Many people first notice urolithiasis (kidney stones) when a sudden, sharp pain starts in the back or side and moves toward the lower abdomen or groin, sometimes coming in waves and strong enough to stop you in your tracks. You may also see blood in the urine, feel a burning sensation when peeing, or need to urinate more often; nausea or vomiting can tag along with the pain. For some, the first signs of urolithiasis show up as a urinary tract infection or as stones found incidentally on an ultrasound or CT done for another reason.
Condition
Urolithiasis
This condition is associated to the following genes:
This condition has the following symptoms:
Side/back painGroin painBlood in urineNausea, vomitingPainful urinationUrgent urinationFrequent urinationUrolithiasis means stones forming in the urinary tract—most often in the kidneys—causing sharp flank or back pain that can radiate to the groin, blood in the urine, nausea, or an urgent need to pee. Many people first hear about urolithiasis when sudden severe pain sends them to urgent care or the emergency department. Stones can occur at any age but are most common in adults; they may pass on their own within days to weeks or require treatment such as pain control, fluids, medications to help passage, or procedures like shock wave therapy or endoscopic removal. Recurrence is common, so long-term care focuses on prevention with hydration, diet changes, and sometimes medications based on stone type. Mortality is rare, but complications like infection or kidney blockage need prompt medical attention.
Short Overview
Symptoms
Urolithiasis causes sudden, severe side or back pain that can move toward the lower belly or groin. Blood in urine, burning, frequent urges, nausea, or vomiting are common. Fever or chills with pain can signal infection and need prompt care.
Outlook and Prognosis
Most people with urolithiasis do well once the stone passes or is treated, and many return quickly to normal activities. The main challenge is recurrence; stones often come back. Long-term success improves with tailored prevention, hydration, diet changes, and follow-up.
Causes and Risk Factors
Urolithiasis often starts with highly concentrated urine and crystal formation. Risks include dehydration, high salt or animal‑protein diets, sugary drinks, obesity, gout, hyperparathyroidism, recurrent urinary tract infections, some medicines, and urinary tract abnormalities. Family history and cystinuria raise risk.
Genetic influences
Genetics plays a meaningful role in urolithiasis. Certain inherited variations affect urine chemistry—raising calcium, oxalate, uric acid, or cystine—and increase stone risk or recurrence. Family history can guide prevention, screening, and, in rare cases, genetic testing.
Diagnosis
Doctors suspect Urolithiasis based on sudden flank pain, blood in urine, or infection signs. Diagnosis of Urolithiasis uses lab tests plus imaging, usually ultrasound or low-dose CT, to confirm stone size and location. Additional tests check blockage or complications.
Treatment and Drugs
Treatment for urolithiasis focuses on easing pain, helping stones pass, and preventing new ones. Small stones often pass with fluids, pain relief, and medicines that relax the ureter; larger or stubborn stones may need shock-wave lithotripsy, ureteroscopy, or rarely surgery. Your plan includes stone analysis and tailored prevention with hydration, diet changes, and targeted medications.
Symptoms
With urolithiasis, pain can strike suddenly in the side or back and make it hard to get comfortable. Early symptoms of urolithiasis may be mild urinary changes or a dull ache that comes and goes, then build into sharper, wave-like pain that can stop you in your tracks. You might also notice blood in the urine, burning with urination, or feeling like you have to go more often. Symptoms vary from person to person and can change over time.
Severe side pain: Sudden, intense pain hits the side or back and often comes in waves. It can make it hard to sit still or find a comfortable position.
Pain that radiates: The pain may move toward the lower belly, groin, or genitals as the stone shifts. This moving pattern is typical during urolithiasis.
Blood in urine: Urine may look pink, red, or brown. People with urolithiasis can notice this off and on, especially after activity or during painful spells.
Urgency and frequency: You may feel a strong need to urinate often, even when little comes out. A stone can irritate the bladder and lower urinary tract.
Burning urination: Stinging or burning when you pass urine can occur. It’s usually from irritation as the stone moves through the urinary tract.
Nausea or vomiting: Severe pain can trigger nausea and vomiting. Some people with urolithiasis also feel sweaty or lightheaded during painful waves.
Fever or chills: Fever, chills, or feeling unwell with urinary pain can signal an infection behind a blockage. This combination is an emergency and needs prompt medical care.
Cloudy, smelly urine: Urine may turn cloudy or develop a strong odor. This can happen with infection or inflammation during urolithiasis.
Trouble urinating: A stone can slow or briefly stop urine flow. You may strain, pass only small amounts, or feel pressure in the bladder.
Passing grit or stones: You might see tiny grains or a small stone in the toilet or strainer. This often follows a burst of pain and then relief.
Restlessness and sweating: During painful episodes, many people with urolithiasis can’t find a comfortable position. Pacing, sweating, and anxiety are common with severe waves of pain.
