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Calcifications in the prostate gland or in common people are disturbed by a fairly large number of men over 45. These are round or oval formations with a diameter of up to 2.5 cm. Calcifications are divided into:
By chemical composition, they are: calcium phosphates or oxalates. Calcifications in the prostate gland are formed due to a decrease in the secretion of the gland of special substances (citrates), which prevent the conversion of salts into crystals and the presence of amyloid (starch) bodies, on which salts are deposited calcium. The following main locations of calcifications are distinguished:
In the presence of these formations, in almost all cases, an inflammatory process joins, and if the inflammation becomes chronic, the bacteria form colonies and become insensitive to antibiotic therapy.
When contacting a specialist, patients complain of difficulty urinating, constantly arising pain in the lower abdomen and sacral spine during defecation, ejaculation, physical work (even with not significant), short walking. The pain radiates to the scrotum. Also, during ejaculation and urination, blood may appear in the semen, this occurs due to a violation of the integrity of the tissue when rubbing against a stone.
If there are no complaints, then treatment can not be carried out. If there are complaints, either resection of the prostate by the transurethral method or prostatectomy is performed.
Advantages: the least invasive and traumatic method, short postoperative period, few complications, easier to tolerate by patients. This operation is performed through the urethra.
An instrument is inserted into it, which removes the prostate in pieces, in parallel, the tissue is cauterized to reduce bleeding. Contraindications: the patient is in serious condition, there are acute diseases at the time of the operation, blood diseases, diseases of the hip joints; channel.
The prostate gland is removed through an incision in the lower abdomen. It is impossible to massage the prostate gland in the presence of stones, since the harm caused by this manipulation is more beneficial. During massage, strong friction of the tissue against calcification occurs, damage to the gland increases, bleeding increases, the inflammatory process worsens.
Everyone needs to lead an active lifestyle, nutrition should be properly balanced, and you should not overcool. Conduct an annual examination of the pelvic organs, if there are any diseases, then it is necessary to treat in time and not start the process. Conduct a survey of metabolic processes and make a correction. Share the article on social networks:
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TRUS revealed large calcifications up to 3 mm, solitary. Do I need to undergo an additional examination for a more detailed clinical picture? Does TRUS thoroughly detect prostatitis?
The result, as they say, is more aggravated. I was here on this forum 2 years ago exactly. And mention of the cyst of the right testicle, which did not decrease and did not increase (thank you for that)) there were also calcifications. OMG! Helpful feedback? Yes 01
No 01 Calcifications can be with prostatitis, without prostatitis. To begin with, it’s not bad for yourself to understand what chronic prostatitis is. Helpful tip? Yes 12
No 12But my data on chronic prostatitis is not confirmed by TRUS done yesterday, except for calcifications, of course.Useful review? Yes 01 No 01
Read and optionally subscribe to the RSS feed of questions and answers.Your questions are answered by the doctor urologist-andrologist, candidate of medical sciences Anatoly Vasilyevich Radzievskiy. You can ask your question by filling out the "Ask a question" form.
Does rosehip help with calcifications in the prostate? The calcifications formed in the prostate are very problematic to eliminate by conservative methods of treatment (or rather, it is almost impossible). It is possible to prevent the formation of new calcifications by conducting repeated courses of complex treatment. open How to treat calcifications in the prostate?
Already formed calcifications in the prostate (if they cause persistent pain and urination disorders) can only be removed by surgery. Crushing of calcifications in the prostate is impractical. open Crushing of calcifications in the prostate, what is the effectiveness of this treatment?
Treatment of calcifications in the prostate by crushing is absolutely ineffective and makes no sense, because after the procedure, fragments of calcifications cannot leave the prostate. open What is the treatment for pain in prostate calcification? In the treatment of pain in patients with calcifications in the prostate, non-specific anti-inflammatory drugs are most often used. open What are calcifications in the prostate and the reasons for their formation?
. open Is it possible to have sex with Prostate calcifications? Possible, without restrictions. open Calcifications in the prostate and premature ejaculation, what addiction?
Prostate calcifications appear as a complication in the late stages of chronic prostatitis and more often cause the development of chronic pelvic pain syndrome. There is no direct connection between calcifications and accelerated ejaculation. open How to prevent the growth of calcifications in the prostate gland?
