What patient education is recommended for managing flank pain?

Patient Education for Flank Pain

For patients with flank pain, education should focus on maintaining increased fluid intake, attempting to strain urine to catch any passed stones, and understanding when to seek immediate medical attention if pain worsens or new symptoms develop. 1

Understanding Flank Pain

• Flank pain often presents as an abrupt onset of severe unilateral pain radiating into the groin or genitals, commonly associated with renal stones but can have other causes 1
• Patients should understand that hematuria (blood in urine) supports the diagnosis of renal stones, present in over 80% of cases 1
• Flank pain may also be caused by conditions other than kidney stones, including pyelonephritis (kidney infection), renal infarction, or rarely, more serious conditions like Page kidney or abdominal aortic aneurysm 2, 3

Home Management Instructions

Pain Management

• After medical assessment, appropriate analgesia should be provided for pain control 1
• Patients should be instructed on proper use of prescribed pain medications and when to seek medical attention if pain is not adequately controlled 1

Hydration and Monitoring

• Patients should be advised to maintain higher fluid intake to promote stone passage and prevent dehydration 1
• Instruct patients to void urine into a container, tea strainer, or through gauze to catch any passed stones for identification 1
• Catching the stone is important as it helps confirm diagnosis and can guide future prevention strategies 1

Warning Signs Requiring Medical Attention

• Patients must be educated to contact their healthcare provider if: 1, 4
  • Pain worsens or becomes uncontrollable with prescribed medications
  • Fever develops, which could indicate infection
  • Nausea and vomiting prevent adequate hydration
  • Symptoms of urinary tract infection develop (increased frequency, urgency, burning)
  • Visible blood in urine increases significantly

Follow-up Instructions

• A follow-up assessment (which may include a phone call) should occur within one hour after initial treatment and analgesia administration 1
• Patients should understand the importance of completing any recommended imaging studies to determine: 1
  • If a stone was identified, its size and location
  • Whether intervention might be needed for larger stones
  • If alternative diagnoses should be considered when no stone is found
  • Risk factors for developing future episodes

Special Populations

Pregnant Patients

• Pregnant patients with flank pain should be informed that ultrasonography is the preferred imaging method to avoid radiation exposure 1
• These patients should understand that physiological changes during pregnancy can sometimes cause hydronephrosis (kidney swelling) that mimics stone symptoms 1

Patients with Recurrent Stone Disease

• Patients with history of kidney stones should be educated about the importance of preventive measures 1
• For recurrent stone formers, limited CT imaging focused on the area of concern may be appropriate to minimize radiation exposure 1

Diagnostic Testing Education

• Patients should understand that their healthcare provider may recommend different imaging tests based on their specific situation: 1
  • Ultrasonography is often used as an initial test, especially in pregnant patients or those with recurrent stones
  • CT scans without contrast provide the most accurate diagnosis for kidney stones but involve radiation exposure
  • Other tests may be needed if conditions other than kidney stones are suspected

By following these educational guidelines, patients can better manage their flank pain, understand when to seek additional care, and potentially help identify the cause of their symptoms through proper urine collection and follow-up.