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Creno therapy Drinking cure by use of mineral waters Ca waters More than 1 g Ca/l and more than 20% of kation equivalents Indication of Ca waters Alimentary Ca-malfunction situations Supportive treatment of osteoporosis Supportive treatment of allergic diseases Urology (only Ca/Mg/HCO3-waters) Chronic urinary tract infections, also supportive together with antibiotics Prophylaxis and metaphylaxis in Oxalate, Carbonateand phosphate urinary calculi, also post operative and after lithotripsy. Contraindication of Ca waters Hyper-absorptive hyper-calciuria with urinary calculi Cardiac-circulation insufficiency and kidney insufficiency Side effects of Ca waters Trend to obstipation especially in high Ca concentrations Ca/Mg/Hydrogen-carbonate waters More than 1 g /l kation and anion equivalent part more than 20% of Ca, Mg, and Hydrogencarbonate Indication of Ca/Mg/Hydrogencarbonate waters Prophylaxis and metaphylaxis in Oxalate, Carbonate- and phosphate urinary calculi, also post operative and after lithotripsy supportive treatment in chronic urinary tract infections Alimentary Ca-malfunction situations with nervous hyperirritability Alimentary Mg-malfunction situations with performance decrease and signs of vegetative dystonia Functional disturbance in stomach-intestine esp.. Trend to emotional diarrhoea Contraindication of Ca/Mg/Hydrogen-carbonate waters In Hyper-absorptive hyper-calciuria and hyperparathyreoidism waters with high Ca amount should not be used. In E.-coli-infections of urinary tract and development of infect calculi (Phosphate- and Carbonate-stones) waters with more than 3,0 g/l Hydrogen carbonate and Sodium content should be avoided. Cardiac-circulation insufficiency and kidney insufficiency Side effects of Ca/Mg/Hydrogencarbonate waters Nothings Iron waters More than 20 mg /l Fe(II) in solution Indication of Iron waters Manifest and larvate Iron malfunctions (Iron deficiency anaemia, lost of iron by pregnancy, climacteric disturbance or other blood loss). General roboration and promotion of recovery esp.. Post infections Contraindication of Iron waters Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of Iron waters Oral uptake of Iron in case of adstringent effect of Iron (III) could stimulate gastro-intestine complains and uncomfortable symptoms. These can be decreases by drinking of mild warm water. CO2 waters More than 1 g /l CO2 Indication of CO2-waters Concentration more than 1 g/l CO2 General stimulation of the digestion Disorders in appetence Concentration more than 2 g/l CO2 Stimulation of diuresis in urology diseases Contraindication of CO2 waters Pre-damage of the stomach (esp.. gastric ulcer) Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of CO2 waters By liberate of CO2 and stretching the stomach wall pressure complaints are possible (Roemheld syndrome) By uptake of big drinking volumes complaints like irritable stomach (dyspepsia) are possible. The symptoms disappear normally during serial application. Hydrogen carbonate waters More than 1 g /l minerals in solution and NaHCO3 more than 20% of the kation and anion equivalent Indication of hydrogen carbonate waters Prophylaxis and metaphylaxis of uric acid-, cystine-, and calcium oxalate-urinary calculi, also post operative and after lithotripsy supportive treatment in chronic urinary tract infections without E. coli infections Functional diseases of the stomach, supportive treatment of chronic relapse of gastric ulcera Supportive treatment of disorders of the uric acid metabolism (gout) Contraindication of Hydrogen carbonate waters Alkaline urine promote the E.coli infection of urinary tract and the development of infect calculi (phosphateand carbonate stones) Acute gastritis and enteritis, haemorrhage diathesis, and risk of rupture in the intestinal tract (esp.. ulcera, post operations), hindrance of passage higher stages (stenosis, invaginations) Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of hydrogen carbonate waters By liberate of CO2 and stretching the stomach wall pressure complaints are possible (Roemheld syndrome) By uptake of big drinking volumes complaints like irritable stomach (dyspepsia) are possible. The symptoms disappear normally during serial application. Sulphate waters More than 1,2 g /l sulphate in solution Indication of sulphate waters Dyskinesia of the derivative bile tract including post operative complaints To stimulate the secretion of bile and pancreas Disturbance of the intestine motility without significant organic reasons, esp. Different forms of obstipation and colon irritable. Functional disturbance of the upper stomach organs In supportive treatment of adipose In prophylaxis of calcium-phosphate urinary calculi, esp. In case of high pH value in urine. Supportive treatment of urinary tract infections (esp. By use of Ca-sulphate waters). Contraindication of sulphate waters Organic dependent disorders in motility and secretion in intestine tract, esp. Ileus, intestine vagination, obstructive jaundice. Acute inflammatory diseases and haemorrhage diathesis in intestine tract (esp. Ulcus and post operations) Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Hyper tonic sulphate waters (esp. Mg-sulphate waters may not used in dehydration states In case of urinary calculi long time use of sulphate waters is contra indicant. Side effects of sulphate waters Long time use of high dosages of