Timely and regularly conduct a course of treatment of prostate vesiculitis, exclude adverse effects on the organs of the reproductive system (including bad habits, irregular sexual intercourse, overweight, etc.). open Is it possible to conduct prostate massage sessions in the presence of calcifications in it? It is undesirable, as this can provoke complications. open Tell me, please, where can calcifications in the spleen come from, and do they somehow affect health?
Konstantin, town. SW. Konstantin ! And since when is the spleen attributed to the organs of the urinary-genital system?
Contact the relevant specialists. open Calcifications in the prostate gland, is this the end? Can I make babies? Stones (calcifications) in the prostate are always accompanied by an inflammatory process.
Therefore, the secret of the prostate (and it makes up to 40% of the volume of sperm) may contain toxic products of inflammation. open My husband's prostate was found to have 14mm calcification, is it possible to crush it with a laser? Crushing of calcifications in the prostate is impractical, since the diameter e of the excretory ducts does not allow fragments of calcification to leave the prostate after crushing. open Severe unbearable pain in the perineum (possibly calcifications?). If there is no option to get rid of, what to do, to operate?
Jamshed Malikov (38 years old), Dushanbe. It will be right not to guess, but simply to undergo an examination and find out the cause of these pains.
Calcifications are perfectly visible on ultrasound of the prostate. open I am 25 years old, last year I suffered a serious injury to the hip bone, during the examination, signs of calcification of the prostate parenchyma were found. Could the appearance of calcifications be due to trauma?
Perhaps, with a fracture of the pelvic bones with their displacement, the prostate was also damaged. open How to treat calcifications petrificata in the prostate.
Can it be treated conservatively? Already formed calcifications and petrifications in the prostate cannot be treated with conservative methods.
With a significant size of these formations and the clinical picture of CPPS, surgical removal of calcifications is possible. open My husband was advised to do scraping (not crushing) of calcifications. What is this procedure and will it help with prostate Calcifications?
There is no such procedure as "scraping" Prostate stones in nature. You either didn’t understand something, or the doctor who suggested it to you, to put it mildly, does not quite imagine that he is going to scrape. open Doppler ultrasound examination done rectally.
Conclusion: chronic prostatitis and mass formation in the right seminal vesicle with blood flow. I turned to another urologist, he looked at the conclusion of the ultrasound of institution N, did his own ultrasound, saw something in the seminal vesicle and sent me for an MRI to exclude the tumor.
MRI showed no abnormalities in either the prostate or the seminal vesicles. The question is, do calcifications require all these cultures for tuberculosis and MRI? The fact is that calcifications are a consequence of transferred, as a rule, inflammatory diseases.
By themselves, they may not cause any inconvenience to the patient. On the other side.open Please comment if infection with the old set of venereal diseases, more precisely, chlamydia, trichomonas and mycoplasmas, is possible through the release of residual bacilli from calcifications (2 pcs 5 and 6 mm). After treatment, about 3 years passed with frequent check-ups throughout the entire time.
The comment to your question is that if STIs are detected, regardless of the reasons for their appearance (whether they are old or newly acquired), measures should first be taken to eradicate them. open Did an ultrasound of the prostate. Prostate dimensions: 38x 29x 32 mm.
Volume: 18 cc Contour: smooth, clear. The structure of the inner part: medium echogenicity. The structure of the outer part: medium echogenicity.
Please tell me the ultrasound is very bad and sufficient treatment, he prescribed me? The terms you describe the prostate are not entirely clear.
For centuries, in the prostate, we distinguish between the right, left lobe and isthmus (sometimes called the middle lobe). What "outer" and "inner" part are you talking about. open After an ultrasound, stones were found in the prostate gland. If it's not difficult, tell me how it is treated?
I was prescribed an antibiotic and protomol uno. I am 31 years old, not married. Can it affect potency? The formation of calculi (stones) in the prostate indicates that your prostatitis is many years old and, apparently, has never been treated at the proper level, since stones have formed in the prostate. open
Calcifications in the prostate are deposits of calcium salts of various forms. This phenomenon is common in men over 45 years of age. The prostate gland, along with the gallbladder, kidneys and some other organs, is prone to the formation of stones under certain conditions.
There are several theories for the development of prostate stones. According to one of them, calcifications occur at the site of a long-term ongoing inflammatory process.
Any inflammation goes through several stages, the last of which is the organization of the focus of inflammation through the development of connective tissue. Subsequently, calcium salts are deposited at the site of fibrosis.
