UROLITIASIS or stone found anywhere from the kidneys up to the urethral meatus or the opening of our urethra. It is important to emphasize at this point that stones may also form in different parts of the human body.
Cholelithiasis is your gall bladder stone; of course the more tongue-twisting choledocholithiasis refers to stone along the biliary tract or where bile flows from the liver to gall bladder to the common bile duct to its exit at the second portion of the duodenum. Don’t be surprised, if your ENT doctor tells you about sialolithiasis/sialodocholithiasis in which stones may form in the salivary glands and their ducts.
Before we go to the crux of the matter, let's go basic with water intake. The most recommended amount is 8-10 glasses a day, and mind you, this is not arbitrary meaning, it's not a whimsical decision- it is based on how much water or fluid- urine, sweat, feces, even the air we breathe out contains water- we put out every day. With this amount, still the ph of normal urine is within the acidic range (3.5-6.5 because of the presence of sodium sulfuric acid and sodium phosphoric acid.
There are three common sediments in normal urine; urates, oxalates and phosphates. If the person does not drink enough water or in severe dehydration, the ph of the urine would have become very acidic thus favoring the precipitation of oxalate and urates, later forming crystals and eventually form stones the size of which may obstruct or block urine flow. In alkaline urines, that is the ph is higher than 7, phosphates would precipitate starting the formation of stones. So at this juncture, we cannot overemphasize the importance of enough hydration or water intake.
Attached to water intake is of course, dietary restriction of foods known to contribute sediments in the urine. Vitamin C. taken in excess (Minimum dietary requirement is 75 mg, RDA or recommended daily allowance is 500 mg) whether taken as tablet or capsules or syrups or derived from vit-C rich veggies and fruits- oranges and citrus fruits=- may later manifest as oxalates in the urine.
By now, we are all familiar with the so-called purine-rich food which if taken in excess, makes their presence in the urinalysis as uric acid sediments or crystals. Thus, we are taught to cut down or minimize intake of foods which have as their main ingredients innards, visceral organs - talk about igado, dinakdakan, pinapaitan, bopis and the like- seeded fruits and vegetables- strawberry, beans of all colors, tomatoes, eggplants, okra- sauces especially liver-based, and please don’t forget alcoholic drinks.
Indeed, your favorite beer- Pale Pilsen, draft or low-calorie variety- also contribute to the uric acid population in the urine. At this point, it is also important to say that, the amount of uric acid in the blood and in the urine is due either to overproduction of uric acid or under excretion of uric acid or, in worse cases, a combination of both.
Stones may form in the kidneys-nephrolithiasis; in the ureters- ureterolithiasis; or in the urinary bladder-cystolithiasis. Your doctor will tell you that the closer the stone is to the kidneys, that is, obstructing or blocking urine flow, the more serious are the clinical complications.
When urine from the kidneys is blocked by a stone in the ureter, the build-up of back pressure will be exerted on the kidneys so that eventually, there would be hydro nephrosis- as the word implies swelling and edema of the kidneys. Of course, the other kidney might be perfectly normal, so that might give a sense of false security on the person.
However, before long, there would be abnormalities already in the function of the kidneys which, as well know by now, might lead to chronic kidney disease, he only solution or remedy is hat dreadful word, dialysis.
Having said that, dear readers, heed the advice of your doctor and elders.
Water is not only healthy for cleansing, removal of toxic waste, it also has cosmetic value. Be sensible in your food choices; variety is the rule, a little of which should not harm. That way, you leave the stones to the gravel and sand business industry. Let's drink to that, I mean water!
Published in the SunStar Baguio newspaper on June 03, 2017.
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