When summer comes, people often drink beer and eat seafood while riding in the cool, but do you know that there is a disease that is happening while we are drinking and enjoying the delicious food? Gout is an old and young topic. As early as in the ancient book “Six Books of Medical Strategy”, the name of the disease was formally introduced, and nowadays, with the improvement of people’s living standards, gout has become a common and frequent disease. A group of authoritative survey data is alarming, in recent years China’s gout patients more than doubled, of which 95% are men, and there is a trend of younger development.
Gout is a disorder of purine metabolism and (or) uric acid excretion disorder caused by the disease. It is characterized clinically by hyperuricemia, recurrent acute monoarthritis, gout stones, chronic arthritis caused by gout stones, urinary stones and renal parenchymal lesions. The causes include excessive uric acid production or (and) reduced uric acid excretion, the latter being the most common.
What are the risks of gout?
Gouty arthritis is mostly self-limiting and resolves on its own within 1-2 weeks; recurrent episodes of arthritis can leave behind chronic joint pain. Temporary pain often does not attract the attention of patients, but the danger of gout lies in the long-term recurrent attacks caused by joint ring breaking, uric acid crystals deposited in the kidneys causing kidney function damage, and hyperuricemia accompanied by metabolic disorders syndrome, such as obesity, hyperlipidemia, abnormal blood sugar, significantly aggravate the development of atherosclerosis, so that the incidence of myocardial infarction stroke in gout patients significantly increased.
Why does gouty arthritis tend to strike at night, mostly involving the toe joints?
The solubility of uric acid is influenced by temperature and blood pH. The low temperature at night reduces the solubility of uric acid and makes it easier to precipitate and form crystals in the tissues, which is the reason why gout attacks occur more often at night. The toe joint is the best site for gouty arthritis. It can also affect the small joints at the end of the body, such as the fingers, ankles and wrists, while gouty arthritis is less likely to occur in the joints of the trunk. This is because the small terminal joints have less subcutaneous fat and lower temperature, while the blood circulation is poor, the tissues are relatively hypoxic, and the local pH value is low, which is conducive to uric acid deposition.
What is the difference between the treatment of gout attack and remission period?
The aim of treatment during the acute phase of gout attack is to rapidly control the symptoms of arthritis. General treatment includes bed rest, elevation of the affected limb, and avoidance of weight bearing on the joint. NSAIDs are preferred, which not only relieve joint pain but also reduce the inflammatory response of the joints. Treatment in remission is mainly to maintain blood uric acid in the normal range and prevent gout attacks. If the blood uric acid still cannot reach the standard under strict dietary control, uric acid-removing drugs, such as propoxur and gout lixin, can be applied; allopurinol, a drug that inhibits uric acid production, can be given to those with abnormal renal function or significantly elevated 24-hour uric acid.
Does asymptomatic hyperuricemia need treatment?
Hyperuricemia and gout are not synonymous. Only when uric acid crystals are deposited in the joints or kidneys on the basis of hyperuricemia is gout called gout. The risk of asymptomatic hyperuricemia lies in the development of gout attacks or, eventually, kidney stones. The likelihood of developing gout in patients with hyperuricemia is roughly proportional to the degree of increase in serum uric acid levels. The causes of hyperuricemia and related factors such as diuretics, antihypertensive drugs, chemotherapy drugs and kidney diseases, blood diseases, diabetes, hypertension and dyslipidemia should be looked for, while avoiding obesity, high purine and high calorie diet, alcoholism and other bad habits.
How to detect gout early?
Large-scale blood uric acid screening of the population can detect hyperuricemia in time, which is very important for early detection and prevention of gout. In the absence of a large-scale blood uric acid test, at least the following people should have regular blood uric acid tests: ① elderly people over 60 years old, regardless of male or female and whether they are obese or not. (2) Obese middle-aged men and postmenopausal women. ③Patients with diabetes mellitus, hypertension, atherosclerosis, coronary heart disease, cerebrovascular disease (e.g. cerebral infarction, cerebral hemorrhage). (iv) Patients with arthritis of unknown cause, especially those over middle age characterized by the onset of monoarthritis. ⑤ Kidney stones, especially multiple kidney stones.
Table: Table of purine content of food
Category I: Foods with high purine content (100-1000 mg of purine per 100 g of food)
Liver, kidney, pancreas, heart, brain, meat pies, gravy, broth, mackerel, anchovies, sardines, fish eggs, small shrimps, goose, spotted chicken, stone chicken, yeast.
Point: It is prohibited during both gout attacks and intermittent periods.
The second category: foods containing medium purines (75-100 mg of purines per 100 g of food)
1.Fish: carp, cod, halibut, sea bass, pike, shellfish, eel and eel.
2.Meat: smoked fire retreat, pork, beef, beef tongue, veal, rabbit, venison.
3, poultry: duck, pigeon, quail, pheasant, turkey.
Comment: Gout attack period prohibited, intermittent period to limit consumption.
The third category of food containing less purine (purine <75mg per 100g of food)
1.Fish and crab: mackerel, herring, salmon, anchovy, tuna, white fish, lobster, crab, oyster.
2, meat: ham, lamb, beef soup, chicken, bacon.
3, bran: cereals, bread, coarse grains.
4, vegetables: asparagus, string beans, green beans, peas, beans, spinach, mushrooms, dried beans, tofu.
Comment: Gout attack period is prohibited, intermittent restriction of food.
The fourth type of food containing little purine
1.Grains: rice, wheat, millet, rice, caper wheat, cornmeal, refined white flour, rich flour, macaroni, noodles, bread, steamed buns, soda crackers, butter snacks.
2.Vegetables: cabbage, cabbage, carrot, celery, cucumber, eggplant, kale, turnip greens, collard greens, lettuce, cut beans, pumpkin, bonito, zucchini, tomato, yam, potato, kimchi, pickles.
3, fruit: a variety of fruits.
4, eggs, dairy: fresh milk, condensed milk, cheese, yogurt, cream of wheat.
5, drinks: soft drinks, tea, coffee, cocoa, chocolate.
6, other: all kinds of fats and oils, peanut butter, foreign vegetable jelly, jam, dried fruit, etc.
Comments: Both the onset and intermittent period can be consumed
Chili, curry, pepper, pepper, mustard, ginger and other food seasonings, can excite the plant nerves, inducing acute attacks of gout, should also try to avoid the application.