1.What is gout
Gout is a disease caused by the accumulation of uric acid due to the disorder of purine metabolism, which is a kind of arthritis, also known as metabolic arthritis. Gout is defined as a disorder in the metabolism of a substance called purine in the body, which increases the synthesis or decreases the discharge of uric acid (oxidized metabolite of purine), resulting in hyperuricemia. When the blood uric acid concentration is too high, uric acid is deposited in the form of sodium salts in joints, soft tissues, cartilage and kidneys, causing a foreign body inflammatory reaction in the tissue, which is called gout.
2.Cause of gout
The cause of gout is excessive blood uric acid (hyperuricemia), and according to the cause of hyperuricemia formation, gout can be divided into two categories: primary and secondary. On the basis of this, it can be further divided into excessive production and reduced excretion according to the production and metabolism of uric acid.
Excessive production of uric acid: It is a high excretion type. It is mainly due to enhanced nucleic acid metabolism, i.e., excessive synthesis or degradation of purine bases due to various reasons, and excessive purine metabolites, resulting in increased blood uric acid.
Decreased excretion type: About 2/3 of free uric acid in the body is excreted by the kidneys, 1/3 is passively excreted by the digestive tract with intestinal fluid, and in the colon uric acid is degraded by bacteria into ammonia and carbon dioxide and excreted out of the body. In patients with low excretion type, nucleic acid metabolism is not enhanced, but mainly due to decreased renal excretion and slow excretion of uric acid, resulting in elevated blood uric acid levels.
If hyperuricemia persists for a long time, uric acid will be deposited as urate in joints, subcutaneous tissues and kidneys, causing a series of clinical manifestations such as arthritis, subcutaneous gout stones, kidney stones or gouty nephropathy.
The disease is a recurrent acute or chronic arthritis of the peripheral joints, caused by the deposition of monosodium urate crystals in and around the joints and tendons in supersaturated hyperuricemic body fluids.
The main reason for the low incidence of gout in women is that estrogen in women can promote uric acid excretion and inhibit arthritis attacks.
3. Why are men prone to gout?
Gout disease can occur at any age. However, it is most common in middle-aged men over 40 years old. According to the latest statistics, the incidence ratio of men to women is 20:1, and the incidence rate is higher in people who are brainy and fat.
The reason why gout prefers men is that estrogen in women promotes uric acid excretion and has the effect of inhibiting arthritis attacks. Men like to drink alcohol, go to banquets, and eat food rich in purines and proteins, which increases uric acid in the body and reduces its excretion. Some doctors statistics, feast constantly, the incidence of 30%, often eat hot pot incidence also more.
This is because the raw materials of hot pot are mainly animal offal, shrimp, shellfish, seafood, and then drink beer, naturally adding oil to the fire. Investigation proves: shabu shabu a hot pot than a meal purine intake 10 times higher, or even dozens of times. A bottle of beer can double the uric acid. Hypertensive patients are 10 times more likely to suffer from gout. Gout, like diabetes, is a lifelong disease. The key is to control your own diet, eat more alkaline foods containing low purine, such as fruits and vegetables, and less acidic foods such as meat and fish, so that the diet is light, low fat and low sugar, and drink more water to facilitate the excretion of uric acid in the body.
Caution gout patients: men should not drink alcohol, meat and fish do not overdo it. Once diagnosed with gout disease, meat, fish and seafood are among the restricted foods. Spicy, stimulating food should not eat more, but also resolve to quit drinking.
4, gout often have what complications?
(1) Kidney dysfunction: If gout is not properly treated, long-term persistent hyperuricemia will cause excessive uric acid crystals to precipitate in the kidneys, resulting in gouty nephropathy, or kidney dysfunction.