Also, calculi can form when the composition and consistency of the secretion of the gland changes. Prolonged stagnation of prostate juice leads to the formation of small stones in the ducts.
According to the third theory, calcifications result from the reflux of urine into the ducts of the gland. In this case, stones are formed from calcium phosphates and oxalates, just like kidney stones.
The reasons for the formation of stones in the prostate can be:
The deficiency of citrates in the secretion of the prostate contributes to stone formation (normally, these substances prevent the crystallization of inorganic salts). Another provoking factor is the presence of amyloid bodies (starch clots), which serve as the basis for the formation of calcifications.
If the stones in the prostate gland are small, then they can exist without any symptoms. They are found by chance during a prophylactic pelvic ultrasound. But more often still there are some clinical signs. They may be associated with the underlying cause of stone formation or directly with the presence of stones. The main symptoms of prostate calcifications are as follows:
Characterized by increased pain during intercourse and during physical exertion. Important: if you find these symptoms in yourself, you should be examined by a urologist to avoid various complications.
Calcification in the prostate can be detected by three main methods. The simplest type of diagnosis is a digital examination of the prostate through the rectum.
The disadvantage is that this method only detects large stones, and additional studies are carried out to clarify the diagnosis. The most informative diagnostic methods are ultrasound and radiography.
Calcifications are clearly visible on x-rays. With ultrasound scanning, you can also determine the cause of stone formation - an inflammatory process or congestion.
When stones are found in the prostate, the choice of treatment tactics depends on the size of the stones, their number, symptoms, causes and comorbidities. If the calcifications are small, there are few of them and they do not cause any discomfort, then it is not necessary to treat them. In this case, active monitoring is carried out, and if the stones increase or symptoms appear, then treatment is carried out in one of the following ways:
With the help of conservative therapy, it is impossible to completely get rid of stones in the prostate gland. But with the help of some drugs, it is possible to slow down or stop their development and prevent the appearance of new calcifications.
Also, drug therapy can be directed to the underlying disease that led to stone formation: urogenital infections, prostatitis, etc. Medication can reduce pain or eliminate problems with urination. Important: with stones, finger Prostate massage is contraindicated, since existing calcifications can damage the glandular tissue.
Laser or ultrasonic crushing means that parts of the stones can independently exit through the ducts of the gland. In many cases, this is a fairly effective method. But some experts have a negative attitude towards the crushing method.
They believe that large fragments cannot exit through the narrow ducts of the gland and subsequently become new centers of stone formation.
Surgery is the only radical method of getting rid of calcifications in the prostate. Surgical intervention can be performed open (through the abdominal wall), laparoscopic access (through small punctures in the abdomen) and transurethral. If the prostate gland is significantly affected, it may be removed (prostatectomy).
There are no specific measures to prevent prostate stones. It is necessary to eat right, protect yourself from genitourinary infections, and exercise. To reduce the risk, you should stop smoking and limit alcohol consumption.
It is also necessary to undergo regular medical examinations and seek medical help in a timely manner in order to identify and treat various diseases of the genitourinary system. If these symptoms appear against the background of chronic prostatitis, you should consult a doctor. If at the same time a high temperature has risen, you need to visit a doctor immediately, as this may be a clear sign of a prostate abscess.
Treatment of calcifications and cysts of the prostate gland is carried out conservatively, if the pathological process is local, small in size and does not cause concern. In conservative treatment, a course of anti-inflammatory therapy is carried out.
This is necessary, since infection of the cyst and suppuration with the formation of an abscess is possible. Calcifications and cysts are diagnosed on the basis of prostate palpation, after urethrocystoscopy and urethrocystography, computed tomography and ultrasound. In the absence of discomfort and inflammation behind the cyst and the nature of its contents, doctors often just watching. If the cyst grows and leads to a violation of urination, then a cyst puncture will be prescribed. When a cyst is suppurated, an operation is performed to excise it. To avoid such problems, it is necessary to take all measures to prevent inflammation of the prostate gland, exclude hypothermia, and promptly treat the pathology of the genitourinary system.
The formation of stones in various organs is a fairly common phenomenon. Kidneys, urinary and gallbladder, lungs, prostate - in each of them, under certain conditions, calcifications can form - crystals consisting of calcium oxide. And in the latter case, they are especially common.