No symptoms: Some stones cause no symptoms and are found on scans done for another reason. Small, non-moving stones may sit quietly until they start to travel.
How people usually first notice
Types of Urolithiasis
Urolithiasis has several well-recognized stone types that form for different reasons and can lead to different symptom patterns. Some people feel sudden, severe side pain, while others only notice blood in the urine or frequent urges to go. Symptoms don’t always look the same for everyone. Understanding the main types of urolithiasis can help you discuss the types of urolithiasis you might be dealing with and what prevention could look like.
Calcium oxalate
These are the most common stones and often form when urine is concentrated and oxalate levels run high. Pain can be intense and sudden, sometimes with visible or microscopic blood in the urine. Diet and hydration changes often help reduce recurrences.
Calcium phosphate
These stones can form in more alkaline urine and may be linked to conditions that raise calcium in the urine. People may have flank pain and urinary burning or urgency, sometimes with recurrent episodes. Managing urine pH and underlying causes can lower risk.
Struvite (infection) stones
These stones develop with certain urinary tract infections and can grow quickly. People may notice fever, cloudy or foul-smelling urine, and flank pain. Treating the infection and removing the stone are both important to prevent return.
Uric acid
These stones form in persistently acidic urine and may be linked to gout or metabolic syndrome. Colicky side pain and blood in the urine are common, but stones can sometimes dissolve with urine alkalinization. Hydration and diet changes often complement medication.
Cystine
These are rare and caused by an inherited condition that spills cystine into the urine. Stones tend to recur from a young age and can cause repeated bouts of severe flank pain. High fluid intake and medicines that change urine chemistry are often needed long term.
Drug-related stones
Certain medicines can crystallize or change urine chemistry to promote stone formation. Symptoms mirror other stones—sharp side pain, nausea, and blood in the urine. Reviewing medications with a clinician can guide prevention and alternatives.
Did you know?
Some people inherit changes in genes that raise urine calcium, oxalate, or uric acid, which can trigger kidney stones and sharp flank pain, blood in urine, or nausea. Variants in SLC26A1, SLC26A6, SLC3A1, AGXT, and APRT link to specific stone types and recurrences.
Causes and Risk Factors
Hot weather, not drinking enough water, or heavy sweating can concentrate your urine and make kidney stones more likely. Eating a lot of salt and animal protein, frequent sugar-sweetened drinks, and very low calcium in meals can shift urine chemistry toward stone formation, especially when daily fluids are low. Other risk factors for urolithiasis include a prior stone, obesity, diabetes, gout, recurrent urinary infections, bowel disease or bariatric surgery, and differences in kidney or urinary tract structure. Urolithiasis also tends to run in families, reflecting inherited traits that increase the amount of calcium or uric acid in the urine. Doctors distinguish between risk factors you can change and those you can’t, so steps like drinking enough water, moderating salt and animal protein, and maintaining a healthy weight can help, while age, sex, and family history are fixed.
Environmental and Biological Risk Factors
Kidney stones can disrupt daily life when they form and move through the urinary tract. Urolithiasis refers to these stones, and both environmental and biological factors can raise the chance they develop; below are key environmental risk factors for urolithiasis and body-based conditions that can make stones more likely. Doctors often group risks into internal (biological) and external (environmental). Understanding these can help you and your care team focus on what is changeable in your surroundings versus what is body-based.
Hot climates: Living or working in high heat increases sweat loss and concentrates urine. Concentrated urine makes crystals more likely to form, raising the risk of urolithiasis.
Recurrent UTIs: Some bacteria make urine more alkaline and fuel infection-related stones. Repeated infections can rapidly create large stones and drive urolithiasis.
Overactive parathyroid: Too much parathyroid hormone raises blood and urine calcium. High urine calcium is a common driver of calcium stones.
Type 2 diabetes: Insulin resistance tends to make urine more acidic. Acidic urine favors uric acid stones and increases overall stone risk.
High uric acid: Gout or other causes of excess uric acid can seed crystals directly. These crystals can also act as a starting point for calcium stones.
Bowel disease or surgery: Chronic diarrhea or intestinal bypass raises oxalate absorption and causes fluid loss. This combination increases stone formation and the likelihood of urolithiasis.
Low urinary citrate: Citrate normally keeps crystals from clumping together. Low levels from acid-base imbalances or potassium loss remove this protection.
Alkaline urine states: Conditions that keep urine too alkaline, such as a kidney acid-balance problem known medically as distal renal tubular acidosis, favor calcium phosphate stones. This biologic setting can contribute to urolithiasis.
Urine flow blockage: An enlarged prostate, scarring, or structural differences can slow urine and cause stasis. Stagnant urine encourages crystal growth and infection-related stones.
Stone-forming medicines: Some medicines can crystallize in urine or alter urine chemistry, including topiramate, acetazolamide, and certain HIV drugs like indinavir. These effects raise the chance of kidney stones.
