Passing Kidney Stones: What To Expect

Kidney stones are extremely common — about 10% of us will get them at some point or another. But they’re also easily misunderstood. One of the more significant sources of confusion is the term “passing a kidney stone.”

Urologist Smita De, MD, PhD, explains what’s happening in your body when you pass a kidney stone, how to interpret your symptoms and when it’s time to get professional help.

What does it mean to ‘pass’ a kidney stone?

Contrary to popular belief, the act of “passing” a kidney stone isn’t the same thing as peeing it out — and it doesn’t always mean the situation has resolved.

When a healthcare provider tells you you’ve passed a kidney stone, they’re telling you that the stone has made it through your ureter and into your bladder. This is when your pain lets up. If all goes well, you’ll pee out the stone shortly after.

But this is important: Feeling better doesn’t always mean your kidney stone is gone.

“The only ways to know you’ve expelled a stone in your urine are if you see it, a urologist removes it or imaging shows that it’s gone,” Dr. De says.

What does passing a kidney stone feel like?

Pain may not be a good way to tell if you’ve passed a stone, but it does follow a pretty reliable pattern. And understanding what your pain means can help you better care for yourself throughout the process.

Kidney stones are clusters of minerals, acids and salts that form in your kidneys. And they can hang out there for a long time without causing any symptoms.

“Many people don’t even know they have them until they develop pain,” Dr. De says. The discomfort usually starts when the stone leaves your kidney and enters your ureter — the narrow tube that connects your kidney to your bladder.

Kidney stone pain can be mild, moderate or severe. But it usually starts in your side or back and moves into your groin. Most people have two kidneys — one on either side of their body. Unless you’re unlucky enough to have stones leaving both kidneys at the same time, the pain will be on one side only.

It’s natural to assume the pain means the stone is moving, but that’s not quite right. “The pain is usually when the stone is stuck, not while the stone is moving,” Dr. De clarifies.

The discomfort comes from the stone blocking the flow of urine into your bladder. It causes your pee to back up into (and stretch out) your kidney. In addition to hurting, this can cause nausea and vomiting.

Another thing to know about kidney stone pain? It comes and goes. Providers call this pattern renal colic.

“If urine finds a way around the stone, the swelling goes down and the pain improves,” Dr. De adds. “Then, it gets stuck again, and the pain comes back.”

This cycle can trick you into thinking that your kidney stone has passed when it hasn’t.

As the stone travels through your ureter, the renal colic pain will migrate down with it toward your groin. As the stone approaches your bladder, Dr. De says that you may notice pressure in your lower abdomen. Some people liken the feeling to having a bladder infection. Men may also be saddled with pain in their scrotum or in the testicle on the affected side.

Once the stone enters your bladder, your urine will flow freely — meaning an end to the pain.

For most people, passing the stone means the hard part is over. But Dr. De observes that you may have more difficulty peeing the stone out if you have certain anatomical issues (like a big prostate) or you’ve had prior surgeries involving your genitals or urinary tract. In those situations, the stone may need to be removed from your bladder surgically or else it could continue to grow and cause bleeding or infection.

How to pass a kidney stone

There’s nothing you can do to make a kidney stone pass into your bladder. How quickly or slowly it moves depends, in large part, on the stone’s size and shape. But Dr. De says there are things you can do to manage your pain and support your body during the process, like:

• Staying hydrated: Drinking plenty of water ensures that your kidneys produce a steady flow of urine to push the stone through your urinary tract.
• Taking over-the-counter pain medicine: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve pain and reduce swelling, which may make passing a stone a bit easier on you. If you can’t take NSAIDs, acetaminophen is usually a good alternative.
• Using prescription medications as directed: In some cases, you may get a prescription for alpha-blockers — medications that help you pass a stone by helping your ureter relax. Dr. De notes that these drugs can cause side effects if used incorrectly, so follow your provider’s instructions carefully.

How long it takes to pass a kidney stone varies widely from person to person and stone to stone. Dr. De reports that some take hours or days, while others can take weeks.

In some cases, a stone can’t pass on its own. If that happens, your doctor will need to do a procedure to remove or break up the stone.

Can you speed up passing a kidney stone?

While taking your medications and staying hydrated may help, there’s no proven way to speed up the process of passing a kidney stone.

So, don’t put too much stock into what you may see online. There’s no “best position” to pass a kidney stone, and you aren’t going to get relief faster by drinking beer or cranberry juice. Your best bet? Follow your healthcare provider’s instructions and ask questions as they arise.

(Side note: There are rare stone types that can be dissolved, but Dr. De says this can take months and usually requires prescription medications.)

When to call a doctor or go to the ER

Most of the time, a kidney stone can be managed at home with over-the-counter pain relievers and a healthy dose of patience — but certain symptoms are red flags that you need medical attention.

Call a healthcare provider’s office if:

• You’ve never had a kidney stone before: Lots of other conditions can cause the symptoms we’ve discussed, so it’s not safe to assume you just have a stone.
• Your symptoms aren’t improving: The pain you get with kidney stones usually comes and goes. If the “going” part isn’t happening, it’s important to find out why — and get you the relief you need.
• It’s been several weeks: If the stone hasn’t passed within two or three weeks, let your urologist know. It may not be time to think about removal just yet, but they’ll still want to monitor your condition closely.

Seek help immediately if you:

• Have signs of infection in addition to the kidney stone pain: A fever, chills, confusion, or cloudy or foul-smelling urine are all signs that the kidney stone may have become infected. An infected kidney stone is a medical emergency, and you should go to the emergency room right away.
• You can’t stop vomiting: A little nausea and vomiting aren’t unusual when you have a kidney stone. But it’s crucial that you stay hydrated. Alert your provider if you’re so sick that you can’t keep fluids down.
• You can’t pee much, or at all: If the stone is making it difficult or impossible to pee, you need immediate medical attention to clear the blockage.
• The pain is extreme: Discomfort is common with kidney stones. But if you’re doubled over or screaming in agony, go to the emergency room. Ditto if your pain can’t be managed with over-the-counter medicines.
• You have kidney disease: If you have a health condition that affects your kidney function, you’re more likely to have complications. Better to see your provider at the first sign of trouble.
• You only have one kidney: “If you have a blockage and only have one kidney, that can lead to kidney failure,” Dr. De stresses.

What happens if the stone doesn’t pass?

While about 80% of kidney stones pass on their own, others require medical treatment. Letting a stone hang out in your urinary tract for too long can cause serious complications.

“We don’t like people to have a blockage for more than about six weeks,” Dr. De explains. “At that point, there’s a risk of scar tissue and permanent kidney damage.”

Your provider will either perform a procedure to break the stone into smaller pieces (so it can pass into your bladder and get peed out naturally) or remove the stone themselves. The course of action they take will depend on:

• How big the stone is
• Where the stone is located
• Your medical history and other risk factors

Luckily, surgical procedures for stones are typically outpatient, which means you get to go home the same day.

“There are a lot of newer tools that make the process more efficient and less uncomfortable,” Dr. De reassures.

Final thoughts

Nobody wants to get a kidney stone. The process can be painful, frustrating and confusing. But understanding what’s happening can make a difference. It won’t make the stone pass any faster, but it will help you manage both your expectations and your symptoms.

Not sure if it’s time to ask for help? When in doubt, ask. Your urinary tract will thank you.