Q: I am 47 years of age, 5.8 feet in height and weigh 72 kg. My blood pressure and sugar levels are normal. I do not have any cardiac problem. I have three major problems – migraine, gastro-esophageal reflux disease (GERD) and a stone, which was removed from the urethra last year. I take Vasograin and Omeprazole 20 mg on SOS basis to address my first two problems. I take more than 3 litres of water per day to address my third problem. Is there any way that Vasograin and/or Omeprazole would accentuate my third problem and lead to renal calculi formation? Also, the stone was analysed through FTIR spectroscopy. It was 0.013 g by weight and made up of Calcium Oxalate Monohydrate 80% and Calcium Oxalate Dihydrate 20%. I am restricting my animal protein intake (max 4 to 5 meals out of 14 per week), 1/2 glass of milk per day, restricted milk products/ chocolate/ nuts, no spinach and tomatoes (including tomato ketchup). Kindly advise me whether I should increase my calcium intake. Also, is any medication for restricting renal calculi formation advisable?

A:Review of your data clearly shows that you have developed oxalate stone in the past. It also seems you are already practicing what appears to be oxalate restricted and generous fluid diet. Besides sodium restriction in diet, only other medicine that may prevent oxalate absorption (and stone formation) would be Calcium Carbonate 500 mg to be taken only with major meals of the day. Moderate calcium consumption in fact retards stone development. Thus, calcium restriction is not advised.