Prolonged immobilization: Long periods in bed from injury or illness increase bone calcium release into the bloodstream. Higher urine calcium can lead to stone formation and increase urolithiasis risk.
Genetic Risk Factors
If kidney stones run in your family, genetics may explain part of your risk. Some risk factors are inherited through our genes. Urolithiasis can arise from rare single-gene conditions as well as common gene changes that subtly shift how the kidneys handle minerals. This overview focuses only on genetic causes of urolithiasis, not lifestyle or environmental factors.
Family history: Kidney stones often cluster in families, reflecting shared genes that influence urine chemistry. This inherited pattern raises the likelihood of urolithiasis even when no single rare disorder is present. Risk can vary widely among relatives.
Cystinuria: A genetic change makes the kidneys spill too much cystine, an amino acid that can crystallize. This leads to repeated stones, often starting in childhood or young adulthood. It often involves gene changes passed along by both parents.
Primary hyperoxaluria: The liver makes too much oxalate, which the kidneys must excrete, forming hard deposits. This genetic condition can cause early and frequent urolithiasis and kidney calcifications. Early recognition can protect kidney health.
APRT deficiency: A rare inherited enzyme problem causes a substance called 2,8-dihydroxyadenine to build up and form stones. These stones can recur and may be missed on standard X-rays. Genetic testing can confirm the cause.
Distal renal tubular acidosis: Genetic changes impair the kidney’s ability to acidify urine, promoting calcium-phosphate deposits. People may develop urolithiasis and kidney calcifications, sometimes beginning in childhood. Some forms also link to hearing changes.
Dent disease: This hereditary kidney disorder mainly affects males and causes protein and calcium losses in urine. It leads to frequent stones and calcifications and can gradually reduce kidney function. Female carriers can have milder features.
Vitamin D breakdown: When the body cannot break down vitamin D efficiently due to inherited changes, calcium levels can run high. Excess calcium in the urine raises stone risk and can cause kidney calcifications. Symptoms may appear from infancy through adulthood.
Hereditary hyperparathyroidism: In some families, overactive parathyroid glands are genetic and raise blood calcium. The kidneys then excrete more calcium, boosting stone risk. Clues can include bone, abdominal, or kidney issues across relatives.
Sickle cell conditions: Inherited changes in hemoglobin can acidify and concentrate urine and increase uric acid handling problems. These shifts make both uric acid and calcium stones more likely. Even sickle cell trait can mildly raise risk.
Polycystic kidney disease: This inherited condition alters kidney structure and urine flow. Those changes can foster urolithiasis, especially when cysts disrupt normal drainage. Stone type may vary.
Lifestyle Risk Factors
Kidney stones can upend daily life—from skipping workouts to being jolted awake by sharp back or side pain. The good news is that everyday habits around fluids, food, and movement play a big role in stone risk. Here are some of the most relevant lifestyle risk factors for Urolithiasis based on what you drink, eat, and how active you are. Risk is more of a probability than a promise.
Low fluid intake: When you don’t drink enough, urine becomes concentrated and crystals form more easily. Most adults do better aiming for about 2–3 liters (68–101 oz) of fluid daily, unless your clinician advises otherwise.
High sodium diet: Too much salt pulls more calcium into the urine, feeding stone formation. Cutting back on packaged foods and salty restaurant meals can lower Urolithiasis risk.
Heavy animal protein: Large portions of meat, fish, or poultry can raise uric acid and lower citrate, a natural stone blocker. This combination can encourage both uric acid and calcium stones.
Oxalate-heavy foods: Frequent large servings of spinach, rhubarb, beets, almonds, or peanuts can raise urinary oxalate. Eating these with calcium-containing foods at meals can reduce oxalate absorption and help people with Urolithiasis.
Low calcium intake: Skimping on calcium in food lets more oxalate get absorbed from the gut. Steady, food-based calcium spread through the day is usually safer for stone prevention than high-dose pills.
Sugary drinks: Colas and sugar-sweetened beverages are linked with more stones. Choosing water or unsweetened citrus drinks is a better fit for managing Urolithiasis risk.
Too few fruits/veg: Low produce intake means lower citrate, which helps keep crystals from clumping. Adding citrus like lemon or orange can nudge urinary citrate upward.
Excess vitamin C: High-dose vitamin C supplements can convert to oxalate and raise stone risk. Staying near typical daily amounts is safer unless your clinician suggests otherwise.
Ketogenic or crash diets: Very low-carb or rapid weight-loss plans can increase uric acid and calcium in urine. Choosing gradual, balanced weight loss can reduce Urolithiasis risk.
Sedentary routine: Little movement can contribute to weight gain and changes in bone turnover that may raise stone risk. Regular activity supports a healthier urine chemistry profile.
Calcium supplement timing: Taking calcium pills without food may increase urinary calcium. If supplements are needed, taking them with meals can better protect against Urolithiasis.
