The national epidemiological cross-sectional survey study of urolithiasis found that the incidence of urinary stones in the southern region is significantly northern; the incidence is higher in rural areas than in urban areas; and the incidence is higher in men than in women.
During the Spring Festival, how can we eat to better prevent or alleviate the formation of urinary stones? Sweating more, urinating less is an important reason for the formation of urinary stones, it is recommended that the best daily intake of 2000 ml of water. Also, different types of urinary stones have different dietary concerns and different prevention priorities.
Urolithiasis is one of the most common diseases in urology and can cause symptoms such as pain, hematuria and fever, leading to recurrent and severe urinary tract infections and acute urinary tract obstruction, causing serious consequences such as acute and chronic renal failure and even nephrectomy.” The incidence of urolithiasis in different regions of the world is 2% to 20%.
The incidence of urinary calculi is significantly higher in the South than in the North.” Among urological diseases, the most southerners suffer from urinary stones, accounting for more than 50% of urology inpatients; while in the north, the proportion of urological tumors and prostate enlargement is a bit more.
The high temperature leads to more sweating and less urination, which can easily form stones. The fact that there is more sweating and less urination in physical labor is also one of the important reasons why the incidence of urinary stones is higher in men than in women, and higher in rural areas than in urban areas.
Therefore, people at high risk of urinary stones should pay more attention to drinking water, and it is best to ensure that they drink more than 2000 ml of water per day. For those with existing stones, it is recommended to drink 200 ml of water before going to bed. This will allow you to get up once during the night, thus reducing the accumulation of crystals in the renal collecting system. Of course patients with poor sleep quality will need to weigh the pros and cons before making a choice.”
Treatment Myth #1.
Thinking you can stop taking medication if you don’t have pain
The treatment of urinary stones requires a treatment plan based on the size of the stone. Usually, small stones less than 5 mm can be treated conservatively with medications; stones less than 2 cm can be treated by extracorporeal shock wave lithotripsy or holmium laser lithotripsy and stone extraction under ureteral soft microscopy; stones larger than 2 cm can be treated by percutaneous nephrolithotomy for stone extraction.
Patients have two misconceptions about the treatment of urinary stones.
One is that many patients who use drugs to treat small stones think that if they are not in pain, they can stop the drugs and are cured. This is not true. Just because a patient with stones is not in pain does not mean that the stones do not exist anymore. Many times the small stones are stuck in the ureter and do not move, so the patient does not feel any pain. However, because the stones block the ureter, it is easy to cause hydronephrosis, resulting in the loss of kidney function. And once the kidney function is seriously damaged, it is irreversible. Therefore, patients with urinary stones, especially ureteral stones, are treated with medication, which usually requires two weeks of medication and a follow-up visit in two weeks. “If the stone has not moved down from the kidney to the ureter, it needs to be checked every three to six months, even if it is not painful.”
Treatment myth #2.
Thinking that extracorporeal shock wave lithotripsy can cause kidney damage
Another misconception is that extracorporeal shock wave lithotripsy can lead to kidney damage. Extracorporeal shock wave lithotripsy began to be used in China in the early 1980s. In the early days of its use, there were indeed cases where some doctors misused this technique. Sometimes the stones reached four or five centimeters or even cast stones, but some doctors still used this technique, which resulted in patients receiving extracorporeal shock wave lithotripsy several times, causing kidney atrophy and serious damage to kidney function.
But in fact, kidney stones or ureteral stones smaller than 2 cm can be considered for extracorporeal shock wave lithotripsy if the obstruction is not serious, as long as they are not lithotripped more than three times and the time between each two lithotripsy is more than two weeks, so that there is no great impact on the kidney. Moreover, this lithotripsy technique is non-invasive, the patient has almost no pain, and the cost is cheap, only six or seven hundred dollars. In terms of stone recurrence rate, it is not much different from surgery or minimally invasive stone extraction.
Prevention.
The focus of prevention is different for different types of urinary stones
1. Calcium oxalate stones: eat less spinach
Urinary stones, calcium oxalate stones account for 70% to 80%, therefore, in the diet, in addition to drinking more water to prevent calcium oxalate supersaturation and flush out the calcium oxalate crystals, but also try to eat less spinach. Because spinach is rich in oxalic acid, and at the same time to limit the intake of protein and salt.
2, uric acid stones: eat less high purine food
Although patients with uric acid stones may not all have gout, and patients with gout may not always have uric acid stones, some of the uric stones do have stones due to high uric acid.
Uric acid stones are prevented in the same way that gout is prevented. In terms of diet, it is important to avoid high purine foods. For example, red meat, animal offal, seafood, beer, red wine, and old fire soup are all high purine foods.
3. Infected stones: control infection
Many of women with urinary stones are caused by urinary tract infections. Urease produced by bacteria present in the urinary tract infection can catalyze the decomposition of urea into ammonia and carbon dioxide, and ammonia is then combined with water to form ammonium hydroxide. When the urine pH reaches 7.2, ionic ammonium can combine with magnesium and phosphate in urine to form magnesium ammonium phosphate. When the urinary magnesium ammonium phosphate reaches supersaturation levels, crystals are precipitated. However, these crystals adhere to the urinary epithelium and, over time, form stones.
This type of urinary stone has a high recurrence rate, up to 50% within a year if not controlled. Therefore, for infected stones, in addition to getting enough water, it is important to find out what bacterial infection is causing the infection, prescribe the right medicine to control the infection, and at the same time remove the stone as clean as possible in order to effectively prevent recurrence.
4.Pediatric cystine stones: drink more water and control protein intake
There is another type of urinary stone that belongs to cystine stones, a genetic stone caused by too much cystine in the urine. These stones usually develop from a very young age and are prone to recurrence. However, this type of stone has every chance of preventing recurrence if proper preventive measures are taken. First of all, it is necessary to ensure that the daily urine volume is above 3000 ml, in addition to alkalinizing the urine. Patients must control their protein intake and eat a low protein diet based on vegetables and cereals, but be careful to avoid affecting the physical development of the child.
Patients with complex conditions, prone to recurrence, and those whose stones are still not removed after treatment need to be followed up closely. The current clinical follow-up is mainly based on performing 24-hour urine lithogenic risk factor analysis as the main means to prevent stones by giving dietary adjustments as well as medication to patients with stones through analysis of urine composition.