(2) Ischemic heart disease: Ischemic heart disease refers to the hardening or blockage of the coronary arteries that carry oxygen and nutrients to the heart muscles, resulting in the obstruction of blood flow, thus causing chest pain and myocardial necrosis, mainly sarcopenia and myocardial infarction, which is just like a water pipe, due to the blockage of dirt, the caliber of the pipe is getting smaller and smaller, resulting in reduced water flow or completely blocked. Strictly speaking, this can happen to all people, but the difference is that some people will be affected by special factors and accelerate the process, currently the American Heart Association has listed gout as a risk factor for ischemic heart disease and a promoter of atherosclerosis. If gout is not properly treated, persistent hyperuricemia will cause excessive uric acid crystals to settle in the coronary arteries, and platelet agglutination will accelerate the progression of atherosclerosis.
(3) Kidney stones: According to statistics, the chance of kidney stones in gout patients is about one thousand times higher than that of normal people; since the more uric acid in the urine and the more acidic the pH is, the more likely stones will occur, so it is necessary to take extra measures.
(4) Obesity: China’s rapid economic growth and food sufficiency have led to an increasing number of obese people; obesity not only causes hyperuric acid synthesis, resulting in hyperuricemia, but also hinders uric acid excretion, which can easily cause gout, combined hyperlipidemia, and diabetes. The main reason is often overeating, so obese people should lose weight.
(5) hyperlipidemia: gout people are more often binge drinking and obesity, so a lot of combined hyperlipidemia, which is very closely related to the occurrence of atherosclerosis.
(6) Diabetes mellitus: Oral glucose load test is done on gout patients, and it is found that 30-40% of them have “mild non-insulin-dependent” diabetes mellitus; that is due to low insulin sensitivity caused by obesity and overeating, if diet therapy can be used early and weight control can be done, insulin sensitivity can be recovered soon.
(7) hypertension: about half of the gout patients combined with hypertension, in addition to the above renal hypertension caused by renal dysfunction, gout patients combined with obesity is also one of the reasons. Because hypertension treatment drugs often use antihypertensive diuretics, will inhibit uric acid excretion, and make uric acid value rise, this point must be noted.
5.How to treat gout medication?
Before taking any medication, please consult a specialist!
Purine control medication
If diet control is not effective, long-term medication is necessary. There are two types of medications commonly used:
Reduction of uric acid synthesis
Allopurinol tablets (Allopurinol 100mg), also known as allopurinol, are commonly used to reduce uric acid levels in the blood. This drug, which can be combined with a purine derivative, can trigger the redissolution of uric acid crystals that have accumulated in the soft tissues, which can trigger and aggravate arthritis. Therefore, it should be discontinued in case of inflammation.
Increasing the excretion of uric acid
Probenecid
The mechanism of action of uric acid excretory agents is to inhibit the reabsorption of uric acid by the renal tubules and to increase the excretion of uric acid from the urine, thus reducing the concentration of uric acid in the blood and ultimately reducing the deposition of uric acid in the soft tissues and the occurrence of gout inflammation. The following patients should not be used; urinary stones, blood loss, chemotherapy and cancer-induced uric acidosis.
Common anti-inflammatory drugs.
Acute gout can take
Diclofenac Sodium, also known as Diclofenac Sodium, is a non-steroidal anti-inflammatory and analgesic drug. 25mg is taken two to three times daily after meals, one to two tablets each time. For stomach problems, take as directed by your doctor.
Celecoxib 200mg
One capsule with one to two meals daily. Heart and stomach patients must take as directed by their physician.
Colchicine is an obsolete drug, which is harmful to the liver and should be used with caution by people with defective liver function.
6.Gout diet
Gout diet.
Diet is the main source of exogenous purines and uric acid in gout patients, and uric acid is mainly derived from the breakdown of nucleotides in the diet. About 20% of the total uric acid in the body. For hyperuricemia, endogenous metabolic disorders are more important than exogenous factors. If blood uric acid is high and purines are high, gout forms a chain of reactions. Therefore what you can’t eat and what you can eat when you have gout is quite important, and patients must pay attention to the gout diet along with gout treatment.