Weight gain/obesity: Higher body weight is linked to more acidic urine and more stones. Step by step, small changes can set the course toward resilience.
Risk Prevention
Urolithiasis (kidney stones) can often be prevented or its risk lowered with everyday habits and, when needed, tailored medical steps. Alongside medical care, everyday habits also matter. For many, that means staying well hydrated, adjusting salt and protein intake, and adding more citrate-rich foods like citrus. Recognizing early symptoms of urolithiasis—such as sharp side pain or blood in the urine—can prompt quick care and extra fluids before a blockage worsens.
Hydration first: Aim to drink enough to make at least 2–2.5 liters (about 68–85 fl oz) of urine daily. That usually means 2–3 liters (8–12 cups) of fluids a day, spread out.
Cut back salt: High sodium makes you lose more calcium in urine, which can feed stones. Keep sodium under about 2,300 mg/day (about 5–6 g of salt).
Keep calcium normal: Do not cut dietary calcium unless your doctor advises it, because too little calcium can raise oxalate absorption. Get calcium from foods (about 1,000–1,200 mg/day) and pair it with meals.
Watch oxalate foods: For calcium oxalate stones, limit very high-oxalate foods like spinach, rhubarb, beets, almonds, and peanuts. If you eat them, combine with calcium-containing foods to bind oxalate in the gut.
Moderate animal protein: Large amounts of meat, fish, or shellfish can raise stone-forming acids in urine. Favor smaller portions and include more plant proteins like beans and lentils.
Boost citrate intake: Citrus fruits and juices (like lemon or lime) increase urinary citrate, which helps block crystals. Your clinician may prescribe potassium citrate if urolithiasis recurs.
Limit sugary drinks: Sugar-sweetened beverages and colas can raise stone risk, especially those with phosphoric acid. Choose water, sparkling water, or citrus-added water instead.
Mind heat and sweat: Hot weather, saunas, or hard workouts increase fluid loss and concentrate urine. Drink extra and aim for pale-yellow urine during and after activity to lower urolithiasis risk.
Healthy body weight: Excess weight and insulin resistance can shift urine chemistry toward stones. Gradual weight loss through balanced eating and regular activity can reduce urolithiasis risk.
Review meds and supplements: Some medicines and supplements can promote stones, including certain diuretics, topiramate, and high-dose vitamin D. Ask your clinician to adjust options if you have urolithiasis.
Be cautious with vitamin C: High-dose vitamin C can convert to oxalate and raise stone risk, especially in men. Avoid routine doses above ~1,000 mg/day (about 1 g/day) unless advised.
Manage uric acid: For uric acid stones, less purine-rich meat and a more alkaline urine can help. Your doctor may use alkalinizing agents or allopurinol if urolithiasis keeps returning.
Personalized testing: A 24‑hour urine test can pinpoint your drivers—calcium, oxalate, citrate, uric acid, and volume. Results guide tailored steps and, if needed, medicines like thiazide diuretics or potassium citrate.
Regular follow-up: Periodic check-ins and, when advised, imaging help track changes and catch small stones early. This supports long-term control of urolithiasis.
How effective is prevention?
Urolithiasis is an acquired condition, and prevention can cut your risk of future stones, but it’s not a sure thing. For many people, daily steps like drinking enough fluids, limiting sodium, and tailoring diet to stone type reduce recurrences by about one-half. Medicines such as thiazide diuretics, potassium citrate, or allopurinol lower risk further when matched to your urine chemistry. Regular follow-up with urine and blood tests helps fine-tune the plan and keeps protection strongest over time.
Transmission
Urolithiasis (kidney stones) is not contagious—you can’t catch it from someone else through touch, the air, food or water, toilets, or sex. Most stones form because of dehydration, diet, or other health factors in your own body, not because urolithiasis spreads between people. A family history can raise your risk, and a few rare inherited conditions (for example, cystinuria) can cause stones, but that’s a predisposition, not person-to-person transmission. If you’ve wondered is urolithiasis contagious, the answer is no.
When to test your genes
Consider genetic testing if you formed kidney stones at a young age, have recurrent stones, unusual stone types, chronic kidney issues, or a strong family history. It also helps when stones occur with other features like gout, metabolic acidosis, or childhood growth issues. Results can guide targeted prevention—specific diets, medications, and monitoring for you and relatives.
Diagnosis
Kidney stones can announce themselves with sharp back or side pain, blood in the urine, or nausea that seems to come in waves. For many, the first step comes when everyday activities start feeling harder. Doctors usually begin with your story and a simple exam, then use tests to confirm the diagnosis of Urolithiasis and check for blockage or infection. Here’s how Urolithiasis is diagnosed in routine care.
History and exam: Your provider asks about pain location, timing, urine changes, prior stones, and medicines. They check your belly and back for tenderness and signs of dehydration.
Urine dipstick: A quick urine test looks for blood, crystals, and signs of infection. This helps confirm stone clues and spot an urgent infection that needs antibiotics.