hyper tonic sulphate waters could stimulate strong diarrhoea following disorders of the electrolytes and exsiccosis. Minimum dose limit of diarrhoea is 3,0 g soluble sulphate. Zinc waters More than 2 mg/l zinc in solution Indication of zinc waters Supportive treatment of zinc malfunction In increased zinc lose esp. During lactation, diabetes mellitus, alcoholism, sport and working in heat, scaly skin diseases. Increased zinc requirement during pregnancy and in young age. Alimentary zinc requirement (esp. post delactation). In zinc malfunctioned wound healing disturbances, skin ulcera and immune disturbances. Acne vulgaris (to spare antibiotics and vitamin-A-acid) Contraindication of zinc waters Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of zinc waters Nothing. Fluoride waters More than 1 mg/l fluorides in solution Indication of fluoride waters Alimentary fluoride requirement. Caries prophylaxis Supportive treatment osteoporosis of fluoride concentration is more than 10 mg/l Contraindication of fluoride waters Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of fluoride waters Nothing. Sodium chloride waters More than 1 g/l minerals in solution and minimal 20% equivalents of NaCl Indication of sodium chloride waters Stimulation of gastric secretion Inhibition of increased gastric secretion. Stimulation of the gastric and small intestine motoric. Stimulation of the liver- and pancreas-secretion. Contraindication of sodium chloride waters Acute gastritis and enteritis, haemorrhage diathesis in intestine tract (esp. Ulcus and post operations), stenoses, invaginations. Disturbance of bile- and pancreas flow, acute liver diseases Arterial hypertension and oedema (more than 1 g/l NaCl) Drinking cure by high additive uptake of liquid is contra indicant by cardiac-circulation insufficiency and kidney insufficiency Side effects of sodium chloride waters Nothing. Iodide waters More than 1 mg/l iodide in solution Indication of iodide waters Supportive treatment of iodine malfunctions esp. euthyroit iodine deficient struma. Contraindication of iodide waters Latent and manifest hyper thyreosis Hypersensitivity like iodine allergy and iodismus Side effects of iodide waters Allergic reactions with pruritus, exanthema, eosinophilia, fever etc. in few cases. Diseases of digestive system Functional and inflammatory diseases of stomach and intestine Hydrogen carbonate Decrease of persistence of gastric contents, improvement of gastric disturbances by pain decrease, inhibition of inflammation and mucolytic effect, normalisation of gastric secretion. Gastric secretion: to much not enough Hydrogen carbonate Carbonic acid more than 1 g/l Neutralisation and normalisation Stimulation of secretion Constipation Sulphate Decrease of intestine water absorption Functional disease of bile and pancreas Sulphate Stimulation of secretion Metabolic diseases Diabetes mellitus Hydrogen carbonate Increase of the carbon hydrate tolerance, insuline efficacy, and glycogen storage Disturbance of the uric acid metabolism (Hyper uricaemia, gout) Hydrogen carbonate Increase of uric acid elimination´and solubility in in urine, disability of uric acid calculi Adipose Sulphate Supportive treatment Urological diseases Chronic infections of urinary tract Hydrogen carbonate Calcium Magnesium Carbonic acid (more than 2 g/l) Neutralisation of the inflammation milieu by Hydrogen carbonate, Antiinflammatory effect by Ca and Mg Irrigation of the urinary tract and Increase of diuresis Ca-oxalate calculi Hydrogen carbonate Magnesium decrease of calculi development Uric acid, Cystine, and Xantine calculi Hydrogen carbonate Increase of pH value in urine and effect against crystallisation Calcium- and phosphate calculi Sulphate Magnesium Decrease of pH in Urine and effect against crystallisation Different diseases Circulation disorders Hypertension Hydrogen carbonate Calcium Magnesium Balance of water and electrolytes Normalisation of blood pressure Osteoporosis Calcium Fluoride Increase of calcium and fluoride in malfunctions Allergic diseases Calcium Inhibition of allergic reactions Malfunctions Ca-malfunction Calcium Increase of Ca blood level (Osteoporosis, allergic reactions, nervous hypersensitivity) Mg-malfunction Magnesium Increase of Mg blood level, and effectiveness in cardiac deceases F-malfunction Fluoride Prevention in Caries, inhibition of bacterial acids in the mouth Prevention Pregnancy Magnesium Fluoride supportive in higher metabolic used Performance sports Hydrogen carbonate Against acidosis by increase of the alkali reserve Prevention of tetany, cramps, and disturbance of cardiac rhythm Magnesium Summary Ion Indication Guide value Dosage Ca Ca-lack allergic diseases osteoporosis > 250 mg/l 0,5 – 1 g/d Mg Mg-lack Ca-calculi > 100 mg/l 150 – 300 mg/d 300 mg/d Zn Zn-lack > 10 mg/l 5 mg/d Li Li-lack > 0,5 mg/l 03 mg/d Fe(II) Fe-lack > 20 mg/l 3 x 300-600 ml/d SO4 Stimulation Bile and Pancreas Obstipation > 1200 mg/l > 3000 mg/l 300-1500 ml 3g HCO3 Urology Indication Stomach-intestine-Indications metabolism > 1300 mg/l > 1500 mg/l > 1300 mg/l 0,7.2,8 l CO2 Diuresis Appetence disability > 2000 mg/l > 2500 mg/l J J-lack > 0,2 mg/l 0,1 mg/d F Caries-prophylaxis > 1 mg/l 1-2 mg/d 3 x 200-350 ml Interpretation of mineral water analyses Literature about drinking mineral waters Chr. Gutenbrunner, G. Hildebrandt: Handbuch der Heilwasser Trinkkuren. Sonntag Verlag Stuttgart 1994. ISBN 3-87758-015-7