Gall stones and Kidney stones

We used to talk about precious stones, diamonds and rubies but today gall stones and kidney stones are familiar topics of conversation. However many do not seem to know the difference and many seem to apply the same treatment for both e.g. Somebody is avoiding eating tomatoes since they have been diagnosed with gall stones.

Kidney stones are formed in the kidney, gall stones are formed in the gall bladder. In both cases there could be a genetic pre disposition towards this formation in some individuals. Besides this of course are influences of certain life style habits like exercise, water intake, diet, weight control, etc. Gall bladder is the place where bile is stored. Bile is an enzyme necessary for the digestion of fat consumed in our food. When our food reaches the small intestine the gall bladder contracts and releases bile into the bile ducts to send it to the intestine. The amount of bile released is according to the amount of fat in the food.

In some cases if food with high fat content and high cholesterol content are eaten frequently or in large quantities then we see that gall stone formation is precipitated in the gall bladder. The gall stones may stay in the gall bladder without showing any outward symptom or discomfort. It may be discovered only if an ultrasound of that area is done by chance. Sometimes however a gall stone may move out of the gall bladder and get stuck in the duct causing obstruction and pain and this disturbs the digestion as the bile flow is hindered. Sometimes drugs or surgery is advised but both are useless unless serious changes are made in the diet.

The best results are when the following principles are followed.

1. Low fat diet – Avoid all deep fried foods, all nuts, all bakery foods like cakes, cookies, pies and puffs, all mittai, chocolates, desserts and ice cream till symptoms subside or for 3 months.

2. Low cholesterol diet – Avoid butter, ghee, cream of milk, egg yolk, mutton, beef, pork, bacon, shrimp, organ meats, coconut chutney, etc. for 3 months.

3. High fiber diet - Eat atleast 2 fresh fruit daily, eat fresh salad for both lunch and dinner. Strictly eat whole wheat roti, or whole wheat bread or tandoori roties made of whole wheat flour at dinner, for the rest of your life.

The end products of the digestion of all ingested food and tissue breakdown are excreted by the kidneys along with minerals like sodium, calcium and magnesium. They are formed into crystalloids to be excreted through the urine. If there is insufficient fluid intake, insufficient fiber content in the diet, excess protein food intake like meat, fish and poultry and a hereditary proneness to stone formation then these crystals may be separated from the urine and deposited on the inner surfaces of the kidney as stones. This can cause pain in the back or sides around the lower abdomen and may also spread to the groin. Another symptom is the need to urinate frequently and a burning sensation during urination.

The fundamental principle in the treatment of kidney stones is to ensure adequate water intake, 2 and a half liters is the normal requirement. If you are living in a very hot place or you are an athlete or player you may need anything between 3-4 liters of water per day.2. The Next step is to find out what kind of stone is being formed and then be specific about the foods you avoid. The most common stones are calcium oxalates or uric acid. Foods rich in oxalates, calcium and uric acid which should be avoided or restricted, are as follows.

Oxalate - almonds, cashew nuts, peanuts, chocolates, cocoa, spinach, tomato, strawberry, chickoo, custard apple, beef and tea.

Calcium - cheese, paneer and milk cream, egg yolk, cauliflower, beans, potato, figs.

Uric acid - organ meats, kidney, liver, brain, beef, small fish, prawns, meat gravies, meat soups, veg. soups, spinach, French beans and pulses - channa, rajma, moong, etc. People trying crash diets for weight reduction and low carbohydrate and high protein diets can end up with kidney problems as they break down protein and muscle tissue during their weight loss which over works the kidneys. Sports people who consume large amounts of protein foods or protein supplements may also have a kidney problem.