Urinalysis microscopy: The lab examines urine under a microscope for red cells, white cells, bacteria, and crystals. Finding certain crystal types can hint at the stone’s makeup.
Urine culture: If infection is suspected, urine is sent to grow any bacteria. Results guide the right antibiotic when needed.
Blood tests: Tests check kidney function, minerals like calcium, and signs of infection or blockage. Abnormal results can change the urgency and imaging plan.
Noncontrast CT scan: A low-dose CT of the belly and pelvis is the most sensitive test to find stones and measure size and location. It also shows if urine flow is blocked.
Ultrasound: Sound-wave imaging can detect many stones and swelling of the kidney without radiation. It is often used first in pregnancy and in younger people.
KUB X-ray: A plain abdominal X-ray can show some—but not all—stones. It’s useful to track movement of stones that are visible on X-ray.
Pregnancy-safe approach: Ultrasound is the first-line test during pregnancy to avoid radiation. If more detail is needed, MRI without contrast may be considered.
Stone analysis: If you pass a stone or it’s removed, the lab analyzes its composition. Knowing the type guides prevention and future treatment choices.
Metabolic evaluation: People with recurrent stones may have a 24-hour urine test to measure minerals, salt, and acid levels. This helps tailor diet and medicines to prevent new stones.
Specialist referral: In some cases, specialist referral is the logical next step. Urology input is common when pain is severe, infection is present, or a larger stone is unlikely to pass on its own.
Stages of Urolithiasis
Urolithiasis does not have defined progression stages. It tends to occur in episodes when a stone forms or moves, and the effects differ depending on the stone’s size, number, and location; symptoms can range from no pain to sharp, wave-like pain. Different tests may be suggested to help confirm a stone and check for blockage, such as urinalysis, ultrasound, or a low-dose CT scan. Clinicians often monitor recovery or recurrence by tracking early symptoms of urolithiasis, seeing whether the stone passes, and sometimes ordering a metabolic evaluation with blood tests and a 24-hour urine collection.
Did you know about genetic testing?
Did you know that genetic testing can help explain why some people are prone to urolithiasis (kidney stones), including stones that start early, keep coming back, or run in families? Finding a gene change can guide targeted steps—like tailoring fluids, diet, and specific medications—to lower stone risk and protect kidney health. It can also help your relatives understand their own risk and decide whether simple screening or prevention makes sense for them.
Outlook and Prognosis
Many people ask, “What does this mean for my future?”, especially after a first kidney stone with urolithiasis. The outlook is not the same for everyone, but most people do well between episodes and lead full, active lives. The biggest issue is recurrence: without changes, roughly half of people have another stone within 5–10 years. Early care can make a real difference—drinking enough fluids, moderating salt and animal protein, and taking medicine when needed can cut the risk of another stone and protect kidney function.
Prognosis refers to how a condition tends to change or stabilize over time. Most stones pass on their own, though they can be very painful and may temporarily disrupt work, travel, or sleep. A smaller group needs procedures if a stone is too large, stuck, or causing infection. Serious complications like lasting kidney damage, sepsis from a blocked infected kidney, or long-term loss of kidney function are uncommon with prompt treatment, but they are the main reasons urgent care is important. People living with urolithiasis who have other risks—single kidney, recurrent infections, certain metabolic or bowel conditions, pregnancy—benefit from closer follow-up and prevention plans tailored to them.
Looking at the long-term picture can be helpful. Mortality from urolithiasis itself is low in high-resource settings, but risk rises if a blockage and infection are not treated quickly; this is a medical emergency. Over time, most people avoid repeated ER visits by focusing on prevention and by learning early symptoms of urolithiasis such as flank pain, blood in the urine, or burning with urination, so they can act sooner. With ongoing care, many people maintain good kidney health and go years without another stone. Talk with your doctor about what your personal outlook might look like, including whether a metabolic workup or 24-hour urine test could guide a more targeted prevention plan.
Long Term Effects
Urolithiasis can come and go over the years, so the long view matters for everyday life. Long-term effects vary widely, and many people never develop serious kidney damage. The biggest issue for most is repeat stones, while a smaller group faces infections or gradual strain on kidney function.
Repeat stones: New stones are common months to years after the first one. This can mean repeated painful flares and more scans or procedures.
Kidney function strain: Most people keep normal kidney function, but a history of urolithiasis raises the risk of chronic kidney disease over time. Damage is more likely with repeated blockages or infections.
Blockage and swelling: A stone can block urine flow and cause kidney swelling (hydronephrosis). Persistent or repeated blockages can leave lasting kidney scarring.
Urinary infections: Stones can trap bacteria and make infections more likely. Infection-related stones, like struvite stones, can grow quickly and recur.
Pain flares: Sharp side or back pain can return with new stones, sometimes with nausea. Early symptoms of urolithiasis, like sudden flank pain or blood in urine, may signal another episode.