Many men who visit a urologist with characteristic complaints find out on ultrasound that they have calcifications in the prostate. Their size, location, as well as the reasons for the formation may differ. They are not yet known thoroughly, but the following are most often distinguished:
Of course, this is not a complete list of the reasons for their formation, but it makes it clear which factors increase the likelihood of detecting calcifications.
One of the dangers of this disease is a long latent process. Depending on the size and location, the symptoms are determined. So in some cases, alcincts may not manifest themselves for a long time.
Then they are most often found during a random examination or other complaints. But most often, calcinitis manifests itself in the following series of symptoms:
It is worth noting that these signs may accompany other diseases. And, in any case, when they appear, it is necessary to contact a urologist as soon as possible. After all, like other diseases, it is easier to treat in the early stages.
If you feel any obvious changes with your prostate gland, you should first of all contact a specialist. In the early stages, all recommendations for the treatment of the prostate can be carried out at home "Treatment of the prostate at home"
At the moment, there are several methods of treatment for this disease. The scheme is selected depending on the size, location of stones and characteristic symptoms. But most often they use one of the following methods:
But the main thing is to follow the rules of prevention even after removing the stones: move more, walk, take drugs that prevent the growth of calcifications. If they remain in the gland, it is very important to protect yourself from hypothermia and other factors that can provoke an exacerbation of inflammation of the prostate. Thus, the treatment of calcifications is a complex and unpleasant procedure that will make you take care of the prostate gland for the rest of your life in order to prevent their growth , inflammation and other complications. Therefore, it is better to engage in prevention in advance.
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Contents: Is it possible to remove stones from the prostate with massage What can prostate massage with stones lead to How to replace prostate massage with stones It can immediately be noted that prostate massage with calcifications is prohibited in urological recommendations. There are several reasons for this. Starting from the almost complete uselessness of the procedure and ending with a high probability of the transition of the disease to an acute stage.
In short, no. Even if during manual exposure it is possible to crush single calcifications, they will have nowhere to go out of the gland. In fact, although it is possible to crush stones in the prostate with massage, this measure is ineffective.
Studies show that after sessions, the growth of new calcifications occurs at an increased rate. This is facilitated by two catalyst factors:
There is another reason for the lack of therapeutic results. It is impossible to feel all the calcifications during the massage. Moreover, only small seals are determined to the touch, which may simply be the result of swelling of the gland.
Rectal digital examination reveals the suspicion of the presence of stones in the prostate. To clarify the diagnosis, ultrasound, CT and MRI are required.
The presence of single or multiple calcifications is a direct contraindication to any manual effect on the prostate. Pressing, massaging the damaged organ is strictly prohibited.
It happens that due to an oversight of the urologist or due to swelling of the gland, the presence of calculi has not been established. In this case, the patient should pay the attention of the doctor to some symptoms:
In severe cases, after a session of manual therapy, the complications become so severe that an urgent complete prostatectomy is required. Massage is dangerous because with a low effectiveness of the method, the symptoms of prostatitis increase. Exacerbation of the disease as a result of sessions leads to a sharp deterioration in the patient's well-being.
There is a developed scheme for the treatment of calcifications. In the presence of stones, massaging The prostate gland is prohibited. This rule applies to any stones, regardless of their size. Therefore, even with small calcifications, prostate massage is prohibited.
The therapeutic approach to treating the disease is as follows:
The effectiveness of manual therapy in the presence of calcifications is minimal, and the likelihood of complications after massage (bleeding, acute inflammation) is high. For this reason, prostate stones are treated medically and surgically.
The prostate is an exocrine organ of the male reproductive system, the main function is the production of secretions, as the main component of the ejaculate. Under the influence of exogenous (external) and endogenous (internal) factors, salts are deposited in the prostate gland, which can be converted into stones. Calcifications in the prostate are localized mainly in the back, in large ducts (macroscopic) and acini (microscopic) of the lateral lobes of the prostate.
The mechanism of prostatolithiasis is intraprostatic reflux of urine, which leads to the deposition of salts. Violation of secretion contributes to the growth of the calculus. Calcification of the prostate often occurs against the background of benign hyperplasia.
Studies have been conducted that have not proven an increase in PSA levels with asymptomatic uninfected stones.
