Office workers tend to graft so hard they rarely get up out of their chair. They neglect essential things like eating and even drinking enough water. That can lead to health problems such as gallstones which are partly caused by not drinking enough water. If you don't want to suffer with this condition, here’s how to recognize and avoid it.
Gallstone chemistry
Gallstones are stone formations composed from minerals present in urine, including calcium, phosphate, oxalate, urate, uric acid, and cysteine? When the concentration of these substances gets too high along with certain other conditions, solid pebble-like crystals or stones are formed. When the stones are small, they just flow out with the urine. But once they get to a certain size, they’re too big to budge, causing clogging which in turn results in pain and complications.
There are several theories about the contributing factors to gallstones. One theory highlights crystallization or precipitation of saturated compounds including minerals. Crystallization takes place where concentrations in the urine are very high. The crystals bind, agglomerate, and expand.
Another theory suggests that inhibitors in urine are the key factor. Said inhibitors inhibit crystal core attachment, crystal growth and aggregation. A list of inhibitors would include pyrophosphate, citrate, and magnesium. Lack of any of these substances, leaves the coast clear for crystallization and gallstones.
Gallstone types
Gallstones usually begin to form in the kidneys then move into and along the urinary tract. After a while, the stones are found throughout the urinary tract and other areas. Different terms apply to the stones in the different locations in which they are detected.
Urinary tract stones usually occur when urine is left in the bladder and settles. They can also be caused by recurrent infections or certain conditions affecting bladder function. Bladder stones are more common in men than women because the male urinary system is longer and more tortuous, making the gallstone more likely to remain.
Symptoms: The most common symptoms are caused by the stones irritating the bladder wall or blocking the flow of urine resulting in:
· Pain in the lower abdomen
· Pain or discomfort in the penis and testicles when urinating
· Frequent urination
· Difficulty urinating
· Urine is cloudy or unusually dark and has blood in it
Kidney stones are caused by too much salt, minerals, and other substances in the urine to the extent that they can’t dissolve and become less concentrated, instead adhering in the kidneys.
Symptoms: Very small stones come out spontaneously with urine so that no pain is felt. However, if a stone moves around a kidney or into the ureter tube that connects the kidney and bladder, this causes:
· Pain in the back or lower abdomen on either side
· Pain in the groin area
· Feeling pain from time to time
· Bloody or red, pink, or brown urine
· Pain while urinating
· Frequent urination
· Less urine
· May be accompanied with pyelonephritis
Gallstones: The gallbladder is a small sac that lies beneath the liver which is responsible for storing the bile the liver produces. The exact cause of gallstones in the gallbladder isn’t known for sure. Medical professionals speculate that they could be caused by too much cholesterol in the gallbladder or too much bilirubin in the bile, to the point that it forms into sediment and eventually becomes a gallstone. Or perhaps the muscles in the gallbladder are unable to squeeze out all the cholesterol which becomes concentrated and forms stones. Gallstones are more common in women than men.
Symptoms: Gallstones usually don’t cause illness. However, if a gallstone is lodged at the exit of the gallbladder, the following symptoms ensue:
· Severe abdominal pain, especially in the upper or right abdomen area.
· May radiate to the scapula area or the right shoulder.
· Sudden and severe pain in the middle of the abdomen or under the breastbone.
· Nausea, vomiting.
· Other gastrointestinal symptoms such as indigestion, flatulence, feeling tightness in the epigastric region after eating.
· Fever.
· Abdominal pain under the right side of the ribcage.
· Yellow eyes, yellow body.
· Dark colored urine.
Causes of urinary tract stones
· Not drinking enough water or drinking beverages other than plain water that as they are filtered in the kidneys produce mineral wastes that precipitate a clot.
· Environment and heredity: Thai people in the northeastern and northern regions of the country are more likely to develop gallstones than other regions due to their particular metabolic and assimilation systems.
· Eating spicy foods, especially very salty foods such as pickled bamboo shoots, pickled fish, and salted fish, that overload the kidneys, leading to gallstones.
· Insufficient calcium intake: While calcium is a gall-making element, it doesn't trigger it. Conversely, lack of calcium in the body accelerates absorption of calcium in the intestines which can lead to gallstones.
· Eating too much red meat: Red meat as well as offal, beer and other foods are high in purines. Purines, in turn, cause accumulation of uric acid in the body which, if it accumulates in the kidneys, can lead to kidney stones.