Blood in urine: Microscopic or visible blood may appear during and after stone episodes. This usually settles once the stone passes but can recur with new stones.
Blood pressure changes: People with recurrent stones have a higher chance of developing high blood pressure. This link may relate to kidney stress over time.
Procedure effects: Repeated procedures can leave mild ureter scarring or strictures in a small number of people. Temporary stents can cause urinary urgency and discomfort while in place.
Quality of life: Anticipating another stone can cause stress or worry and affect work, travel, or sleep. Many living with urolithiasis describe planning around bathrooms and pain medication during flares.
How is it to live with Urolithiasis?
Living with urolithiasis (kidney stones) often comes in waves: long stretches of feeling fine interrupted by sudden, sharp pain that can halt your day, send you to urgent care, and leave you drained afterward. Between episodes, many people plan ahead—drinking more fluids, watching sodium and certain foods, keeping pain medicine handy, and arranging follow-up imaging—because prevention and early detection can spare a crisis. Work, travel, and sleep can be disrupted during attacks, and partners or family may need to help with rides, childcare, or simply staying present through a painful spell. The good news is that with a prevention plan tailored by your clinician and quick attention to early symptoms, most people regain control and keep recurrences less frequent and less severe.
Treatment and Drugs
Treatment for urolithiasis (kidney stones) focuses on easing pain, helping the stone pass, and preventing new stones. Small stones often pass on their own with good hydration, pain relievers like ibuprofen or naproxen, and sometimes a short course of tamsulosin to relax the ureter; a doctor may also prescribe anti-nausea medicine if needed. Larger or stuck stones may need procedures such as shock wave lithotripsy to break the stone, ureteroscopy with laser to remove or fragment it, or percutaneous nephrolithotomy for very large stones; antibiotics are used if there’s an infection. Alongside medical treatment, lifestyle choices play a role, including drinking enough fluids (aim for urine that’s pale yellow), limiting salt, and tailoring diet based on stone type; doctors may add medicines such as thiazide diuretics, potassium citrate, or allopurinol to reduce future risk. Ask your doctor about the best starting point for you, especially if you have severe pain, fever with a suspected stone, one kidney, are pregnant, or have recurrent stones.
Non-Drug Treatment
Painful stones can disrupt sleep, work, and daily routines; early symptoms of urolithiasis like sharp side pain or peeing more often may appear suddenly. Alongside medicines, non-drug therapies can support stone passage, ease discomfort, and lower the chance of another stone. The best choices depend on your stone type and urine chemistry. Most plans focus on fluids, food choices, daily habits, and, when needed, device-based procedures.
High fluids: Drink enough to make at least 2–2.5 liters (68–85 oz) of urine each day. Water is best; spread it through the day and include a glass before bed. Extra fluids help dilute minerals that form stones in urolithiasis.
Sodium reduction: Limit salt to under 2,300 mg sodium per day (or 1,500 mg if advised). Lower sodium reduces calcium in urine and helps prevent recurring urolithiasis. Read labels and choose fresh foods over processed.
Adequate calcium: Aim for normal dietary calcium, about 1,000–1,200 mg per day from food. Getting calcium with meals binds oxalate in the gut and lowers stone risk. Avoid high-dose calcium supplements unless your clinician recommends them.
Oxalate-smart eating: If you form calcium oxalate stones, moderate high-oxalate foods like spinach, beet greens, nuts, and rhubarb. Pair oxalate foods with calcium sources at meals. Do not over-restrict; variety matters.
Protein balance: Keep animal protein moderate, especially red meat and organ meats. High purines raise uric acid and can worsen stones in urolithiasis. Favor plant proteins for part of the week.
Citrus intake: Include lemon or lime in water, or eat citrus fruits. Natural citrate can help block crystals from clumping. Aim for regular intake if well tolerated.
Weight management: Gradual weight loss if you have overweight can lower stone risk. Focus on balanced meals and steady activity. Avoid crash diets, which may raise uric acid.
Regular activity: Gentle movement, like brisk walking, can help some pass small stones and support bone and metabolic health. Some may find short walks ease restlessness during colicky pain. Stop and seek urgent care for fever, heavy bleeding, or uncontrolled pain.
Heat therapy: A warm bath or a heating pad over the flank may ease muscle spasm and pain while a stone moves. Use 15–20 minutes at a time and avoid sleeping with a heating pad. Combine with fluids during a urolithiasis flare.
Urine straining: Use a simple urine strainer to catch the stone. Saving it lets the lab test its type, which guides targeted prevention for urolithiasis. Bring the stone to your appointment.
Alcohol and soda limits: Limit sugar-sweetened drinks and excessive alcohol. Colas with phosphoric acid and high-fructose beverages can increase stone risk. Choose water or citrus-infused water instead.
Follow-up testing: A 24-hour urine collection helps tailor diet goals like fluid, sodium, citrate, and calcium targets. Imaging checks stone position and progression without adding drugs to your plan for urolithiasis. Ask how often you need monitoring.