There are a number of pathological conditions that contribute to prostolithiasis:
- excess intake of vitamin D; - alkaptonuria (an autosomal recessive hereditary disease that is caused by a loss of oxidase function, which leads to metabolic disorders and the loss of a large amount of homogentisic acid into the urine); - tuberculosis of the prostate; - systemic diseases; - varicose veins of the small pelvis; - concomitant chronic diseases of the genitourinary system; - metabolic disorder.
Predisposing factors include:
- sedentary lifestyle; - lack of regular ejaculation; - alcoholism and chronic nicotine intoxication; - tendency to constipation; - excessive intake of certain drugs; - malnutrition; - surgical interventions on the prostate, urethra, bladder; - iatrogenic damage during medical research.
In some patients, the deposition of salts in the prostate is diagnosed against the background of prolonged standing of the catheter in the bladder.
Prostate stones are classified according to their morphological structure and mineral composition. When analyzing the structure of stones in men with benign prostatic hyperplasia using electron microscopy and X-ray microanalyzer, the following elements were revealed:
-zinc; - aluminum; - magnesium; - sulfur; - phosphorus; - calcium.
The size of calcifications correlates with the likelihood of developing prostatitis and the addition of chronic pelvic pain syndrome. Stones in the gland are often uninfected.The main components are calcium salts: calcium phosphate, calcium oxalate in combination with carbonate apatite and hydroxyapatite.
Inflammation of varying severity may accompany calcifications in the prostate, but it is still unknown whether the inflammatory process is the cause or the result of the formation of stones.
Saline formations in the prostate are discovered by chance, during a routine urological examination or during diagnostics for complaints.
Prostate calcifications are common during transurethral resection. In the literature, data on the prevalence of prostatolithiasis are variable, on average - from 41 to 70%, in older men, pathology is recorded more often.
With the addition of pathogenic and opportunistic microflora and the assistance of predisposing factors, inflammation develops - calculous prostatitis.
- discomfort with frequent urination; - an admixture of blood in the semen; - heaviness in the perineum; - lower abdominal pain; - erectile dysfunction: sluggish erection, dyspareunia, pain during ejaculation, painful spontaneous erections, decreased libido.
Calcification in the large prostate is one of the causes of chronic pelvic pain.
General complaints characteristic of any inflammatory process include:
- weakness, fatigue; - increase in temperature reaction (the stronger the inflammation, the higher the temperature); - headache; - arthalgia and myalgia.
General symptoms are not pathognomonic for calculous prostatitis and can accompany any infectious and inflammatory process in the body.
The urologist, after collecting and evaluating complaints, palpates the prostate through the rectum: areas of density are characteristic of prostate calcifications, sometimes crepitus is possible. Palpation of the prostate gland is not very informative, therefore, a comprehensive clinical and urological examination is carried out to assess the full picture.
Uneven dense areas can be a sign of prostate cancer or urogenital tuberculosis, so specific tests are prescribed to rule out these diseases.
In addition to the standard general blood and urine tests, the level of prostate-specific antigen in men over 40 years of age (but not earlier than 10 days after the rectal examination or before it), urine culture for Mycobacterium tuberculosis, Mantoux test and diaskin test are examined. In the general analysis of urine, an increased number of leukocytes, bacteria, erythrocytes and protein may be present, which requires the diagnosis of inflammation of the bladder and kidneys, general uronephrolithiasis.
To identify the provoking factor, tests for sexually transmitted infections are prescribed.
Prostate secretion may contain leukocytes, erythrocytes, macrophages, a decrease in the number of lecithin grains, which is typical for calculous prostatitis.
It may be informative to culture the prostate secretion for flora and sensitivity to antibiotics to determine the need for antibiotic therapy. If the prostate secretion contains more than 103 CFU / ml of uropathogenic bacteria of one strain or more, antibacterial drugs are prescribed taking into account sensitivity.
The gold standard - transrectal ultrasound - demonstrates hyperechoic inclusions with acoustic shadowing. With a concomitant inflammatory process, an increase in the size of the prostate and diffuse changes in the structure of the tissue are visualized. X-ray examination - excretory urography with voiding cystography - allows you to diagnose the causes of infravesical obstruction, but X-ray negative stones are not visible on urograms.
In case of severe urination disorders against the background of prostate calcifications, it is justified to perform a urodynamic examination - uroflowmetry, and, if necessary, a more complete diagnosis - cystometry.