· Eating too much fatty foods: A high-fat diet with low-fiber foods such as lean pork, cause cholesterol build-up in the body which, if it accumulates over an extended period, leads to gallstones developing in the gallbladder.
· Obesity.
· Resistance to exercise and eating vegetables.
· Age: urinary tract stones are most common in working people aged 40-60.
· Certain oral medications such as Guaifenesin, Triamterene, Atazanavir and Sulfa.
· Urinary tract infection.
· Anatomical abnormalities of the urinary system.
Treatment pros and cons
1. Open surgery – a surgical procedure through the skin to the site of the gallstone to remove it and then close the wound with sutures.
o Advantages:
§ Treats all types and sizes of gallstones.
o Disadvantages:
§ Large surgical wound.
§ Surgery through the kidney tissue to remove the stone will cause the kidney to become fibrous from the scar so that it works less efficiently, some kidney cells die, and capacity is reduced.
§ Risk of bleeding from the surgery site.
2. Extracorporeal Shock Wave Lithotripsy (ESWL) – shock waves are transmitted through the skin to the stones, the lump is crumbled into small pieces that flow out with the urine, thereby avoiding surgery.
o Advantages:
§ No surgical wound.
o Disadvantages:
§ May bruise various tissues and kidneys and cause internal scarring and depletion of kidney cells.
§ Treatment of larger patients may be ineffective or less effective because the power of the waves emitted by the generator isn’t sufficient to penetrate the layers of tissue and break down the stones.
§ May not be effective in cases of large and hard gallstones. This treatment is most appropriate for gallstones of 1-2 cm. or up to 1,000 HU density.
3. Percutaneous Nephrolithotomy (PCNL) is a small hole of about 1 cm. made through the skin of the back at a point corresponding to the kidney location. Using a telescope attached with a camera and modern tools, the doctor breaks the stone into small pieces and extracts them.
o Advantages:
§ Can be used to remove gallstones of all sizes and hardnesses.
§ The wound is smaller than with open surgery.
§ Fast recovery.
o Disadvantages:
§ May cause some bleeding. A skilled surgeon is required.
4. Ureteroscopy (URS) involves a small endoscope inserted into the ureter to the location of the stone. A laser is used to make the stone smaller and surgical tools are used to remove the stones without surgery.
o Advantages:
§ No wound, fast recovery, high safety.
§ The camera-attached endoscope is small and bendable, enabling it to be inserted into the confined areas inside the kidneys without damaging them.
§ The camera makes the stones clearly visible.
§ All the stones can be extracted without having to wait for them to come out on their own.
o Disadvantages:
§ Only works with gallstones of 1-2 cm.
§ Restricted access to hard-to-reach areas. A highly skilled surgeon is required.
Self-care practices
· Drink at least eight glasses or two liters of water daily.
· Drink lemon juice and orange juice as the citrate they contain helps prevent gallstones. Drinking one or two glasses of lemon or orange juice daily slows gallstone growth and prevents recurrences.
· Reduce intake of beverages high in calcium oxalate such as tea, coffee, and cocoa.
· Maintain a nutrition-rich diet that covers all the five main food groups.
· Reduce high-fat foods, meats, spicy foods, and foods high in uric acid.
· Eat fiber-rich foods.
· Take regular exercise.
· Have regular health checks.
Healthy habits we choose to neglect on a daily basis can lead to unpleasant symptoms such as urinary tract stones. Making small behavioral adjustments is key to living a healthy and happy life.
Krungthai-AXA Life Insurance customers who may need gallstone surgery can get medical advice and find more information about treatment at https://www.krungthai-axa.co.th/th/health-services/care-coordination.
References
· Bumrungrad Hospital
https://www.bumrungrad.com/th/conditions/bladder-stone
· Siriraj Piyamaharajkarun Hospital
https://www.siphhospital.com/th/news/article/share/urinary-stone
· Phyathai 3 Hospital
https://bit.ly/3zR7s9g
· Bangkok Hospital
https://bit.ly/3tOoReO
https://bit.ly/3N6gmCR
https://www.bangkokhospital.com/content/kidney-stones
· Paolo Hospital
https://bit.ly/3QxASiu
https://bit.ly/3y4joDa
https://bit.ly/3y39v8O
https://bit.ly/3y39AJE
· Pobpad Hospital
https://bit.ly/3QrtYeG
Phyathai Hospital
https://bit.ly/3nSeQtP