Watch what they eat, what they do (or don’t)

By Thuy Vi, Thanh Nien News

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A rich diet with a lot of salt, combined with a lack of physical activity is seeing more and more children in Ho Chi Minh City suffer stones in their urinary tract, doctors say.
The condition is said to be rare among children with occurrence rate at between one per 7,000 and one per 1,000, but doctors at the Children’s Hospital No. 2, a leading pediatrics facility in the city, say they have been seeing an uptick in the number.
Doctors said the most common condition was kidney stones, followed by stones in the urinary ducts and then bladders.
One recent patient was a nine-year-old child from the south central province of Phu Yen, suffering severe urinary retention.
X-rays and an ultrasound scan found a stone in the bladder neck, which caused difficulty and pain while passing urine.
The child’s parents said doctors in their area had diagnosed bladder and urinary tract inflammation but their treatment did not work.
Doctors removed the stone using endoscopic tools, and the child has since been discharged.
Earlier, a 2-year-old boy from Dong Nai Province was admitted in similar condition.
His parents said he began skipping meals from age one and cried a lot when urinating, but they did not know what these signs meant. It was only when his urine turned bloody that they rushed him to hospital.
Local doctors diagnosed him with inflammation, but tests at the city hospital detected a stone of around 10x3 millimeters in the bladder neck.
Another girl of 11 years old, diagnosed with coral kidney stone, a complicated kind that is prone to recurring, is required to visit the hospital every month.
Doctors had performed a surgery to remove most of the stone of around 17 millimeters in diameter but the rest keeps growing and she still needs to visit the hospital every month.
Many parents are initially upset and angry with the kidney stone diagnosis, thinking that their children are too small to develop this condition, doctors said.
They said parents should instead be worried about problems created by the modern lifestyle that involves a lot of salty fast food and functional foods that the children are not able to properly digest.
Doctor Le Tan Son, head of the kidney and urinary department at the hospital, said besides the inheritance factor, kidney stones in children can develop from abnormal inborn structures that block the urinary tract, or disorders of some enzymes and glands, or renal tubular acidosis which is a group of disorders where the renal tubules are unable to maintain the acid-base balance in the body.
Nearly 25 percent of the kidneys are a kind of calcium oxalate, a compound formed by the body’s calcium with acid oxalate which is found in some foods like fresh bamboo shoots or in illegal chemical bleaches added to food products.
In some cases, patients have been using medicine that causes too much waste elimination through the kidneys, more than they can handle, Son said.
But, he added, those are the traditional causes, and the modern causes that lead to the surge in the number of patients are fast food with excessive amount of fat and salt, and functional food with excessive amounts of protein.
He said diabetes and a lack of physical activities, problems increasingly seen among children in cities, are also among the culprits. The lack of clean public toilets, including at schools and in parks, forces children to hold their bladder and worsens the problem.
Doctors say kidney stones are indicated by several symptoms, including pains in the back and hips, insufficient urination, blood in urine, nausea, pale face, and heavy sweating.
Easily irritated children who are also reluctant to engage in physical activities could also be suffering from kidney stones.
Son said some children show no symptoms at all, and stones have been detected while they underwent ultrasound scans for other problems.
He said there’s no perfect solution or treatment for the problem. There are always problems like debris remaining after the stones are removed, with scans unable to detect the smaller pieces. Pieces of stone can also be dropped during the removal process. Bleeding while the stones are removed, blockage of the urinary duct by stone debris, and bacterial infection after surgery are other likely problems.
As the recurrence rate of the stones is at between 4-70 percent, Son said parents need to know how to protect their children in the first place, by not putting them under any medication for a long time, even if they’re just supplements, ensuring they drink enough water – 1-1.5 liters a day (including water from food) for children between 10-20 kilograms, 1.75 liters for those up to 30 kilograms and 2 liters a day for bigger children.
Parents need to keep watch on their children’s toilet habits, increase water consumption, add fruits and vegetables to their diet, and consult a doctor if their children’s urine is unusually dark.
A glass of water upon waking up will help clean the waste accumulated during the night and help mitigate dehydration at times the children are busy studying or playing during the day and not paying attention to their water intake, Son said.

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