CT or MRI of the pelvic organs are not mandatory studies, but if a prostate tumor is suspected, their performance is justified.
The treatment regimen depends on many aspects:
- etiology and pathogenesis; - predisposing factors; - severity of clinical manifestations; - the probability of joining complications; - individual characteristics of the patient; - contraindications to taking drugs.
Asymptomatic uncomplicated prostate calcifications of small size do not require aggressive treatment, it is enough to use preventive measures, correct diet and lifestyle.
Prescribe drugs that promote the dissolution of salts, prevent further stone formation, relieve the accompanying inflammatory process:
- antibiotics; - NSAIDs; - uroseptics; - vitamins; - phytopreparations; - enzymes; - preparations with litholytic action; - alpha-blockers; - peptide bioregulators.
Prostate tuberculosis implies specific therapy.
Prostate massage and vibration physiotherapy are not performed for severe calcifications, since the sharp contours of the stone can injure the tissues of the gland, the prostatic part of the urethra, and the stone itself can migrate.
With calculous prostatitis, hyperthermia cannot be used, since the tissues of the gland with prostate stones will heat up unevenly.
Lithotripsy for prostate calculus is a non-invasive way to solve the problem. During the procedure, the prostate is remotely affected by ultrasound or a magnetic wave. There is a destruction of the calculus into small fragments (sand) and comes out during the act of urination.
The action of a low-intensity laser is similar. But in order to get rid of prostate calcifications, several sessions may be required. During the laser destruction of the stone, the surrounding tissues do not suffer. Not all experts agree with the effectiveness of low-intensity laser therapy for calculous prostatitis.
A defragmented stone breaks into sharp-edged fragments that can damage the seminiferous tubules and prostate tissue. Stuck fragments provoke the crystallization of new calcifications, which contributes to the growth of the calculus and the addition of new complications.
In case of a pronounced violation of the outflow of urine against the background of calculous prostatitis, sclerosis of the bladder neck or sclerosis of the prostate itself, transurethral incision or economical electroresection of the prostate is performed.
Transurethral electroresection is also used for hard-to-reach calcifications in the central, transient and periurethral zones. If the seed tubercle is involved in the process with the development of blockage of the vas deferens, its resection is performed.
Sclerosis of the prostate, accompanied by persistent symptoms without the effect of conservative therapy, requires the most radical transurethral electroresection of the gland.
Adverse consequences and risks of calcifications in the prostate:
For a complex effect on the deposition of salts in the prostate, you can use alternative medicine recipes.
Plants that prevent salt deposition:
- half a floor (woolly erva); - field sage; - ostudnik naked; - wild rose (rhizomes).
To dissolve calcifications in the prostate, it is necessary to prepare a decoction. To avoid addiction, it is better to alternate plants.
Take m cups a day, on an empty stomach, 10 days each month. The effectiveness of herbal medicine can be assessed after 6 months when undergoing an ultrasound examination in dynamics.
Honey, lemon juice, chopped parsley (leaves and roots) will be required to prepare a remedy for dissolving prostate stones.
Chop the washed fresh parsley in a blender, squeeze out the juice. Mix with equal amounts of honey and lemon juice. Take l glass 3 times a day for a month.
Important! Before treatment with traditional medicine recipes, you should consult your doctor. The composition of calcifications in the prostate varies, which requires an individual approach even in the use of natural components.
More often, calcifications in the prostate are synthesized in those men who eat a lot of meat and fatty foods, abuse alcohol, and prefer strong tea or coffee instead of pure artesian water. It is necessary to ensure that the diet contains a sufficient amount of vegetables and fruits rich in vitamins and minerals.
Useful fish and seafood, cereals, nuts and seeds, greens.
It is preferable to abandon animal fats in favor of vegetable (olive, sunflower, linseed) oils.
Experts recommend not to get involved in foods with a lot of preservatives, flavors, hidden fats.
It is better to choose lean meat, and cook it in a gentle way by baking or stewing.
Exclude from the diet:
- rich meat broths; - offal and liver; - alcohol; - smoked meats; - strong coffee and tea; - chocolate.
All broths (meat, chicken, fish) are preferable to the second cooking: after boiling, drain the water, rinse the meat and pour new water.
From drinks you can use fresh vegetable and fruit juices, mineral water, unsweetened compotes, herbal decoctions.