Shock wave therapy: For stones that do not pass, shock waves can break them into smaller pieces. This non-surgical, device-based option is done in a clinic or hospital. Recovery is usually quick, with temporary blood in urine or bruising.
Ureteroscopy removal: A thin scope can be passed through the urethra and bladder to remove or laser fragments. It is minimally invasive and does not require an incision. Most go home the same day, sometimes with a temporary stent.
Did you know that drugs are influenced by genes?
Medications for urolithiasis can work differently based on your genes, which influence how you absorb, break down, and clear drugs like pain relievers or urine-alkalinizing agents. Genetic differences may change dosing needs or side‑effect risks, guiding more personalized treatment.
Pharmacological Treatments
Treatment for urolithiasis focuses on easing pain, helping stones pass, treating infection when present, and preventing new stones based on what the stone is made of. Pain relief is central because early symptoms of urolithiasis often include severe side or back pain and nausea. Drugs that target symptoms directly are called symptomatic treatments. Your plan is tailored to stone size and location, kidney function, other health conditions, and whether you’re pregnant.
Pain relievers: Nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen, diclofenac, or ketorolac ease renal colic by calming ureter spasm and swelling. Acetaminophen can be added; short courses of opioids may be used if pain remains severe.
Alpha blockers: Tamsulosin, alfuzosin, or doxazosin relax the ureter to help pass small to moderate distal stones (often up to about 5–10 mm). Common side effects include dizziness and low blood pressure, so take care when standing.
Calcium channel alternative: Nifedipine may be used if alpha blockers aren’t suitable to aid stone passage. It can lower blood pressure and cause headaches or flushing.
Antiemetics: Ondansetron or metoclopramide treat nausea and vomiting that often accompany a painful stone. This can make it easier to stay hydrated and keep oral medicines down.
Urine alkalinizers: Potassium citrate or sodium bicarbonate dissolve uric acid stones by raising urine pH toward a target around 6.5–7.0. Potassium citrate should be used cautiously in chronic kidney disease or with medicines that raise potassium.
Thiazide diuretics: Hydrochlorothiazide, chlorthalidone, or indapamide lower urinary calcium to prevent recurrent calcium stones. Doctors monitor electrolytes and blood pressure during therapy.
Citrate supplementation: Potassium citrate helps prevent calcium oxalate stones in people with low urine citrate. It also reduces stone formation after certain surgeries by binding calcium in the urine.
Urate-lowering drugs: Allopurinol (and sometimes febuxostat if allopurinol isn’t tolerated) lowers uric acid to prevent uric acid stones or calcium oxalate stones linked to high uric acid in urine. These are for prevention, not for immediate pain control.
Urease inhibitor: Acetohydroxamic acid can suppress struvite (infection-related) stones when surgery isn’t possible or stones recur. Side effects like headaches, fatigue, or stomach upset can occur, and close follow-up is needed.
Antibiotics for infected stones: If a stone is blocking urine and infection is suspected, urgent antibiotics are started and then tailored to culture results. Choices vary (for example, ceftriaxone or ciprofloxacin), and drainage of the blocked kidney is often required.
Genetic Influences
If kidney stones seem to show up in several relatives, that pattern can reflect inherited risk for urolithiasis. Family history is one of the strongest clues to a genetic influence. Genes can affect how the kidneys handle minerals and acids—how much calcium or uric acid goes into the urine, how acidic the urine is, and how much of the body’s natural “stone blockers” are present—so stones form more easily in some families. For many people with urolithiasis, risk comes from many small gene differences working together with everyday factors like diet, salt intake, hydration, weight, and certain medicines; in a smaller number, a single inherited condition can drive frequent or early stones. Genetics may also influence the type of stone and the chance that stones come back, but it doesn’t change what early symptoms of urolithiasis feel like. Understanding your family pattern can help tailor prevention—steady hydration, dietary adjustments, and, when helpful, targeted medicines or genetic counseling to clarify your personal risk.
How genes can cause diseases
Humans have more than 20 000 genes, each carrying out one or a few specific functiosn in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the bodies cells to begin lultiplying uncontrollably and develop into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified, that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call this hotspots “Genetic Variations” or “Variants” in short. In many cases, studies have been able to show, that having the genetic Letter “G” in the position makes you healthy, but heaving the Letter “A” in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
Pharmacogenetics — how genetics influence drug effects
Genes can influence both the type of kidney stones you tend to form and how you respond to medicines used for urolithiasis. For pain control, codeine and tramadol depend on enzymes that vary from person to person; A “slow metabolizer” may process medicine more slowly and feel more side effects, while ultra-rapid metabolizers can have unexpectedly strong effects or side effects. Differences in genes that handle NSAIDs such as ibuprofen or celecoxib can raise drug levels, so your care team may use a lower dose or choose another anti-inflammatory to lower stomach, kidney, or bleeding risks. Before starting allopurinol for uric-acid stones or high uric acid, checking for the HLA-B*58:01 gene marker is recommended in some groups because it greatly increases the risk of a rare but severe skin reaction. If testing shows an inherited stone disorder—like cystinuria or primary hyperoxaluria—treatment choices shift, from higher-dose urine alkalinizers or thiol drugs to vitamin B6 or newer targeted therapies matched to the subtype. While many factors beyond genes guide care, pharmacogenetic testing for urolithiasis can sometimes help avoid trial-and-error and make treatment safer and more effective.
