Kidney Stones 2026: Symptoms, Treatment & Prevention

One in eleven Americans will develop a kidney stone in their lifetime — and if you live in Texas, your odds are significantly higher. The southeastern United States, Texas included, sits squarely in what medical researchers call the "kidney stone belt." In this region, chronic heat exposure and dehydration push kidney stone rates well above the national average. With summer temperatures routinely exceeding 100°F across the state, June through September marks peak season for kidney stone emergencies in Texas.

The good news is that most kidney stones can be managed without surgery, many can be treated safely from home with the right prescription medications, and nearly all of them can be prevented from coming back.

Whether you are trying to pass a stone right now in Houston, Dallas-Fort Worth, Austin, San Antonio, or rural West Texas, here is the clinical guidance you need.

Quick Summary: Key Facts at a Glance

Classic Symptom: Severe, sudden flank pain (side/lower back) radiating down to the groin, coming in waves.

Primary Cause in Texas: Extreme summer heat leading to chronic dehydration, lower urine volume, and mineral crystallization.

First Line Home Care: Aggressive hydration paired with over-the-counter NSAIDs like Ibuprofen to reduce ureteral spasms.

When to See a Doctor: A family medicine physician can manage uncomplicated stones under 10mm via a telehealth visit — including prescribing Flomax (tamsulosin) and ordering local imaging.

Emergency Signs: If you experience a fever over 101°F, constant vomiting, or an inability to urinate, seek an emergency room immediately.

What Are Kidney Stones?

A kidney stone (nephrolithiasis) is a hard mineral deposit that forms inside your kidney when substances in your urine become too concentrated and crystallize. Think of it like salt crystallizing at the bottom of a glass of water left out in the sun. The less water in the glass, the faster crystals form.

Stones can range in size from a microscopic grain of sand to a golf ball. Most clinical issues occur when a stone leaves the kidney and enters the ureter — the narrow, muscular tube connecting your kidney to your bladder. When the ureter spasms around the stone, severe pain begins.

The 5 Main Types of Kidney Stones

Identifying your stone type is vital because it determines your long-term medical prevention plan:

Calcium Oxalate Stones (70% of cases): The most common type by far. Formed when calcium binds with oxalate in your urine, frequently driven by low fluid intake.

Calcium Phosphate Stones (10–20% of cases): Often associated with metabolic or structural conditions that make the urine more alkaline (higher pH).

Uric Acid Stones (5–10% of cases): More common in individuals with gout, diabetes, or diets very high in animal protein. Uric acid stones are radiolucent, meaning they are invisible on standard X-rays and require a CT scan to diagnose.

Struvite Stones (up to 10% of cases): Caused by chronic urinary tract infections (UTIs). These can grow rapidly into massive "staghorn" formations that fill the kidney pathways.

Cystine Stones (1% of cases): A rare, hereditary type caused by a genetic disorder called cystinuria, which causes the kidneys to excrete too much of a specific amino acid.

Kidney Stone Symptoms — How to Know If That's What You Have

Kidney stone pain is widely considered one of the most intense pains a human can experience. When a stone travels into the narrow ureter, it causes sharp, localized, and autonomic symptoms:

Severe Flank Pain: Sharp, stabbing pain in your side or lower back, right below the ribs. This pain typically radiates toward your lower abdomen and groin, coming and going in intense waves lasting 20–60 minutes.

Hematuria (Blood in the Urine): Pink, red, or brown-tinged urine occurs in the vast majority of symptomatic kidney stone episodes.

Nausea and Vomiting: The visceral nerve pathways from the kidneys trigger intense nausea or vomiting during acute pain spikes.

Dysuria and Frequency: A painful, burning sensation or an urge to urinate constantly, especially as the stone moves lower down the ureter near the bladder wall.

Cloudy or Foul-Smelling Urine: A secondary sign that can point to an accompanying urinary tract infection.

Is It a Kidney Stone or a UTI?

