Kidney stones precautions and dietary taboos

Let me give you the simplest conclusion first: The core response principle for kidney stone patients is "enough drinking water + targeted adjustment of diet + regular follow-up visits every six months." There is no 100% untouchable food. All dietary taboos are strongly bound to your stone components and intake. If you have to give a general taboo, it is to avoid long-term and excessive intake of high-oxalate, high-purine, high-sodium, and high-sugar foods. If you step on these minefields, the probability of recurrence will be 3-5 times higher than that of ordinary people.

I met a 28-year-old programmer when I was rotating in the Department of Urology two years ago. During the three months he was working on a project, he couldn't drink half a glass of water a day. He ordered takeout with spinach and fat beef rice and iced Coke. One morning, he suddenly suffered from pain in his waist and abdomen. When he went to the emergency department, he found that a 0.8-cm stone was stuck in the upper part of the ureter, and his kidneys were filled with water. Finally, he had to undergo soft endoscopic lithotripsy to remove it. When I was discharged from the hospital, he grabbed me and asked me three times: Am I never allowed to eat spinach or touch tofu again?

This is also the most confusing point for many people. There has been a debate on the Internet for several years about whether spinach and tofu can be eaten together. One group says that oxalic acid and calcium combine in the intestines and stomach to form insoluble calcium oxalate, which will not enter the kidneys and is safer.； The other group says that people with abnormal oxalic acid metabolism will still have excess oxalic acid entering the circulation, even if it is combined in the intestines and stomach, increasing the risk. In fact, both groups are right. The core thing is to look at your own body constitution and intake - if you are prone to calcium oxalate stones, blanch spinach for 1 minute before eating, which can remove more than 70% of the oxalic acid. Even if you eat it with tofu, it is completely fine. You can't avoid eating green leafy vegetables just to be afraid of stones, right?

After talking about the most common misunderstandings, let’s first talk about the precautions that apply to everyone. The first one is to drink water. Don’t believe in the rigid standard that you must drink 8 glasses of water every day. The sign of drinking enough is very simple: if the color of your urine is light lemonade, it is just right. If it is as yellow as strong tea that has been brewed three times, you must have drank too much. Don't wait until you're thirsty to drink. It's much more useful to sit in front of the computer all afternoon and get up every 40 minutes to drink a cup of warm water than to drink two bottles of iced Coke when you're so thirsty that you're smoking. Oh, yes, there is another controversial point here: can I drink mineral water? Many people say that mineral water contains a lot of calcium and drinking it will cause stones. In fact, as long as you drink mineral water that meets national standards, there is no problem at all. There is no need to deliberately buy distilled water to drink. Long-term mineral deficiency will be bad for the body. But if the tap water at your home is deep well water that is too hard, it is best to install a water purifier. Drinking hard water for a long time will indeed increase the risk of stones.

Also, don’t sit for a long time and hold in your urine. If you sit at your workstation for four or five hours without moving, the crystals in your urine will settle quickly. The small crystals that could have been excreted with the urine will accumulate and become stones. Anyone who has experienced pain knows the feeling of cramping pain in the waist and abdomen, accompanied by nausea and vomiting, and being unable to straighten up. There is really no need to suffer this. In addition, don’t forget to check regularly. A urinary system B-ultrasound once every six months is enough. Most of the small stones smaller than 0.5 cm can be excreted on their own if you drink more water and jump rope, without taking medicine or surgery. I met a college student before who had a small stone of 0.4 cm during a physical examination. He practiced rope skipping for 20 minutes every afternoon and the stones were excreted on his own in half a month without even being prescribed any medicine.

Let's talk about dietary taboos. I don't recommend that you just check the "fasting list" on the Internet one by one. The best way is to take it to the hospital for a component analysis when you pass the stone for the first time. Accurate avoidance of pitfalls is better than anything else. For example, more than 70% of people have calcium oxalate stones, so you should be careful not to eat large amounts of raw spinach, amaranth, and bamboo shoots for a long time. Don't make strong tea every day. It will be much safer to blanch them before eating. If you have uric acid stones and have gout, you should try to avoid high-purine foods such as animal offal, seafood, beer, and rich broth. Don’t drink beer until late at night. The uric acid will increase and stones will soon come to your doorstep.

There is also the high sodium and high sugar content that people tend to overlook. The amount of salt in a serving of heavy takeaway food is almost enough for the recommended daily intake. Eating too much sodium will increase urinary calcium excretion and make it easier to develop stones. There are also high-fructose foods such as milk tea, cakes, and honey. Fructose will promote the excretion of uric acid and urinary calcium, which is also a triggering factor for stones. I met an aunt before who drank two cups of honey water every day for bowel movements. She has a poor body constitution that metabolizes oxalic acid. She developed two small stones in half a year because of the fructose trap. Oh, by the way, there is another question that everyone asks the most: Will calcium supplementation cause stones? Really not. A normal daily calcium supplement of 800-1000mg will combine with oxalic acid in the intestines, reduce the absorption of oxalic acid, and reduce the risk of stones. Only excessive supplementation of more than 2000mg of calcium per day will increase the urinary calcium content and increase the risk of stones.

In fact, I have been in the Department of Urology for so long, and eight out of ten patients with kidney stones I have seen are the result of their living habits: too lazy to drink water, too lazy to move, eat heavily, and drink sweet drinks every day. You really don’t need to be too anxious, and you don’t have to dare to eat anything. As long as you don’t eat the same high-risk foods to death for a long time, drink more water and exercise more, and check once every six months, most people can control it very well. If you find small stones, don’t panic. Just follow the doctor’s advice. Don’t frighten yourself by blindly searching on Baidu. Now you say you can’t eat this, and now you say you can’t touch that. In the end, you don’t dare to eat anything. If you can’t keep up with nutrition, the gain outweighs the gain.