Once a kidney stone passes, the worst pain is over, but your body needs time to heal and your doctor will likely recommend steps to figure out why the stone formed and how to prevent the next one. About 50% of adults who get a kidney stone will develop another within five to ten years, so what you do after passing one matters as much as getting through it.
What the First Few Days Feel Like
Pain usually stops once the stone drops into your bladder and exits your body. But the ureter, the tiny tube connecting your kidney to your bladder (only about 1/8 inch wide), has just been scraped and stretched by a hard mineral deposit. That leaves irritation and mild inflammation behind. You can expect some residual soreness for a few days as the tissue heals.
Blood in your urine is common during this window. It may look pink, red, or brown and can persist for a day or two after passage. Some people also notice cloudy urine or a foul smell, both of which should clear up quickly. Nausea that accompanied the stone episode typically resolves within hours of passing it.
If you develop a fever, chills, or pain that gets worse rather than better in the days after passing a stone, those are signs of a possible infection or an issue that needs medical attention right away.
Saving the Stone for Analysis
If you can catch the stone (your doctor may give you a strainer to urinate through), do it. A lab can analyze its chemical makeup, and this single piece of information shapes your entire prevention plan going forward. There are four main types of kidney stones: calcium stones (the most common), uric acid stones, struvite stones (usually linked to urinary tract infections), and cystine stones (caused by an inherited kidney condition). Each type forms for different reasons and responds to different dietary and medical strategies.
Without knowing what your stone is made of, your doctor is essentially guessing at prevention. With it, they can recommend targeted changes that meaningfully lower your risk.
Follow-Up Testing
Most people discharged after a kidney stone episode are told to follow up with a urologist or their primary care doctor within 90 days. At that visit, your doctor may order imaging to confirm no fragments or additional stones remain. An ultrasound can check your kidneys, bladder, and ureters for stones that haven’t passed yet or for any swelling. A KUB X-ray (a simple abdominal and pelvic X-ray) can also show whether a stone has grown, passed, or returned.
For people who’ve had more than one stone, doctors typically order a 24-hour urine collection. You collect all your urine over a full day, and the lab measures levels of calcium, oxalate, uric acid, citrate, sodium, and other substances. This metabolic snapshot reveals the specific imbalance driving your stone formation. High calcium in the urine is the most common finding in stone formers. Low citrate (a natural stone inhibitor) and high oxalate are other frequent culprits. Urine pH matters too: uric acid stones are more likely to form in acidic urine, while calcium phosphate stones favor alkaline urine. Blood tests round out the picture by checking for conditions like elevated calcium or uric acid in your bloodstream.
How Much Water You Actually Need
The single most effective thing you can do after passing a stone is drink enough fluid to produce at least 2 liters (about half a gallon) of urine per day. This is the threshold recommended by the American Urological Association, the European Association of Urology, and the American College of Physicians. Hitting that target dilutes the minerals in your urine enough to reduce stone recurrence and extend the time before a new stone forms.
For most people, that means drinking roughly 2.5 to 3 liters of fluid daily, since some water is lost through sweat and breathing. Water is the best choice. Spreading intake throughout the day, including a glass before bed and when you wake up, keeps urine dilute around the clock.
Dietary Changes That Actually Help
If you had a calcium oxalate stone (the most common type), you might assume you should cut calcium from your diet. The opposite is true. A landmark study in the New England Journal of Medicine found that higher dietary calcium intake was associated with a lower risk of kidney stones. The reason is counterintuitive but straightforward: calcium in your food binds to oxalate in your digestive tract before either one reaches your kidneys. Without enough dietary calcium, more oxalate gets absorbed into your bloodstream and filtered into your urine, where it drives stone formation. Even small increases in urinary oxalate raise the saturation of calcium oxalate in urine more sharply than increases in urinary calcium do. Restricting dietary calcium can also weaken your bones over time.
The practical takeaway: eat calcium-rich foods (dairy, leafy greens) with your meals so the calcium can bind oxalate in your gut. What you should reduce is sodium and animal protein, both of which increase calcium excretion into the urine. Limiting high-oxalate foods like spinach, rhubarb, and nuts can also help if your urine oxalate is elevated.
For uric acid stones, the focus shifts to reducing purine-rich foods (organ meats, shellfish, red meat) and sometimes making urine less acidic through dietary adjustments or supplements.
Medications for Repeat Stone Formers
Preventive medication is generally considered after someone has had at least two kidney stones. The specific drug depends on your stone type and metabolic test results, and these medications are typically taken daily on an ongoing basis.
Citrate salts are the most versatile option, used to prevent calcium, uric acid, and cystine stones. They work by binding to calcium in the urine and raising citrate levels, which inhibits crystal formation. In clinical studies, kidney stone recurrence within two years dropped from 44% to 11% with citrate treatment. About 12 out of 100 people stop taking them due to stomach and digestive side effects.
Thiazide diuretics reduce the amount of calcium that enters your urine from your bloodstream. Studies show they cut three-year recurrence from 47% to 24%. Side effects can include low blood pressure, dizziness, dry mouth, and erectile problems, with about 8 out of 100 people discontinuing due to side effects.
For uric acid stones specifically, a medication that lowers uric acid production by blocking purine breakdown is sometimes prescribed. Magnesium supplements may also help prevent calcium oxalate stones by binding to oxalate in the urine, though the evidence is less robust.
The Recurrence Reality
Kidney stones are a chronic condition for many people. Roughly half of adults who form one stone will form another within five to ten years. In younger patients, recurrence can be even faster, with a 50% chance of a second stone within just three years. These numbers underscore why follow-up care, dietary changes, and adequate hydration aren’t optional extras. They’re the difference between a one-time event and a recurring problem. Despite this, many people skip follow-up after an emergency room visit for kidney stones and never receive metabolic testing or a prevention plan, missing the window when intervention would be most useful.