Because both conditions affect the urinary tract and cause overlapping symptoms like painful urination, blood, and urgency, patients frequently confuse the two. Use this diagnostic matrix to evaluate your symptoms:

Diagnostic Feature	Kidney Stone Episode	Urinary Tract Infection (UTI)
Primary Pain Location	Side, lower back, or deep groin (flank)	Lower abdomen, directly above the pubic bone
Type of Pain	Severe, sharp, cramping waves	Constant burning or stinging during urination
Blood in Urine	Common and visually apparent (pink/red)	Sometimes present (often microscopic only)
Fever & Chills	Absent unless an infection has developed	Common as the body fights the active bacteria
Nausea / Vomiting	Highly common during pain spikes	Uncommon
Urinary Urgency	Intermittent (spikes as stone hits bladder)	Constant and severe
Urine Clarity/Odor	Typically clear (unless infected)	Frequently cloudy, hazy, or foul-smelling

Critical Clinical Warning: A kidney stone can cause a UTI if it mechanically blocks urine flow, allowing bacteria to multiply rapidly behind the obstruction. A kidney stone accompanied by a fever is a medical emergency requiring immediate intervention to prevent sepsis (a life-threatening systemic blood infection). If you suspect a UTI rather than a stone, our team also treats urinary tract infections by telehealth across Texas.

Why Kidney Stones Are More Common in Texas

Texas sits squarely in the epicenter of the U.S. Kidney Stone Belt, a geographic swath of southern states stretching from the Carolinas through Texas where stone rates are significantly higher than the rest of the nation.

The primary environmental catalyst is heat. When ambient temperatures soar, your body loses substantial fluid through sweat. If oral fluid intake doesn't match this loss, your overall urine volume drops and the concentration of minerals inside your kidneys spikes, creating a volatile environment where calcium, oxalate, and uric acid crystallize.

Peer-reviewed research in Kidney International directly ties rising ambient temperatures to a predictable surge in stone formation. Furthermore, a landmark study published in the Proceedings of the National Academy of Sciences (PNAS) projected that expanding global climate trends will drive the kidney stone belt further north, increasing the percentage of Americans living in high-risk zones from 40% to 56% by 2050.

For Texans, this is a year-round reality that peaks fiercely in the summer. Outdoor laborers, athletes, and those who do not actively adjust their fluid intake during hot months experience a measurable rise in stone risk. Texas urologists and family practitioners report a highly predictable surge in emergency room visits and clinic calls from June through September.

What to Do If You Think You Have a Kidney Stone

Step One: Clinical Home Care for the First 24 Hours

If your pain is manageable, your vitals are stable, and you do not display any of the emergency red flags listed below, you can safely initiate conservative management at home:

Aggressive Fluid Loading — Immediate Execution: Drink 2 to 3 liters of water over the next 24 hours. Your goal is to generate massive urine volume and hydrostatic pressure to physically push the stone out of the ureter.

Target Inflammation and Spasms — Every 6 to 8 Hours: Take over-the-counter Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Ibuprofen (Advil, Motrin) at 400–600 mg targets the specific prostaglandin pathways causing ureteral spasms. NSAIDs provide superior stone pain relief compared to acetaminophen because they directly target the inflammatory swelling of the ureteral wall.

Apply Direct Thermal Therapy — As Needed: Place a localized heating pad or a hot water bottle onto your flank or lower back. The localized heat helps relax the smooth muscle tissue of your urinary tract, taking the edge off the sharp waves of pain.

Strain Your Urine — Every Bathroom Visit: Urinate through a dedicated plastic mesh strainer or clean cheesecloth. Catching the stone is arguably the most critical step; it allows your doctor to send the physical sample to a pathology lab for chemical analysis to map your prevention plan.

When to Go to the Emergency Room

Go to the nearest hospital emergency department or call 911 immediately if you experience:

A fever above 101°F or sudden chills paired with flank pain (indicates an obstructed, infected kidney).

Persistent vomiting that prevents you from keeping oral medications or basic fluids down.

