Urinary stones (urolithiasis) are a common disease of the urinary tract. It includes kidney stones, ureteral stones, bladder stones and urethral stones. The prevalence of urolithiasis in China is as high as 5-10%. It accounts for nearly a quarter of urological inpatients. Seriously affect the health of people. Therefore. Urolithiasis patients after the relevant treatment. How to prevent the recurrence of stones is particularly important.
First of all． Drinking plenty of water has a preventive effect on all components of urinary stones. In the hot summer. When the daily urine volume is less than 1200 ml. The risk of urinary stone growth increases significantly. If you can make the daily water consumption in 2000-4000 ml. This can maintain the daily urine volume in 2000 ml or more. You can give the whole day drinking water in the morning, between meals and before bedtime. The amount of water drunk in the morning can be 500-1000 ml. In order to maintain the nighttime urine volume. Drink 500 ml of water before going to bed. Drink 300-500 ml of water after getting up to urinate during sleep. The rest of the water is drunk between meals respectively. Drinking a lot of water can promote the discharge of small stones. Dilute urine can prevent the formation of urinary stone crystals. And can slow down the growth rate of stones. Jiang Hualong, Department of Urology, Dongguan Donghua Hospital
Secondly. Adjusting the dietary structure according to the composition of the stones and matching the appropriate medication are important preventive measures. In China, calcium oxalate stones are up to 80%. The main component of infected stones is phosphate stones. Uric acid stones and carbonate stones are rare. Cystine stones are rare. Usually urinary stones are formed with a mixture of salts.
(1) Calcium oxalate stones: low calcium and low oxalate diet is recommended. Eat less milk and dairy products, soy products, endosperm, animal offal (such as liver, heart, kidney, intestines, etc.), as well as chocolate, strong tea, sesame paste, egg yolk, mushrooms, spinach, shrimp, radish, cocoa, celery, potatoes, etc.. In recent years, it was found that fiber in food can reduce the formation of urinary calcium. Such as wheat bran food bran bread, rice bran also has the same effect. Effective for recurrent high calcium urinary stones. Vitamin Bl, vitamin B6 deficiency to increase urinary malic acid. It should increase the food rich in such vitamins, such as cereals, dried fruits, hard fruits, etc., and can be supplemented with vitamin B. To reduce the excretion of oxalate. The amount of vitamin C should be limited, otherwise more than 3 to 4 grams a day. May increase the manufacture of oxalic acid． Increase the chances of stone formation． Adequate vitamin A supplementation can help to heal the mucosa of the urethra damaged by stones. Do not take too much vitamin D. Oral magnesium chloride can increase the solubility of oxalic acid in the urine. Reduce salt intake. Reduce the daily salt intake to 2~3 grams.
(2) Infected stones (calcium phosphate stones and magnesium ammonium phosphate stones): control the infection, remove the stones; acidify the urine, apply urease inhibitors such as ammonium chloride. There is a role in controlling the growth of stones. Restriction of high calcium diet is the same as for calcium oxalate stones. Restrict foods high in phosphorus, preferably less meat, fish and bone broth. Apply aluminum hydroxide gel to limit the absorption of phosphorus in the intestine.
(3) Uric acid stones: Patients with high uric acid should avoid high purine foods such as animal offal. Alkalinize urine by taking potassium citrate and sodium bicarbonate orally to keep the pH at 6.5. Take allopurinol orally to reduce uric acid.
(4) Cystine stones: oral potassium citrate, sodium bicarbonate, etc. can be used to alkalize the urine. A-mercaptopropionylglycine and acetylcysteine have litholytic effect. Captopril has the effect of preventing the formation of cystine stones. In addition… For hyperparathyroidism. The adenoma or hyperplastic tissue must be removed; there is urinary tract obstruction, urinary tract foreign body, urinary tract infection or long-term bed rest. It should be treated promptly. Appropriate exercise can also prevent the recurrence of stones.