However, when it enters the narrow ureteral lumen, it can be considered as a “one man’s gate, no one can open it”, which can cause serious damage to the kidney, obstruction, infection and even loss of kidney function. In addition, long-term friction and stimulation between stones and local mucosa of urinary tract may lead to uroepithelial cancer. Therefore, once stones are found, we should go to the hospital for active and regular treatment.
How to catch stone prevention
First, increase water consumption and dilute urine
Keep at least 2.5-3.0 liters of urine per day, and keep the color of urine clear and light yellow is appropriate, which is beneficial for the prevention of stones of any component type. There are two issues that need to be clarified: first, what kind of water to drink? Drink more plain water, mineral water, rather than strong tea, coffee, cola and other drinks; second, when to drink water? Here we are talking about “evenly distributed throughout the day”, rather than the daytime “open drink”, the night “dripping water”. Studies have shown that a 50% increase in urine volume can reduce the incidence of kidney stones by 86%. However, people with poor kidney function and heart function should pay attention to the appropriate amount of water, do not overdo it.
Second, adjust the diet structure
Change the bad dietary habits, eat less high-fat food, and increase the intake of fruits and vegetables appropriately. If you have suffered from urinary stones in the past, your diet should be changed according to the composition of the stones and according to your doctor’s opinion.
1. Eat less meat and animal offal because meat metabolism produces uric acid, and animal offal is high purine food, decomposition and metabolism will also produce high blood uric acid, which is the main component of stone formation. Daily diet should be mainly vegetarian, to eat more fiber-rich food.
2, reasonable calcium supplementation, especially dietary calcium supplementation Kidney stone patients often “talk about calcium”, wrongly believe that the culprit of kidney stones is calcium, but in fact, kidney stone patients also need calcium supplementation. There are two different perspectives in the medical field to explain why kidney stone patients need calcium supplements.
The first is that calcium supplementation can combine with oxalic acid contained in vegetables in the gastrointestinal tract to form insoluble calcium oxalate, which is excreted in the feces, reducing some of the oxalic acid absorbed by the gastrointestinal tract and excreted by the kidneys, thus reducing the chances of forming kidney stones.
The second is the “acid-base balance theory” proposed by Japanese scholars. In other words, when blood is acidic, stones are easily formed. When it is alkaline, it inhibits the formation of stones. The blood is acidic when calcium is deficient, and the blood is alkaline when calcium is reasonably supplemented, which is beneficial to inhibit stone formation.
3, limited intake of sugar The results of a recent study by American scientists show that the intake of high-sugar foods can increase the chances of developing kidney stones, so pay attention to eating less sweets. Sugar is an important nutrient for the human body and should be added regularly in moderation, but adding too much at once, especially lactose, can also create conditions for stone formation. Experts point out: whether normal people or stone patients, after consuming 100 grams of sucrose, after 2 hours to check their urine, found that the urinary calcium and oxalic acid concentration are rising, if you take lactose, it can promote the absorption of calcium, more likely to lead to the accumulation of calcium oxalate in the body and the formation of urinary stones.
4, eat less food with high oxalate content Food with high oxalate content include tomatoes, spinach, strawberries, beets, chocolate, etc. Excessive oxalate intake is also one of the main causes of kidney stones.
5, eat less soy products Soy foods contain high oxalate and phosphate, can be fused with calcium in the kidney, the formation of stones.
6, be careful to drink milk before going to bed People who do not sleep well, drink a glass of milk before going to bed to help sleep. However, after sleep, the urine volume is reduced, concentrated, and various tangible substances in the urine increased. And 2 to 3 hours after drinking milk, it is the peak of calcium excretion through the kidneys. The sudden increase of calcium through the kidneys in a short period of time makes it easy to form stones. Therefore, kidney stone patients should not drink milk with high calcium content before going to bed.
7, eat more black fungus Black fungus is rich in a variety of minerals and trace elements, can produce a strong chemical reaction to a variety of stones, so that the stones exfoliate, differentiate, dissolve, discharged from the body.
8, do not take too much cod liver oil cod liver oil is rich in vitamin D, has the function of promoting intestinal membrane absorption of calcium and phosphorus, suddenly increase the excretion of calcium and phosphorus in the urine, is bound to produce precipitation, easy to form stones.
