[Pulse Points] Persimmon & Hawthorn Lovers Alert: Stomach Stones

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Autumn and the Rise of Gastrolithiasis

Autumn brings an abundance of fresh fruits, but it also marks the annual peak season for gastrolithiasis – a condition caused by the consumption of tannin- and pectin-rich foods such as persimmons, hawthorns, and jujubes. (Gastrolithiasis refers to the formation of hard masses, or gastric stones, in the stomach, often due to the accumulation of undigested food particles and substances like tannin and pectin.)

The condition primarily affects individuals with reduced stomach motility (the stomach's ability to contract and empty its contents), leading to symptoms like early satiety (feeling full quickly after eating), nausea, and stomach pain.

Recent Cases in Shanghai Hospitals

Recently, both Shanghai Ninth People's Hospital and Shanghai East Hospital reported cases of giant gastrolithiasis.

One notable case involved a 62-year-old patient who sought treatment from Dr. Wang Dong at the Digestive Disease Department of Shanghai Ninth People's Hospital.

A 10-Centimeter Gastric Stone

The patient had a gastric stone measuring 10 centimeters in diameter....jeeeeezz... (approximately the size of a grapefruit), and doctors in his hometown had recommended open surgery (a traditional, invasive procedure involving large incisions to remove the stone) after conventional treatments – such as medications and carbonate beverages (drinks like soda water, which are sometimes used to break down gastric stones) – proved ineffective.

Minimally Invasive Options

Determined to avoid invasive surgery, the patient requested a minimally invasive approach (procedures performed with smaller incisions, leading to faster recovery and fewer complications).

After conducting a thorough examination, including a CT scan (a detailed imaging test that creates cross-sectional views of the body) and gastroscopy (a procedure where a flexible tube with a camera is inserted through the mouth to examine the stomach), Wang developed a two-phase operation plan to address the condition.

Challenges of Breaking Gastric Stones

"Breaking up stones under a gastroscope is not easy, as the tool is only designed to grab objects no smaller than 3 centimeters," explained Dr. Wang Dong. (A gastroscope is a flexible tube with a camera and tools used to examine and treat the stomach.)

Ordinary equipment requires cutting the stone little by little, a process that can take several hours. This poses risks for patients under prolonged anesthesia. Additionally, the stone's hard and smooth surface makes it difficult to fragment with traditional tools, which typically have a plastic cover.

Innovative Solution: Adjustable Steel Wire Tool

To overcome these challenges, Wang introduced an innovative set of tools equipped with two adjustable steel wires. "The wires can wrap around the stone like arms, allowing doctors to tighten them for effective and precise fragmentation," said Wang.

Two-Phase Surgery: Successful Outcome

Following a carefully planned schedule, one-third of the patient's gastric stone was cut and removed during the first minimally invasive procedure. The remaining portion was successfully removed two days later. The patient has since been discharged and is recovering well.

How to Stop Your Stomach From Turning Into a Fruit Cemetery

Gastrolithiasis isn't something you brag about at brunch. It's when stones form in your stomach after you go ham on tannin-heavy fruits like persimmons and hawthorns. Blame it on gastric acid – it reacts with tannin and turns your healthy snack into a rock-hard souvenir. People with dodgy stomachs? You're first in line for trouble. Left untreated, these stones can lead to ulcers, internal bleeding, and even perforations (yes, holes in your stomach – yikes).

The Fix: Medicine, cola therapy (hello, phosphoric acid), endoscopic fragmentation (sci-fi stomach smashing), or surgery.

What Not to Pair with Your Persimmons

You know the old Chinese saying about crabs and persimmons being "cold foods"? Well, there's science behind it. Crabs, fish, and shrimp are packed with protein. When that protein meets tannin, it solidifies into the stuff nightmares are made of – persimmon stones. Skip the seafood-persimmon combo unless you want your stomach to audition for a geology exhibit.

Why Does Your Stomach Hate You After Eating Persimmons?

Persimmons are packed with soluble tannins. Gastric acid turns these into a sticky, dense mass that can outlast your patience – and harder than most other phytobezoars (those are plant-based stomach stones, for those keeping score). If you're prone to stomachaches, consider this your red flag.

Should You Eat Persimmons at Night?

Not a great idea. A late-night persimmon can spike your blood sugar and mess with your sleep. Save it for the daytime.

Can You Eat Persimmons on an Empty Stomach?

Nope. Don't even try it. Tannin on an empty stomach is like inviting your gastric juices to a rave – it causes nausea, vomiting, and a VIP pass to gastrolithiasis if you make it a habit.

What's the Upside of Persimmons?

Persimmons aren't all bad. They're loaded with vitamins A and C, plus manganese, which keeps your blood clotting like it should. They also come with flavonoid antioxidants and heart-friendly tannins that lower blood pressure, ease inflammation, and keep cholesterol in check. So, they're basically a superfruit… in moderation.

How Many Persimmons Can You Eat Without Regret?

One medium-sized persimmon (around 100 grams) a day is plenty – enough to fight atherosclerosis and still keep your stomach in one piece. Mix it up with apples, bananas, avocados, citrus fruits, grapes, and berries for the best results. Your body will thank you.

Final Thought

Enjoy persimmons, but don't let them enjoy you. Moderation is key, or you might find yourself starring in a cautionary tale told by Dr. Wang and a very worried gastro team.