Medicines for Kidney stones

The mainstay during an attack is pain relief, and anti-inflammatory medicines are the preferred first choice for the severe pain of renal colic, with other pain relief added if needed and anti-sickness medicines used for nausea. For some stones in the lower part of the tube to the bladder, a relaxant medicine such as tamsulosin may be given to help the stone pass, an approach called medical expulsive therapy. Medicines do not dissolve most stones, so larger or stuck stones are dealt with by the urology team using procedures to break them up or remove them. After the event, the focus shifts to preventing further stones, mainly through fluids and dietary advice, and a doctor will guide what is right for your situation.

Many small stones do pass by themselves, particularly those that have already moved into the lower part of the tube to the bladder, and good fluid intake and time give them the best chance. Larger stones, or those that become stuck and block the flow of urine, are less likely to pass and often need treatment to break them up or remove them. While you wait for a small stone to pass, pain relief is important, and a relaxant medicine is sometimes used to help it on its way. Your doctor can use scans to judge the size and position of the stone and advise whether passing it naturally is realistic or whether a urology procedure is needed.

The pain comes not so much from the stone itself as from what it does as it moves into the narrow tube that carries urine from the kidney to the bladder. As the stone travels and the tube tightens around it, the flow of urine can be blocked and the system above it stretches and goes into spasm, producing the intense, gripping waves of pain that sweep from the loin to the groin. This is why renal colic can be so severe and why anti-inflammatory pain relief, which helps calm this process, works well for it. The pain often eases once the stone passes or the blockage is relieved.

Once you have had a stone you are more likely to form another, so prevention is worthwhile. The single most important step is to drink plenty of fluids throughout the day so that your urine stays dilute, as concentrated urine makes stones more likely. Beyond that, advice depends on the type of stone you formed, and may include moderating salt, not overdoing certain foods, and keeping to a healthy weight. Sometimes tests are arranged to look for an underlying reason, especially if you form stones repeatedly. Your GP or a specialist can tailor this advice to you and arrange any investigations that would help.