A summer, quietly came to us. In Xinxiang, a delicious snack, a refreshing dish, and a cold beer constitute a pleasant summer food culture for the people. But behind this beauty and comfort, gout, a disease that can produce great pain in a short period of time, has also quietly come to us. Fan Wenqiang, Department of Rheumatology and Immunology, Xinxiang Central Hospital, Henan Province, China Gout is a group of diseases caused by disorders of purine metabolism and reduced uric acid excretion. It shows a high correlation with diet. With the strengthening of the country and the improvement of people’s living standard, we started to change from “eating enough” (filling the stomach) to “eating well” (filling the stomach).
(fill up the stomach) to “eat well” (eat delicious), the demand for delicious food makes more and more people have hyperuricemia. When blood uric acid increases to a certain level (above 535 mol/L), uric acid crystals are formed and deposited in tissues and joint cavities, causing gout. Gout pain is very painful, and the onset of the disease is rapid. Most people wake up at midnight with foot pain, and the pain peaks in 48 to 72 hours, like a knife cut or bite. The pain is usually associated with redness, swelling, heat and pain in the soft tissues around the joints, and the local area cannot even tolerate sheeting or vibration around the joints. 60% to 70% of patients have the first attack on the first metatarsophalangeal joint, but the dorsal foot, ankle, finger, wrist, elbow and knee joints may also be affected. Repeated attacks gradually affect multiple joints, and in patients with severe involvement of large joints there may even be joint effusion, and the lesions may be multisystemic. Without proper treatment, it can lead to joint immobility and deformity, urinary stones, and gouty nephropathy. How should I determine if I have a gout attack and prevent and treat it properly? Most patients with untreated gout have elevated blood uric acid values, and when combined with clinical symptoms, it is not difficult to make a diagnosis of typical gout. For gout not starting in the first metatarsophalangeal joint, it is generally not difficult to identify through uric acid measurement, synovial fluid examination, and joint X-ray examination (of course, those with clinical manifestations such as cellulitis, dermatitis, psoriatic arthritis, ankylosing spondylitis, and other crystal arthritis should be carefully identified). Treatment should begin with mouth control and avoid eating a high purine diet, including animal offal, sardines, oysters, clams and crabs and other seafood, meat and broth, and absolutely avoid beer and grain wine (a small amount of red wine has been reported to be harmless). Patients can consume milk, soy milk, tofu, eggs, various fruits, cereal products and vegetables. Vegetables (rape, cabbage, carrots & melons), seaweed, nori, fruits and other alkaline foods can promote the dissolution of uric acid in the urine, increase the amount of uric acid excretion and prevent the formation of uric acid kidney stones. Drink more water,, drinking water can increase the amount of urine, can promote the discharge of uric acid. Generally, you should drink not less than 2000ml (about 8 to 10 cups) of water per day. But do not drink cool drinks and alcoholic beverages, can drink vitamin and potassium-rich vegetable juice, soy milk, etc.. At the same time limit salt, sodium will promote the role of uric acid precipitation, coupled with gout more combined with hypertension, coronary heart disease and kidney lesions, so gout patients should limit daily salt intake, severe patients should not exceed 6 grams a day. Secondly, drug treatment. The purpose of treatment in the acute stage of gout is to quickly control the symptoms of acute joint attacks and remove the triggering factors. Non-steroidal anti-inflammatory drugs, colchicine for common treatment drugs, severe acute gout can be joint cavity glucocorticoid application. At the same time, the treatment of gout in remission is related to the patient’s prognosis and should be highly valued. The aim of the treatment of intermittent and chronic gout is to maintain the blood uric acid level within the normal range and prevent attacks (blood uric acid should be below 300 mmol/L), avoid the formation of gout stones and the occurrence of gout nephropathy. For patients whose blood uric acid level is still above 416 mmol/L under dietary control, drugs to promote uric acid excretion, inhibit uric acid production and alkalinize urine should be used promptly. The diagnosis, prevention and treatment of gout still have many misconceptions among the majority of patients, and therapeutic medication can cause damage to the organs. Timely medical guidance can relieve patients’ pain and reduce the risks associated with treatment. If you pay more attention to gout in the coming summer, you will increase the glory of summer.