How kidney stone symptoms in children may differ from those in adults

Kidney stones in children can present differently than in adults, with symptoms often being less specific and harder to pinpoint. In both groups, common symptoms include severe pain, hematuria (blood in the urine), and discomfort, but the manifestation can vary.

Pain presentation: Adults typically describe the pain of kidney stones as severe and colicky, often starting in the lower back and radiating to the abdomen or groin. Children, however, might not articulate their pain clearly. Instead, they may show signs of discomfort through crying, fussiness, or irritability. They might also exhibit abdominal pain rather than the specific flank pain common in adults. The smaller the child, the less specific are the symptoms.

Behavioral changes: Kids may display changes in behavior due to pain. This includes increased irritability, decreased appetite, or a reluctance to engage in normal activities. In contrast, adults can often pinpoint the pain's location and severity more precisely.

Gastrointestinal symptoms: Children are more likely to present with gastrointestinal symptoms like nausea, vomiting, or diarrhea, which can sometimes be mistaken for other conditions like gastrointestinal infections. In adults, while gastrointestinal symptoms can occur, they are less common and often secondary to pain or discomfort.

Urinary symptoms: While both children and adults might experience painful urination and hematuria, children may also present with more vague urinary symptoms like frequent urination or bedwetting, which can sometimes be mistakenly attributed to other issues like urinary tract infections or developmental delays.

Diagnosis and evaluation: Due to these differences in symptom presentation, diagnosing kidney stones in children can be more challenging. Healthcare providers might need to rely on imaging studies, such as ultrasounds or CT scans, more often than in adults. Blood and urine tests are also crucial to confirm the diagnosis and determine the best treatment approach. The treatment of stones in children is also challenging as all the instruments are adults oriented and relatively larger.

Complications: Children with kidney stones might face different complications compared to adults. For instance, untreated stones in children can lead to urinary tract obstruction, which can be more immediately problematic due to the smaller size of the child’s urinary tract. This can lead to significant issues like affecting the growth of the kidney and child as well, if not addressed promptly.


In summary, while the fundamental issues caused by kidney stones are similar across age groups, the way symptoms present and are experienced can differ markedly between children and adults. Recognizing these differences is crucial for timely diagnosis and appropriate treatment..
(Author: ‌Dr. Prabhu Karunakran, Consultant Pediatric Urologist, Asian Institute of Nephrology and Urrology, Hyderabad)