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Nephrolithiasis

Resolved Question:

I am fairly sure I have a kidney stone. First symptoms were 4 days ago with intense pain. (Controlled by old supply of Hydrocodone) Pain went away until tonight. Pain is now back but lower and increasing. I have been drinking lots of water, juice, and coke. Frequent urination has been clear to light yellow. At what point do I move beyond pain meds and go into a doctor?


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Could you please provide some additional details so that I give a more solid opinion. You can reply as a followup

1. Where exactly is the pain ? side of the abdomen / left side / mid abdomen / elsewhere ?

2. How long does one pain episode last ? Is it a colicky kind of pain ? (on and off)

3. Any nausea / vomiting / fever / loose stools ?

4. Do you have the pain coming to your groin ?

Thank you


Patient replied :

1. The pain seems to center on my left lower abdomen in the area of the bladder or right above it.

2. I have been pain free for the last 3 days with only slight discomfort. Tonight it is best described as a constant pulsing pressure but radiates from time to time causing discomfort just above the left testis. The pulses of pain usually only last a few seconds to a minute or so.

3. On Saturday I did have nausea. Today No nausea or vomiting. Temperature is 98.5. I feel like I am constipated but stools have been relatively normal.

4. Other then as described above no pain in the groin.

Additional information: I am now feeling a nearly constant need to urinate but am finding that my bladder is not full. Urination is successful but only in very small amounts.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello,

Thank you for the additional information.

The pain and other symptoms are suggestive of Nephrolithiasis - Ureteric or Kidney stone.

Now to your specific question - to wait (for spontaneous stone passage) or to get medical help -

I would recommend you to get in touch with ER / your Doctor. There are several reasons (1) The pain has been there already for 4 days (2) Your Doctor will most likely order and Xray / Ultrasound. This will help in identifying the location and size of the stone. Not all stones will pass naturally. Size and the location of the stone will give a better idea on whether to wait or not (3) Some stones which can cause obstruction to urine may cause strain to Kidneys which should be prevented. (4) Your Doctor may prescribe you medications like Tamsulosin which can help and ease the stone passage.

Hope this helps
Feel free to ask followups
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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