Kidney stones are small, hard deposits that form in the kidneys from minerals and other substances in the urinary tract. While many small stones can pass through the body on their own, they can cause considerable discomfort and pain as they move. Understanding when these symptoms necessitate an emergency room visit versus other medical options is important for appropriate care.
When to Seek Emergency Care
Immediate medical attention in an emergency room is advised for specific kidney stone symptoms, especially those indicating complications. Unbearable pain, particularly if it doesn’t lessen with typical pain relief, warrants emergency care. This severe pain often originates in the lower back, side, or abdomen and can radiate to the groin or genitals, sometimes described as colicky pain that worsens in waves.
A fever above 101.5 degrees Fahrenheit with chills alongside kidney stone pain suggests a possible infection, requiring prompt evaluation to prevent serious issues like sepsis. Persistent nausea and vomiting that prevent fluid intake or keeping down medications also warrant an ER visit, as dehydration can worsen the condition. Additionally, inability to urinate or a significant decrease in urine output indicates a potential urinary tract blockage, which could lead to kidney damage if not addressed quickly. Severe blood in the urine, or cloudy or foul-smelling urine, also requires emergency assessment.
What to Expect at the ER
Upon arrival at the emergency room for suspected kidney stones, patients undergo an initial assessment, including triage, vital signs, and pain level evaluation. Medical professionals will gather a detailed medical history and conduct a physical examination to understand the patient’s condition.
Diagnostic tests are performed to confirm the presence of a kidney stone and determine its size and location. These often include urine analysis for blood or infection, and blood tests to assess kidney function. Imaging tests, such as a CT scan of the abdomen and pelvis without contrast, are frequently used for their accuracy.
Once confirmed, pain management, often involving intravenous fluids and strong medication like ketorolac (Toradol) or opioids, will be administered. Depending on the stone’s size, location, and complications like severe blockage, further interventions may occur. These can include stent placement to aid urine drainage, or discussions about procedures like lithotripsy or surgical removal. Patients may be discharged with follow-up instructions or admitted if their condition requires ongoing monitoring or immediate intervention.
When Other Options Are Sufficient
For less severe kidney stone symptoms, an emergency room visit may not be necessary, and other medical options can be more appropriate. If the pain is mild to moderate and manageable with over-the-counter pain relievers, and there are no signs of infection such as fever or chills, an ER visit can often be avoided.
Patients able to maintain hydration and pass urine without significant difficulty may find appropriate care at an urgent care center. Urgent care clinics can provide symptom assessment, pain management, and sometimes diagnostic services like ultrasounds or X-rays to evaluate the stone. For ongoing management of less severe symptoms or follow-up after an initial stone episode, scheduling an appointment with a primary care physician or a urologist is suitable. These professionals can help with stone prevention strategies, including dietary recommendations and, if needed, further diagnostic tests like a 24-hour urine collection to analyze stone composition.