1. Illnesses and disorders

2.  The process of forming a kidney stone, a stone in the kidney  The development of the stones is related to decreased urine volume or increased excretion of stone-forming components such as calcium  The stones form in the urine collecting area (the pelvis) of the kidney and may range in size from tiny to staghorn stones

3.  The pain with kidney stones is usually of sudden onset, very severe and colicky (intermittent), not improved by changes in position, radiating from the back, down the flank, and into the groin. Nausea and vomiting are common.

4.  PAIN is “not improved by changes in position”

5.  “ colicky (intermittent )”

6.  “ radiating from the back, down the flank, and into the groin”

7.  “very severe”

8.  “of sudden onset ”

9.  In order to manage this event adequately, several goals should be pursued: first, attenuate pain; second, favour progression and spontaneous expulsion of stones; third, prevent from obstructive and infectious complications.

10.  the rationale for therapy is to make urine less conductive to stone formation, by both decreasing state of saturation and increasing inhibitory potential  It can be especially helpful to drink more water  Restriction of oxalate -rich foods, or consumption of more calcium, avoiding consumption of ascorbic acid ( vitamin C)  Taking drugs such as thiazides, potassium citrate, magnesium citrate and allopurinol, depending on the cause of stone formation .

11.  If neither obstruction nor infection is present, analgesics and other medical measures to facilitate passage of the stone (see below) can be initiated with the expectation that the stone will likely pass from the upper urinary tract if its diameter is smaller than 5-6 mm (larger stones are more likely to require surgical measures).