9, eat less salt too salty diet will increase the burden on the kidneys, and salt and calcium in the body has a synergistic effect, and will interfere with the metabolic process of drugs to prevent kidney stones, salt intake should be less than 5 grams per day.
10, drink less beer Some people believe that beer can be diuretic, can prevent the occurrence of urinary stones. In fact, the wort of beer brewing contains calcium, oxalic acid and purine nucleotides and other acidic substances, their interaction can increase the uric acid in the body, becoming an important trigger for the formation of kidney stones.
Third, maintain a good state of mind and increase exercise appropriately
Use the effect of gravity to promote the discharge of stones, often suggest patients to do exercises such as jumping rope, jumping exercises, and raising the heel repeatedly for tiptoe activities. Exercise therapy should be combined with more water and medication, so that the effect is better. Choose a body position for stone removal according to the location of the stone. A news article of Xinhua News Agency mentioned that a farmer in Jiangxi made his own “stone removal bed” to save his sick wife, and also obtained a national patent. Theoretically this is only effective for kidney stones in the lower calyx, it turns the person upside down and promotes the discharge of small stones out of the body. Back to the news, this “stone removal bed” is only applicable to small stones in the lower calyces of the kidney, and it is not effective for stones that are too large or located in the middle or upper calyces.
IV. Stone composition analysis for recurrence prevention
People who have already suffered from urinary stones can have their stones analyzed according to the stones that have been discharged or surgically removed, so as to clarify their composition and formulate effective preventive measures.
For example: preventive measures for calcium oxalate stones.
1, limit the intake of oxalic acid: foods rich in oxalic acid should be avoided, such as rhubarb, mango, spinach and sesame, cocoa (chocolate), tea and nuts (peanuts, almonds and walnuts, etc.) should be consumed in limited quantities.
2, balanced calcium intake: the recommended intake of calcium for stone patients abroad is 800-1000mg/day, while the actual calcium intake in China is only 309mg/day, so the calcium intake should not be strictly controlled.
3.Correct low citrate urine: Oral potassium hydrogen citrate drugs such as Youlite can be taken, while citrus fruits contain a large amount of potassium citrate, 100ml of orange juice can improve the PH value by 0.5 units.
4, control hypercalciuria: if urinary calcium > 8 mmol/24 hours, you can take oral dihydrochlorothiazide tablets.
Preventive measures for calcium phosphate stones.
1, should not drink orange juice, cola and other alkaline drinks to prevent alkalinization of urine.
2.Limit the consumption of high calcium, high phosphorus and high protein foods, including fish, meat, cheese, liver and nuts.
3.Control hypercalciuria: you can take oral dihydrochlorothiazide tablets.
4, acidification of urine: can take oral L-methionine or ammonium chloride.
Preventive measures for magnesium ammonium phosphate stones.
1, to avoid the kidney area, bladder area and foot cold.
2, best to drink acidic beverages: such as apple juice, cranberry juice.
3, should not drink alkaline beverages: such as orange juice, cola.
4, control urinary tract infection oral antibiotics.
5.Inhibit detoxification enzyme: can be taken orally detoxification acetoxime acid.
5, acidification of urine: oral L-methionine or ammonium chloride can be taken.
Preventive measures for uric acid stones.
1.Low purine diet: prefer eggs, milk, vegetables, fruits, etc.
2.Limit purine-rich foods: such as meat, fish, shrimp, etc. (<150g/day), less soy products, mushrooms, and avoid eating animal offal.
3.Alkalinize urine: you can eat citrus fruits rich in potassium citrate.
4, should not drink alcohol, so as not to increase the excretion of lactic acid in the urine and cause acidification of urine.
5.Increase the solubility of uric acid: you can take potassium citrate orally.
6.Control uric acid production: oral allopurinol can be taken.
Cystine stones.
1.Lower urinary cystine concentration and reduce the source of urinary cystine: it is advisable to take alkaline drinks orally to ensure a daily urine volume of 3500ml; strictly limit the consumption of high-protein foods, such as meat, eggs, fish and dairy products, with a protein intake of <0.8g/kg body weight/day; strictly limit the consumption of sodium chloride, <5g/day.
2. Improve the solubility of cystine and convert cystine into soluble substances: oral alkaline citrate, thioprostenol and vitamin C can be taken.
