From the Guidelines
For kidney stone pain, the most effective treatment is to drink plenty of water, at least 2-3 liters daily, and use over-the-counter pain relievers like ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours or naproxen (Aleve) at 220-440mg every 8-12 hours. This approach helps to flush out stones, prevent dehydration, and provide relief from pain [ 1 ].
Key Considerations
- Drinking plenty of water is essential to help flush out stones and prevent dehydration [ 1 ].
- Over-the-counter pain relievers like ibuprofen or naproxen can provide relief from pain [ 1 ].
- Prescription medications such as ketorolac or stronger pain medications may be needed for severe pain.
- A heating pad applied to the affected area for 15-20 minutes can also ease discomfort.
- Alpha-blocker medications like tamsulosin may be prescribed to relax ureter muscles, making stone passage easier and less painful.
When to Seek Medical Attention
- Severe pain
- Fever
- Vomiting
- Inability to urinate These symptoms may indicate complications and require immediate medical attention [ 1 ].
Prevention of Recurrent Kidney Stones
- Increased fluid intake to achieve at least 2 L of urine per day [ 1 ].
- Dietary changes, such as reducing dietary oxalate, reducing dietary animal protein, and maintaining normal dietary calcium [ 1 ].
- Pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol may be recommended for patients with active disease in which increased fluid intake fails to reduce the formation of stones [ 1 ].
From the Research
Treatment Options for Kidney Stone Pain
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce renal colic pain in 30 minutes compared to placebo 2
- The evidence is very uncertain about the effect of NSAIDs on the need for rescue medication 2
- Comparing one NSAID against another, IV ketorolac may be less effective than IV ibuprofen, and pirprofen may result in less need for rescue medication than indomethacin 2
Medical Treatment of Nephrolithiasis
- The medical treatment of nephrolithiasis is aimed at the prevention of relapses, and medical treatment is effective in a large number of patients 3
- Medical treatment includes water intake, diet, and drugs, and the choice of treatment depends on the type of stone and the patient's metabolic profile 3
- Pharmacologic treatment is a more affordable, readily available, and less invasive option for patients, and patient-tailored medical management should be considered by every physician 4
Management of Kidney Stones
- Recognition, diagnosis, and management of nephrolithiasis are pertinent to general surgeons, as the risk of nephrolithiasis is increased in common general surgical conditions 5
- Nephrolithiasis may be induced as a result of general surgical interventions, including gastric bypass and bowel resection with ileostomy 5
- A comprehensive approach to the management of kidney stones includes both surgical and pharmacologic interventions, and the choice of treatment depends on the individual patient's needs 6, 2, 4