Nephrolithiasis

Calcareous stones result from hypercalciuria, hyperoxaluria and hypocitraturia. Hypercalciuria and hyperoxaluria render urine supersaturated in respect of calcium salts; citrate makes calcium oxalate more soluble and inhibits its precipitation from solution.

Noncalcareous stones occur most commonly in the presence of urea-splitting organisms which create conditions in which magnesium ammonium phosphate (struvite) stones form. Urate stones form when urine is unusually acid (pH < 5.5).

Management. Recurrent stone-formers should maintain a urine output exceeding 2.51/d. Some benefit from restricting dietary calcium or reducing the intake of oxalate-rich foods (rhubarb, spinach, tea, chocolate, peanuts).

• Thiazide diuretics reduce the excretion of calcium and oxalate in the urine and reduce the rate of stone formation.

• Sodium cellulose phosphate (Calcisorb) binds calcium in the gut, reduces urinary calcium excretion and may benefit calcium stone-formers.

• Allopurinol is effective in those who have high excretion of uric acid in the urine.

• Potassium citrate, which alkalinises the urine, should be given to prevent formation of pure uric acid stones.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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