Anuria (the complete inability to pass urine).

Intractable pain that does not respond to maximum over-the-counter dosages.

Any stone symptoms if you have a single solitary kidney, a prior kidney transplant, or known chronic kidney disease (CKD).

What a Telehealth Visit Can Do for You

Many Texans assume an agonizing, expensive trip to an Emergency Room or urgent care clinic is the only way to get relief from a kidney stone. However, a licensed family medicine physician can fully manage the vast majority of uncomplicated kidney stones via a virtual telehealth visit from the comfort of your home.

During an online medical consultation, your physician can provide the following care pathway:

Prescribe Medical Expulsive Therapy (MET): Your doctor can prescribe Tamsulosin (Flomax). Flomax relaxes the alpha-1 receptors in the smooth muscle of the lower ureter, significantly reducing resistance. The 2026 American Urological Association (AUA) guidelines strongly recommend MET for stones 10 mm or smaller located in the lower portion of the ureter.

Provide Advanced Symptom Management: Doctors can call in prescription-strength anti-inflammatories or powerful anti-nausea medications like Ondansetron (Zofran) so you can comfortably manage your symptoms at home.

Order Local Diagnostic Imaging: Your telehealth provider can submit an immediate order for a non-contrast CT scan of the abdomen and pelvis at a credentialed freestanding imaging center near you, confirming stone size and location without the ER markup.

Order Laboratory Workups: They can order regional lab diagnostics, including a urinalysis (to screen for microscopic blood or white blood cell counts indicative of infection) and a metabolic panel (to verify stable kidney function).

Coordinate Clinical Referrals: Your primary care telehealth doctor can evaluate your condition and determine if your stone can pass naturally, or if your case warrants a direct, coordinated referral to a local practicing urologist.

How Kidney Stones Are Diagnosed and Treated

Clinical Diagnosis

The definitive gold standard for diagnosing a kidney stone is a low-dose, non-contrast CT scan of the abdomen and pelvis. A CT scan accurately determines the exact millimeter size of the stone, its geographic location along the urinary tract, and whether it is causing severe back-up pressure inside the kidney.

Passing a Stone at Home

Stones under 5 mm: 80–90% chance of passing spontaneously within 1 to 2 weeks via aggressive hydration and basic pain control.

Stones between 5 mm and 10 mm: Roughly a 50% chance of passing naturally. The use of medical expulsive therapy (Tamsulosin) accelerates this process, though it may take up to 4 to 6 weeks. Your physician will typically order follow-up imaging or check-ins within 14 days to monitor for signs of hydronephrosis (kidney swelling caused by trapped urine).

When Surgical Intervention is Required

A specialist referral to a urologist for surgical removal becomes necessary if:

The stone is larger than 10 mm and physically incapable of clearing the ureter naturally.

The stone remains firmly lodged after 4 to 6 weeks of conservative medical management.

There are clear clinical signs of an active bacterial infection trapped behind the stone.

The obstruction causes a measurable decline in kidney function or unmanageable pain.

Modern urological procedures are highly effective and minimally invasive, including Shock Wave Lithotripsy (SWL) using external acoustic shockwaves, Ureteroscopy (URS) utilizing a micro-scope and laser fiber via the urethra, or Percutaneous Nephrolithotomy (PCNL) for massive staghorn stones through a tiny incision in the back.

How to Prevent Kidney Stones From Coming Back

If you have passed one kidney stone, clinical data shows you have up to a 50% chance of forming another within 5 to 10 years. With every subsequent stone you form, your future risk doubles. Long-term medical prevention is essential to protect your kidneys.

1. Advanced Hydration Tactics

To stop crystallization, every past stone former should aim to produce at least 2.5 liters of urine per day. Achieving this typically requires drinking 3 to 4 liters of total fluids daily.

In the Texas summer heat, checking your urine color is far more accurate than counting glasses: aim for a constant, translucent pale yellow color. Pure water is best. Real lemonade made from squeezed lemons is an excellent medical supplement because the natural citrate binds with calcium in the urine, keeping it dissolved and preventing it from linking with oxalate.