V. Etiological treatment
If urinary stones are caused by other diseases, such as hyperparathyroidism and urinary tract obstruction, they should be treated at the same time to avoid recurrence of stones.
Sixth, regular physical examination, early detection and treatment
It is recommended to undergo an annual urinary B-ultrasound to detect the presence of stones. For patients who have had stones in the past, B-ultrasound and routine urine examination should be repeated at least once every six months, mainly to observe whether the stones continue to increase in size, whether there is any change in location, and whether there is any urinary tract infection that increases the occurrence of stones.
You have to choose the “regular army” for stones
Depending on the location and size of the urinary stones, the method of stone extraction is completely different. It is necessary to go to the hospital for examination and follow the doctor’s recommendations for treatment, and not to blindly believe in the secret recipes.
At present, the main treatment methods for urolithiasis are as follows.
I. Drug treatment
The drug treatment of stones is mainly for the obstruction and pain symptoms caused by stones, to take the antispasmodic and pain relief, to promote the discharge of stones. In the onset of pain, atropine or scopolamine can be used to relieve spasm, pethidine and other pain relief. Progesterone 10-20 mg intramuscular injection and indomethacin suppository 100 mg anal plug can also be used. During the period of symptom relief, oral lithotripsy herbal medicine can be taken, while drinking plenty of water. Indications for drug treatment.
1.Small: less than 6mm can be preserved.
2.Smooth: stones with smooth morphology have a high chance of discharge.
3, smooth: besides the stone blockage, there should be no other factors that cause blockage of the urinary tract, such as prostatic hyperplasia.
4. Short: the stone does not cause complete obstruction of the urinary tract and stays in the site for less than 2 weeks.
Chinese herbal medicine: such as money grass-based lithotripsy punch, etc., has diuretic and enhance ureteral peristalsis to promote stone removal.
Oral alpha-blockers (tamsulosin) or calcium channel antagonists: promote ureteral stone expulsion. (Recommendation level B)
II. extracorporeal shock wave lithotripsy
It is a “spacer” type technique. The shock wave generated outside the body is focused on the stones inside the body and crushes them, with minimal damage to the normal tissues. It is suitable for stones that are relatively small in size but are not expected to pass on their own, and where conservative treatment has failed. Extracorporeal shock wave lithotripsy is mainly indicated for stones less than 2.5 cm in the kidney and upper ureter. When the stones are too large, multiple lithotripsy is required, with long stone removal time and high stone residual rate. In addition, people with bleeding disorders, infections, pacemakers, severe cardiovascular disease, urinary tract obstruction and pregnant women are not suitable for extracorporeal shock wave lithotripsy. Frequent extracorporeal lithotripsy within a short period of time is likely to cause kidney function damage, and the interval between lithotripsy must be more than one week.
Ureteroscopic lithotripsy
Our urinary system, which is connected to the outside world through the external urethral opening, ureteroscopy is applied to insert a tiny ureteroscope into the bladder through the urethra, and then go up to the ureter to lithotripsy under direct vision. This method is mainly applied to ureteral stones below the third lumbar plane and bladder stones ureteral stones in the middle and lower part of the ureter. The emerging soft ureteroscope can also be applied to some patients with kidney stones. Patients with urinary tract strictures and severe distortions should not be used.
IV. Percutaneous nephrolithotomy for stone extraction
A small hole of about 0.6 cm in diameter is punctured through the skin to open a “tunnel” into the kidney, and with the help of a chopstick-sized nephroscope or ureteroscope, the kidney and the ureteral stones above the third lumbar vertebra are “peered into”, and pneumatic ballistics, holmium laser, and other forces are used to crush and remove the stones. Holmium laser and other forces are used to crush and remove the stones. Percutaneous nephrolithotomy can also be used for larger stones, such as antler-shaped stones, and is currently the most widely used minimally invasive surgical method for the treatment of kidney stones.
V. Laparoscopic ureteral stone extraction
It is mainly suitable for ureteral stones larger than 2 cm that were originally considered for open surgery. Laparoscopic ureteral stone extraction has gradually replaced open ureteral stone extraction and is an optional surgical method. However, there are complications such as more expensive surgery, postoperative leakage and stricture.
VI. Open surgery treatment
Because open surgery can cause greater trauma to patients, it is less commonly used now.