Renal colic: what to do during an attack and how to prevent new stones

By Dr Ayhan Bakar, urologist and andrologist in BrusselsPublished 1 November 20263 min read

How do you recognise renal colic?

The pain starts suddenly in the lower back or side, on one side only, and often spreads towards the groin or genitals. It comes in waves, no position eases it, and it can come with nausea, vomiting, frequent urges to pass urine or blood in the urine.

When should I go to A&E?

Call 112 or go to A&E in these situations, as blocked urine sometimes needs to be drained quickly:

• Fever or shivering, which may mean an infection behind the stone
• A single kidney, or known kidney failure
• No urine
• Pain that painkillers do not relieve
• Pregnancy

How are stones treated?

Treatment depends on the size and position of the stone and on your symptoms. Small stones often pass on their own within days or weeks, with painkillers and sometimes a medicine that helps them pass.

When a stone is too large, badly placed or will not move, the urologist can break it up or remove it, usually through the natural passages, with no scar.

How can I prevent another stone?

After a first episode, blood and urine tests help find a cause. The basic advice:

• Drink regularly throughout the day, so your urine is pale and you pass about two litres a day
• Cut down on salt and processed food
• Do not cut out calcium: dairy products in normal amounts actually protect against some stones
• Go easy on meat and sugary drinks
• Have the stone you passed analysed: its make-up guides prevention

Which tests after an attack?

A CT scan without contrast is the reference test to see the stone, its size and position. Ultrasound is useful during pregnancy and for follow-up. Urine and blood tests check for infection and kidney function.

Techniques to remove a stone

Depending on the size, position and make-up of the stone, several techniques exist:

• Ureteroscopy: a thin scope passed through the natural passages breaks the stone up with a laser and removes the pieces
• Extracorporeal lithotripsy: shockwaves applied through the skin break up some stones
• Percutaneous surgery: for large kidney stones, through a small incision in the back

Learn more

• CareKidney stonesKidney stones form when substances in the urine crystallise.
• CareKidney stone treatmentDepending on their size and position, stones may pass naturally, be broken up or be removed.
• CareUrological ultrasoundUltrasound uses sound waves to look at the kidneys, bladder, prostate and testicles.

More advice

This information is general and does not replace a consultation. In an emergency, call 112.
Article published by Dr Ayhan Bakar, urologist in Brussels (INAMI 17718534450).
Reference: European Association of Urology (EAU) guidelines.