provide clues on how to prevent recurrence.  If a stone doesn't pass in a reasonable time, patients are usually referred to a urologist.   When a patient repeatedly suffers from kidney stones they may be referred to a nephrologist.