Interactions with other diseases
Urolithiasis often travels alongside other health issues, and the combination can shape how often stones form and how they feel. Repeated urinary tract infections can both result from and contribute to certain stones, especially those linked to bacteria that change the urine’s chemistry; someone might notice early symptoms of urolithiasis during a stubborn UTI that won’t fully clear. Stones are also more common in people living with gout, obesity, and type 2 diabetes, partly because insulin resistance and acidic urine can favor uric acid stones. Doctors call it a “comorbidity” when two conditions occur together, and that’s relevant for digestive diseases too—bowel inflammation or past bariatric surgery can increase oxalate absorption, which raises the chance of calcium oxalate stones.
Overactive parathyroid glands and long-term dehydration can push calcium levels in urine higher, while chronic kidney disease can both result from frequent stones and make management more complex. Certain medicines matter as well: loop water pills may raise calcium in urine, some seizure or migraine drugs can shift urine balance toward stone formation, and a few older HIV medicines can crystallize in urine. Interactions can look very different from person to person, so the mix of risks, symptoms, and treatments depends on your overall health and medications. Talk with your doctor about how your conditions may influence each other, so your plan covers infection prevention, stone type, hydration, diet, and safe medication choices.
Special life conditions
Pregnancy can change how urolithiasis shows up and how it’s managed. Back or side pain may feel different as the uterus grows, and imaging choices shift toward ultrasound to avoid radiation; doctors focus on pain control, hydration, and watching for infection, since fever with a blocked kidney is an emergency. In children, urolithiasis may present with belly pain, blood in the urine, or urinary frequency; stones are often linked to dehydration or metabolic factors, so a metabolic workup and prevention plan are important. Older adults may have subtler symptoms, take medications that affect stone risk, or have other conditions that complicate fluid goals; treatment may lean more on careful monitoring and minimizing procedure risks.
Athletes and people with very active jobs can be at higher risk due to sweating and low urine volume; structured hydration and electrolyte balance help prevent recurrences. After a first stone, some people adjust diet and fluid goals differently during heat waves, endurance events, or travel. Doctors may suggest closer monitoring during pregnancy, after major surgeries, or if you’ve had repeated infections. With the right care, many people continue to work, exercise, travel, and have healthy pregnancies while living with urolithiasis.
History
Throughout history, people have described the sudden, gripping pain of “stone colic”—a pain so sharp it stopped work, travel, or sleep. In many families, elders recalled an uncle doubled over on the road or a parent straining to pass urine, then later showing a small, hard stone as proof of what caused it. These everyday memories mirror what doctors now call urolithiasis, the formation of stones in the urinary tract.
Ancient medical texts from Egypt, India, Greece, and China mention bladder and kidney stones, along with attempts to relieve the blockage or remove the stone. Early healers could sometimes feel a stone in the bladder and, in rare cases, operated to extract it—dangerous procedures by today’s standards. Over time, descriptions became more precise as physicians linked the classic wave-like flank pain and blood in the urine with stones moving from the kidney toward the bladder.
From early theories to modern research, the story of urolithiasis shifted with tools that let doctors see inside the body. In the 19th and 20th centuries, microscopy revealed crystals in urine; later, X‑rays and ultrasound showed stones in real time. Surgeons refined less invasive ways to break or remove them, moving from open operations to shock wave therapy and tiny scopes. As testing improved, patterns emerged: stones came in different types, some tied to diet and dehydration, others to infections or rare metabolic conditions.
Advances in chemistry and genetics helped explain why stones form in some people and not others. Researchers learned that urine has natural “anti-crystal” factors, and when these are low, crystals can grow. Some families showed a tendency toward recurrent stones, and certain inherited conditions—like cystinuria—were identified as causes of early and frequent stones. This also clarified why prevention matters: enough daily fluid, tailored diet, and specific medicines can change the balance so crystals are less likely to form.
In recent decades, awareness has grown that urolithiasis is common worldwide, with rising rates in warmer climates and during heat waves when dehydration is more likely. Historical differences highlight why definitions and treatment have changed: what was once seen only as a surgical problem is now managed as a long-term condition to prevent, monitor, and, when needed, treat with targeted procedures. Looking back helps explain today’s approach—relieve pain, confirm the stone, analyze its makeup when possible, and lower the chances of the next one.