2. Evidence-Based Dietary Changes

Drastically Reduce Sodium Intake: Limit sodium to less than 2,300 mg per day. High dietary sodium forces your kidneys to pump more calcium into your urine, directly increasing stone formation rates.

Maintain Optimal Dietary Calcium: Consume 1,000–1,200 mg of calcium daily exclusively from whole foods (like yogurt, cheese, and calcium-rich greens), not synthetic pills. Dietary calcium binds tightly to oxalates inside your digestive tract, preventing the oxalates from entering your bloodstream and reaching your kidneys.

Cap Animal Protein: Limit heavy animal protein to 6 ounces per day. Excess animal protein raises urinary uric acid, drops urine pH into a dangerous acidic zone, and depletes your body's protective urinary citrate reserves.

Moderate High-Oxalate Foods: Avoid extreme portions of spinach, rhubarb, almonds, and dark chocolate if your lab tests confirm high urinary oxalate levels.

3. The 24-Hour Urine Test: Your Personalized Blueprint

If you have suffered from recurrent stones, you should request a 24-hour urine collection test. This clinical evaluation measures your total daily output of calcium, oxalate, uric acid, citrate, sodium, and total volume.

The lab metrics isolate the exact biochemical vulnerability causing your stones. Your primary care physician can order, track, and interpret this panel without requiring a specialized urology office visit.

4. Targeted Preventative Medications

Based on your 24-hour metabolic urine metrics, your doctor may introduce maintenance prescriptions:

Potassium Citrate: Prescribed to correct low citrate levels and raise an acidic urine pH. This is highly effective against calcium oxalate and uric acid stones.

Thiazide Diuretics (e.g., Hydrochlorothiazide, Chlorthalidone): These specific water pills trigger the kidneys to reabsorb calcium back into the bloodstream, dropping urinary calcium concentrations by up to 50%.

Allopurinol: A medication utilized to stop the metabolic production of uric acid, serving as a primary defense for uric acid stones or gout-related stone conditions.

Frequently Asked Questions

How long does it take to pass a kidney stone?

It depends on size. Stones under 5 mm typically pass within 1 to 2 weeks with aggressive hydration. Stones between 5 mm and 10 mm may take 4 to 6 weeks, especially when supported by medical expulsive therapy with Tamsulosin (Flomax). Stones larger than 10 mm rarely pass on their own and usually require a urology referral.

Can a kidney stone be treated through telehealth?

Yes. A board-certified family medicine physician can manage the majority of uncomplicated kidney stones (under 10 mm, no fever, stable vitals) entirely through telehealth. That includes prescribing Flomax, prescription-strength anti-inflammatories, and anti-nausea medications, as well as ordering a local non-contrast CT scan, urinalysis, and metabolic panel.

Is it a kidney stone or a UTI?

Kidney stones cause severe, wave-like flank pain that radiates to the groin, with visible blood and intense nausea, while UTIs typically cause constant burning, lower abdominal pressure, and frequent urgency. The two can overlap — and a kidney stone with fever is a medical emergency. For more detail, read our UTI symptoms, treatment, and prevention guide.

Why are kidney stones more common in Texas?

Texas sits inside the U.S. "kidney stone belt." High summer temperatures cause heavy sweat losses and chronic dehydration, which concentrates minerals like calcium, oxalate, and uric acid in the urine — the exact conditions that drive crystal formation. Outdoor workers, athletes, and anyone not actively replacing fluids during hot months are at elevated risk.

When is a kidney stone an emergency?

Go to the nearest emergency department immediately if you have a fever above 101°F with flank pain, persistent vomiting that prevents keeping fluids down, complete inability to urinate, pain that does not respond to maximum OTC dosing, or any stone symptoms with a single kidney, transplant, or chronic kidney disease. Fever with a stone can rapidly progress to sepsis.

What is the best way to prevent kidney stones from coming back?

