What can I take if I think I have kidney stones?

What You Can Do If You Think You Have Kidney Stones

If you suspect kidney stones, immediately increase your fluid intake dramatically to achieve at least 2.5 liters of urine output daily, and take an over-the-counter NSAID (like ibuprofen) for pain control while seeking medical evaluation. 1, 2, 3

Immediate Self-Management Steps

Pain Control

• NSAIDs are the preferred first-line treatment for kidney stone pain (renal colic), superior to opioids for this specific condition 2, 3, 4
• Take ibuprofen or naproxen as directed on the package unless you have contraindications (kidney disease, stomach ulcers, bleeding disorders) 4

Hydration Strategy

• Drink enough fluids to produce at least 2.5 liters of urine per day - this typically requires drinking 3-4 liters of fluid daily 1, 2
• Water is the primary choice, but coffee (caffeinated or decaffeinated), tea, wine, and orange juice are associated with lower stone risk in observational studies 1, 5
• Avoid sugar-sweetened beverages and grapefruit juice, which increase stone formation risk 1, 5

Urine Straining

• Strain all urine through a filter or fine mesh to catch any stones that pass 2
• Save any captured stones in a clean container for laboratory analysis, as this guides future prevention strategies 2, 6

When to Seek Emergency Care Immediately

You must go to the emergency department if you experience: 2

• Fever or signs of infection
• Severe uncontrolled pain despite NSAIDs
• Persistent vomiting leading to dehydration
• Complete inability to urinate (signs of urinary obstruction)

What Medical Evaluation You Need

Initial Testing

Once you see a healthcare provider, expect: 2, 6

• Urinalysis (dipstick and microscopic examination) to check for blood, infection, pH, and crystal types
• Serum chemistries including electrolytes, creatinine, calcium, and uric acid
• Imaging studies - ultrasound is first-line (especially safe if pregnant), though CT scan may be needed 2, 3
• Urine culture if infection is suspected 6

Stone Analysis

• At least one stone should be analyzed when material is available, as composition determines prevention strategies 2, 6
• Different stone types (calcium oxalate, calcium phosphate, uric acid, cystine, struvite) require different management approaches 3, 7

Dietary Modifications While Awaiting Medical Care

What to Eat

• Maintain normal dietary calcium intake of 1,000-1,200 mg daily from food sources (not supplements) 1, 2
• Counterintuitively, restricting calcium actually increases stone risk by allowing more oxalate absorption in the intestines 5, 4
• Increase fruits and vegetables to raise urinary pH 5

What to Limit

• Restrict sodium to 2,300 mg (100 mEq) daily, as high sodium increases urinary calcium excretion 1, 2
• Reduce animal protein intake to 5-7 servings of meat, fish, or poultry per week 5
• If you have calcium oxalate stones (most common type at 61% of cases), limit oxalate-rich foods like spinach, rhubarb, nuts, and chocolate while maintaining calcium intake 1, 3

Critical Pitfall to Avoid

Do not take calcium supplements, as these increase stone risk by 20% unlike dietary calcium from food 1, 2

Expected Timeline and Follow-up

• Most stones 10 mm or smaller can pass spontaneously with conservative management (hydration, pain control, and possibly medical expulsive therapy with an alpha-blocker prescribed by your doctor) 3, 4
• Follow-up imaging should occur within 14 days to monitor stone position and check for complications like hydronephrosis 4
• If the stone doesn't pass, interventions like lithotripsy or ureteroscopy may be needed 3, 4

Long-term Prevention Considerations

If you're confirmed to have kidney stones: 2, 6

• High-risk or recurrent stone formers should undergo metabolic testing with 24-hour urine collection
• This identifies specific abnormalities (high calcium, low citrate, high oxalate, high uric acid) that guide targeted prevention
• Prevention strategies may include continued high fluid intake, specific dietary modifications, and medications like thiazide diuretics, potassium citrate, or allopurinol depending on your stone type and metabolic profile 1, 5, 4, 8