Kidney stones are hard mineral and salt deposits that form inside the kidneys. While small stones may pass without significant issues, larger ones can cause considerable pain and may necessitate medical intervention. Understanding when a kidney stone requires immediate emergency care is important for managing this common condition.
Common Indicators of Kidney Stones
Kidney stones frequently manifest through severe pain known as renal colic. This pain typically originates in the side and back, just below the ribs, extending to the lower abdomen and groin. It often comes in waves, fluctuating in intensity as the stone moves through the urinary tract. The discomfort can be quite intense.
Beyond pain, kidney stones can also lead to various urinary symptoms. Individuals may experience a frequent and urgent need to urinate, or pain and a burning sensation during urination. Additionally, blood in the urine, known as hematuria, is a common sign and can make urine appear pink, red, or brown.
Other symptoms associated with kidney stones include nausea and vomiting. These gastrointestinal symptoms can arise due to shared nerve connections between the kidneys and the digestive system, or simply as a response to the intense pain. While these symptoms can be distressing, their presence alone does not always indicate an emergency.
When to Seek Emergency Care
Certain symptoms signal a kidney stone emergency, requiring immediate medical attention. Unbearable pain is a primary indicator; if the pain is so severe that it prevents sitting still, finding any comfortable position, or cannot be managed with at-home pain relief, an emergency room visit is advisable. This level of pain suggests a significant blockage or complication.
Pain accompanied by fever and chills is a serious sign. This combination can indicate a urinary tract infection that has spread to the kidney or bloodstream, a condition known as urosepsis, which is life-threatening. An inability to urinate at all, or a complete blockage of urine flow, is another emergency, as it can lead to urine backing up into the kidneys and potentially causing kidney damage.
Persistent nausea and vomiting, especially when coupled with pain, can lead to severe dehydration and make it impossible to keep down fluids or oral pain medication. This can further complicate the situation, often necessitating intravenous fluid administration. While some blood in the urine is common, severe or increasing amounts of visible blood, particularly when accompanied by severe pain or signs of infection, warrants immediate evaluation. Any sudden or rapid worsening of existing symptoms, or the appearance of new and alarming symptoms, also indicates the need for urgent medical assessment.
What to Expect at the Emergency Room
Upon arrival at the emergency room, the initial assessment will include triage, vital signs measurement, and an evaluation of your pain level. Medical professionals will gather a history of your symptoms.
Diagnostic tests are typically performed to confirm the presence of a kidney stone and assess its impact. A urine test, or urinalysis, will check for blood, signs of infection, or other abnormalities. Blood tests will be conducted to evaluate kidney function, check for infection, and assess electrolyte balance.
Imaging studies, such as a CT scan or ultrasound, are commonly used to locate the stone, determine its size, and identify any blockage or swelling in the kidney, known as hydronephrosis. A CT scan is often preferred in the emergency setting for its accuracy and speed.
Initial treatment in the ER focuses on managing symptoms and addressing immediate concerns. Intravenous (IV) pain medication will be administered to alleviate severe pain. If nausea and vomiting are present, anti-nausea medications will be given intravenously. If an infection is suspected based on lab results or symptoms, intravenous antibiotics may be started. After initial stabilization, next steps will be discussed, which may include discharge with instructions for follow-up care, or in some cases, admission to the hospital for further management or urology consultation if the stone is too large or causing significant complications.