Can Kidney Stones Pass Naturally

Kidney stones can be discomforting and painful, especially if they are larger. When you have kidney stones, you may experience flare-ups, causing sharp pain that may persist for minutes to hours, depending on their size and location. Smaller kidney stones(<6mm) can pass on their own without medical or surgical intervention. In such cases, doctors may also advise waiting for the stone to pass naturally, which may take a few weeks. However, you must be aware of how kidney stones pass through naturally and the potential issues that may arise during this process.

What are Kidney Stones?

Kidney stones (nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. They can affect any part of the urinary tract, from the kidneys to the bladder. Healthcare professionals refer to kidney stones as nephrolithiasis, urolithiasis, or renal calculi. According to a 2023 research published in the ‘American Journal of Kidney Diseases’, kidney stones are a common condition that affects one in 11 people in the United States.

How Are Kidney Stones Formed

Kidney stones form when your urine contains more crystal-forming substances, such as calcium, oxalate, and uric acid, than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for stones to develop. This process is often triggered by:

• Dehydration: Not drinking enough water leads to concentrated urine.
• Diet: High intake of sodium, sugar, or protein.
• Metabolic conditions: Issues with how your body processes certain minerals.

Also Read: Does Vitamin C Increase Kidney Stone Risk

The Natural Passage of Kidney Stones: What to Expect?

The journey of a kidney stone begins when it leaves the kidney and enters the ureter (the narrow tube leading to the bladder).

The phases of the passage of kidney stones are:

• The Ureter Entry: This is often the most painful stage. When a stone moves in the ureter (a tube connecting the kidneys and the bladder), it may cause sharp, cramping pain in the back and side (flank pain).
• The Bladder Entry: Once the stone reaches the bladder, the intense flank pain that you experience in the first stage often subsides. However, you may feel increased pressure on your bladder or the frequent urge to urinate.
• Excretion: The final stage is the passing of the stone through the urethra. This is usually less painful than the ureter journey because the urethra is wider, and it is comparatively easier to pass the stone.

Factors That Influence Natural Passing of Kidney Stones

While kidney stones can pass naturally without any surgical or medical intervention, not each stone can be passed naturally. Certain factors decide the success of passing kidney stones naturally. The three main variables, according to Urologist Dr Nitin Shrivastava, are:

Size: This is the most critical factor for kidney stone treatment.

• Less than 4mm: 80% chance of passing naturally.
• 4mm to 6mm: 50% chance; may require medical intervention (like alpha-blockers).
• Larger than 6mm: Very low chance of passing without clinical procedures.

Location: Stones located closer to the bladder (distal stones) have a much higher success rate for natural passage than those stuck high up near the kidney. Consult your doctor to discover the location of your kidney stone and proceed accordingly.

Type of kidney stone: There are different types of stones based on their mineral or salt composition.

• Calcium stones: The most common; their shape (often jagged) can make passage slower.
• Uric acid stones: Can sometimes be dissolved or softened with specific pH-altering medicines.

Also Read: Can Kidney Stones Cause Back Pain?

Can you help kidney stones pass naturally?

The short answer to this question is yes; however, that varies from person to person. While it is not possible to force a stone out of your body, you can optimise your body's ability to pass it along. According to the information published by the Urology Care Foundation, here are some effective tips that will help you pass kidney stones naturally and smoothly:

• Hydration: Dehydration is a major cause of kidney stone formation. For successful natural elimination, drink enough water to keep your urine clear. Ideally, you must drink 2-3 litres of water daily.
• Citrus Intake: Citrus fruits are good for preventing and managing kidney stones. Lemons and limes, in particular, are most beneficial as they contain citrate, which helps prevent stones from growing and can help break down very small fragments.
• Manage Salt: Consuming excess sodium can cause the kidneys to release more calcium, which may lead to bigger kidney stones. Cut down your salt intake to inhibit the growth of kidney stones.
• Activity: Light walking can sometimes help gravity move the stone through the urinary tract. However, this advice varies from person to person depending on the condition. You should always ask your doctor for the permissible amount of physical activity that you can do, as per your health condition.
• Medicines: It may take several weeks to months for a stone to pass. This process can be painful, and you may need to take over-the-counter pain medicines to alleviate the pain. A doctor may also prescribe an alpha blocker drug that relaxes the ureter muscles, which helps in the smooth passing of kidney stones with less pain. However, this should be done under the supervision of your doctor. Do not take any medicine without consultation.

Also Read: Kidney Stones Risk Factors: What Increases Your Chances?

Signs You Can't Pass Stones on Your Own

Despite all favourable factors, like small size and near the bladder stone location, there is no guarantee that you will be able to pass it on your own. It is important to monitor for red flag symptoms that indicate the stone is causing a dangerous blockage or infection:

• Inability to Urinate: This suggests a total blockage (a medical emergency).
• Fever and Chills: These are signs of a severe kidney infection.
• Uncontrolled Pain: If over-the-counter pain relief medicines do not help and the pain is accompanied by nausea or vomiting.
• Blood in Urine: While this is a common issue with stones, persistent or heavy bleeding must be reported to and evaluated by a urologist.

Complications of Untreated Kidney Stones

Untreated kidney stones can cause serious complications, especially if they are stuck in the urinary tract for a long time. These can block urine flow and cause chronic infection, which may further trigger other issues. The other potential complications of untreated stones are:

• Kidney Swelling or Hydronephrosis: According to a study published in NCBI, when kidney stones block urine flow, redirecting the urine to the kidneys, resulting in kidney swelling.
• Irreversible Kidney Damage/Failure: Pressure caused by untreated blockage can hamper kidney functions and disable the waste filtering properties of the kidneys. As a result, this may lead to chronic kidney disease or end-stage kidney failure.
• Sepsis: An obstructed ureter can cause a chronic UTI that may spread to the bloodstream, causing sepsis.
• Renal atrophy: Long-term untreated kidney stones can also cause complete kidney failure.

Timeline of Passing of Kidney Stones According to Their Size

Here is a simple table to help you understand the estimated timeline of passing a kidney stone.

When To See A Doctor

Several studies indicate that small-sized kidney stones are highly likely to pass on their own, and large stones(>6mm) require medical intervention. You must consult your doctor for the right course of treatment as per the prognosis. However, if you experience the following symptoms, seek immediate medical help:

• Fever and chills
• Severe vomiting and nausea
• Blood in urine
• Severe back and side pain that doesn't go away
• Inability to urinate

Conclusion

In a nutshell, small kidney stones can pass on their own, whereas large stones require medical and surgical intervention. You should not ignore sharp and intermittent back pain, as it is a classic indicator of kidney stones. Get yourself checked and follow your doctor’s guidelines for safe and effective removal of kidney stones.