Diet taboos for gastrolithiasis

First, don’t eat a lot of high-tannic acid and high-pectin foods on an empty stomach. Second, don’t eat hard-to-digest crude fiber and highly viscous foods during the onset of the disease. Third, don’t drink high-protein drinks, strong tea or spirits immediately after eating high-tannic acid foods. Other detailed precautions are actually extended around these three points, so there is no need to remember them too complicatedly.

I met a 62-year-old aunt when I was rotating in the digestive endoscopy room two years ago. The persimmon trees at home had produced fruits in autumn. I was afraid that they would spoil, so she ate almost three kilograms on an empty stomach for two days. As a result, her stomach hurt so much that she couldn't stand up straight. After a gastroscopy, it was found that there was a 7-centimeter dark brown gastric stone lodged in the stomach. The surface was rubbed to the point that the gastric mucosa was bleeding. In the end, two endoscopic lithotripsys were performed before it could be expelled. This is also the most common cause of plant-based gastrolithiasis - the concentration of gastric acid is high on an empty stomach. The tannic acid in persimmons and black dates will combine with the gastric acid and mucus protein in the stomach to form a water-insoluble precipitate, which slowly forms into a hard lump.

Speaking of this, many people will ask, does that mean that persimmons, hawthorns, and black dates cannot be touched at all? In fact, there is no completely unified view in the academic circles. One school of thought believes that as long as the tannic acid content of sweet persimmons is completely deastringent, it can be reduced to less than 0.1%. There will be no problem if you eat 1-2 persimmons after a meal. Many of my colleagues will occasionally eat them in autumn and winter. ； But another group of gastroenterologists will be more cautious, especially those with poor gastric motility, atrophic gastritis, or excessive gastric acid secretion. Even deastringent persimmons may combine with gastric acid and clump when eaten on an empty stomach. Individual differences are indeed very large, and there is no way to say "absolutely safe" to everyone.

In addition to tannic acid, there are also many pitfalls in high-pectin foods. Many people think that hawthorn is appetizing, and it is okay to eat half a pound of it on an empty stomach. However, unripe hawthorn has a particularly high pectin content and can easily solidify into lumps when exposed to acid. Last winter, a senior in high school student Boy, my mother was afraid that he would accumulate food, so she gave him half a bag of frozen hawthorn as a snack every day. He ate it on an empty stomach in the morning and on the road. After eating it for three days, he asked for leave in pain and went to the hospital. A 4 cm stomach stone was found, but it was relatively soft. After drinking sodium bicarbonate for a week, it dissolved.

There is another misunderstanding that is really common. Many people are diagnosed with stomach stones. Their first reaction is "I can eat more leeks and celery and wrap it up, and it will be fine." Hey, don’t try blindly. If it is a new plant-based gastrolithiasis that is smaller than 1 cm and has a soft texture, eating a small amount of soft boiled vegetables may indeed help to expel it. This is also the advice given by many grassroots hospitals. ； But if the stomach stone exceeds 2 cm and is as hard as a pebble, if you eat a lot of crude fiber, the fiber will only wrap around the stomach stone and make it grow bigger, or even get stuck in the pylorus or intestines, causing obstruction, which will make it more troublesome. In fact, it is more suitable to eat liquid and semi-liquid foods such as porridge and soft noodles that are easy to digest during the onset period. Reducing the burden on the stomach is the first priority.

There is another small detail that few people mention, that is, if you eat persimmons, hawthorns and other foods, do not drink iced milk, strong tea, or spirits immediately, especially iced ones. On the one hand, low temperature will slow down gastric peristalsis, allowing enough time for tannic acid to combine with gastric acid and protein. On the other hand, theophylline, The irritation of alcohol can also aggravate gastric mucosal damage. I met a college student before. His roommate brought crispy persimmons from his hometown. He ate two on an empty stomach and then drank a large glass of bubble milk tea with ice. In the middle of the night, he hit 120 in pain. The emergency department found that he had gastrolithiasis and gastric cramps. It took him half a night to recover.

Of course, there are two relatively rare types of gastrolithiasis with different dietary taboos. For example, hairy gastrolithiasis is mostly caused by children with trichotillomania or patients with pica eating hair and plush fibers. The core taboo is not to eat any indigestible foreign bodies.； In addition, lactic acid gastrolithiasis is mostly caused by premature infants or infants and young children with poor digestive function who drink high-concentration milk for a long time. Then the concentration of milk and feeding frequency must be adjusted. It is different from the taboos for plant-based gastrolithiasis in ordinary adults, so don’t be confused.

To be honest, when I educate patients, I never ask them to memorize a long list of taboos. The core thing to remember is: Don’t let your stomach touch things that are easy to clump when it is idling. If you are really greedy, wait until you have eaten half a bowl of rice before trying something new. Don’t be greedy for too much at one time. If you feel bloating, stomach pain, or acid reflux for two or three days after eating, ordinary stomach medicine is useless. Don’t vomit or take laxatives on your own. Go for an abdominal ultrasound or gastroscopy first. If discovered early, most gastric stones can be resolved without surgery. If you delay for a long time, you will suffer.