Kidney stones precautions and dietary taboos

Don’t take long-term high-dose vitamin C supplements, don’t eat high-oxalate/high-purine/high-sodium foods, don’t blindly cut off calcium, and don’t over-supplement calcium.

I have been working in the urology clinic for 7 years, and I have seen too many patients who panic as soon as they receive the B-ultrasound order. They stop all foods containing "calcium" and dare not even drink milk. Some even go on a vegetarian diet and eat spinach every time. On the contrary, the more they eat, the bigger the stones become. Let’s talk about the easiest and most effective way to drink water first. Don’t wait until you are thirsty to drink water. If you sit there typing code for three hours or playing games all afternoon, and only take a sip when you think about it, that will definitely not work. It is best to drink about 100ml every half hour. At the end of the day, if the color of urine is light yellow, close to unsoaked lemon water, then the amount of water you drink must be far different. If you sweat a lot in the summer or run business outdoors for a long time, you should take an extra 500-1000ml. Don't drink iced coke or sweet milk tea as water. There was a young man born in 2000 who drank iced coke as water during the summer vacation. He developed a 0.5cm stone in 3 months. He hugged his stomach and cried in pain. It was completely unnecessary suffering.

At this point, someone may ask, does that mean that as long as you drink enough water, it doesn’t matter what you eat? That's definitely not the case. There are actually more pitfalls in diet, and you don't need to have extreme dietary restrictions. It's best to find out what type of stones you have first. If you don't have time to check, it's not wrong to follow general principles. For example, the commonly mentioned foods with high oxalic acid, such as spinach, amaranth, purslane, strong tea, nuts, chocolate, etc., do not need to be completely blacklisted. Blanching spinach in boiling water for 1 minute before eating can remove 70% of the oxalic acid, so it can be eaten normally. ； Change the strong tea to light tea. Just eat a palm-sized handful of nuts every day. Don't show off half a can while watching TV shows. You'll basically be fine. If you are susceptible to calcium oxalate stones, just pay more attention. There is no need to avoid eating vegetables just to prevent stones.

Here is a controversial point: Can kidney stones be supplemented with calcium? The old view was that calcium will combine with oxalic acid to form stones, so it is best to avoid calcium. But now there are actually two voices in the academic community: one group believes that taking extra calcium tablets to supplement calcium can indeed increase the calcium concentration in urine and increase the risk of calcium oxalate stones. ； Another group of large-scale studies in recent years have shown that an appropriate amount of calcium in the diet (800-1000mg per day for adults, which is about the amount of 1 box of pure milk + 1 small dish of soft tofu) will combine with oxalic acid in the intestines, reducing the total amount of oxalic acid absorbed by the body, which can actually reduce the risk of stones. My usual advice to patients is that it is perfectly fine to drink milk and eat soy products normally. If you really need calcium supplements for osteoporosis, check your 24-hour urinary calcium first and then follow the doctor’s instructions. Don’t just buy calcium supplements from internet celebrities.

Let’s talk about the other two dietary taboos that you should pay more attention to. The first is high-purine foods, such as seafood, animal offal, hot pot soup base, beer, etc. If you are found to have uric acid stones, or you have high uric acid, you really need to keep your mouth shut. Otherwise, there are too many cases where gout will come to your doorstep without preventing the stones. There was an old patient who went out to eat seafood barbecue and ice beer just after being discharged from the hospital. As a result, he relapsed within a week and the pain was worse than last time. He even laughed and said, "The price of gluttony is too high." Also, don’t eat too salty. Eating too much high-sodium foods such as take-out, pickles, and processed ham will double the amount of calcium excreted by the kidneys, which is equivalent to actively providing raw materials for stones. People who eat heavy take-out every day, even if they drink enough water, are more than twice as likely to develop stones than people who eat light meals.

There is another pitfall that many people don’t know: high-dose VC supplementation. Many people like to drink VC effervescent tablets, thinking they can whiten their skin and prevent colds. Studies have now confirmed that taking more than 1,000mg of VC every day will increase the oxalic acid content in urine by about 30%, and the risk of stones will increase significantly. ； However, some scholars say that daily intake of VC from foods such as oranges and kiwis will not be a problem at all, and only supplementing large doses of medicinal VC will have an impact. I usually tell my patients that they just need to eat more fruit, and there is no need to take two or three effervescent tablets a day to supplement their health, which will cause trouble for themselves.

In addition to eating and drinking water, don't sit still in a chair all the time. Get up and jump when you have nothing to do. You can skip rope, climb stairs or even dance square. Smooth stones smaller than 0.6cm can be expelled by themselves if you drink more water and move more. If your back suddenly hurts so much that you can't stand up, don't bear it. Take a piece of ibuprofen to relieve the pain first, and go to the hospital quickly. Don't wait for the stone to block the hydronephrosis. By then, your kidney function may be damaged. I also take 10 minutes every year to do a urinary system B-ultrasound. Many people don’t feel the stones grow up to 2cm, so they can only do surgery when they are discovered. It’s such a loss.

In fact, to put it bluntly, kidney stones are a typical "lifestyle disease". Most people can control it very well if you eat more snacks, don't eat and drink, don't hold your urine, and don't sit for a whole day. Don’t panic if you do find out you have stones. See a doctor first to find out what the condition and type of stones are. Targeted adjustments are much more useful than searching for a bunch of taboo lists on the Internet. After all, everyone’s physique is different, and what works for others may not be suitable for you, right?