The most powerful step is hydration — produce at least 2.5 liters of urine per day. Combine that with a lower-sodium diet (under 2,300 mg/day), normal dietary calcium from whole foods, capped animal protein, and real lemon water for natural citrate. Recurrent stone formers should request a 24-hour urine collection test so a physician can design a personalized prevention plan and prescribe targeted medications when needed.

Does drinking lemonade really help with kidney stones?

Yes — real lemonade made from squeezed lemons (not sugary cocktails) provides natural citrate, which binds with calcium in the urine and prevents it from linking with oxalate to form stones. It is one of the easiest evidence-based home strategies for calcium oxalate stone formers.

Access Same-Day Kidney Stone Care in Texas

If you are experiencing acute flank pain, localized urinary burning, or suspect you are passing a kidney stone, you do not have to sit for hours in an expensive emergency room or wait weeks for an open specialist slot.

At Trinity Family Medicine, we provide dedicated, same-day telehealth visits for comprehensive kidney stone evaluation, acute management, and metabolic prevention across the entire state of Texas*.

Affordable, Transparent Pricing: Comprehensive virtual medical visits start at $49.99, with no insurance required.

Full Prescription Power: We can instantly send prescriptions for Tamsulosin (Flomax), prescription anti-inflammatories, or anti-nausea medications to your local pharmacy.

Local Diagnostics Coordination: We coordinate fast-tracked, direct orders for non-contrast CT scans and comprehensive urinalysis at imaging centers and labs local to your neighborhood.

Long-Term Prevention Programs: For recurrent stone formers, we coordinate 24-hour urine collection kits, analyze your metabolic markers, and design customized diet and prescription medicine protocols to break the formation cycle before the next Texas summer hits.

Take control of your symptoms today. Book your virtual visit online at trinitymedtx.com or speak directly with our clinical coordination team by calling 817-932-4022.

References

Scales CD, et al. "Prevalence of kidney stones in the United States." European Urology, 2012 pubmed.ncbi.nlm.nih.gov/22498635/

Ziemba JB, Matlaga BR. "Epidemiology and economics of nephrolithiasis." Investigative and Clinical Urology, 2017 pmc.ncbi.nlm.nih.gov/articles/PMC5577325/

Pearle MS, et al. "Surgical Management of Kidney and Ureteral Stones: AUA Guideline (2026)." The Journal of Urology, 2025 auajournals.org/doi/10.1097/JU.0000000000004842

Fink HA, et al. "Kidney Stones: Treatment and Prevention." American Family Physician, 2019 aafp.org/pubs/afp/issues/2019/0415/p490.html

Brikowski TH, Lotan Y, Pearle MS. "Climate-related increase in the prevalence of urolithiasis in the United States." PNAS, 2008 pnas.org/doi/10.1073/pnas.0709652105

Fakheri RJ, Goldfarb DS. "Ambient temperature as a contributor to kidney stone formation: implications of global warming." Kidney International, 2011 kidney-international.org/article/S0085-2538(15)54739-X/fulltext

Pearle MS, et al. "Medical Management of Kidney Stones: AUA Guideline." American Urological Association, 2014.

National Kidney Foundation. "Kidney Stone Diet Plan and Prevention." 2024 kidney.org/kidney-topics/kidney-stone-diet-plan-and-prevention

Vaughan LE, et al. "Predictors of Symptomatic Kidney Stone Recurrence After the First and Subsequent Episodes." Mayo Clinic Proceedings, 2019 pubmed.ncbi.nlm.nih.gov/30527866/

Cleveland Clinic. "Kidney Stones: Causes, Symptoms, Diagnosis & Treatment." 2024 my.clevelandclinic.org/health/diseases/15604-kidney-stones

Medical Disclaimer: The information provided in this article is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.

Medical Review Date: June 2026, by Dr. Kathryn Kline, MD, Texas Medical Board License T3117

Kidney Stones: Symptoms, Treatment, and Prevention — A Texas Doctor's Guide (2026 Edition)