1.Why are modern people easy to get gout?
Gout is a metabolic disease that is closely related to life. Modern people’s standard of living has improved, eating and drinking is a common thing, and I don’t know how much diet related to the development of gout is eaten, which makes the cases of gout attack increasing day by day. Therefore, it is considered a disease of affluence. Gout used to occur mostly in middle-aged and elderly people, but in recent years many young people have also started to develop it, mainly obese people and brain workers. When doing annual health check-ups, it is recommended that some white-collar workers who do not exercise frequently should pay attention to testing the uric acid concentration of their blood for timely diagnosis and treatment.
2.What are the main symptoms of gout?
The cause of gout is the high concentration of uric acid in the blood, forming uric acid crystals deposited in the tissues. If deposited in the joints, it will cause arthritis, and if deposited in the kidneys, it will lead to kidney stones.
The earliest symptom that most people with gout experience is acute gouty arthritis. Acute gouty arthritis mostly occurs in the small joints of the lower extremities, especially the first toe-metatarsal joint. Moreover, it often develops suddenly at night, with localized redness, swelling and severe pain in the affected joints, and extreme sensitivity to temperature, touch and vibration. Gout has a rapid onset and fades quickly, resolving on its own within a week or so. Since this type of arthritis is not caused by bacterial infection, it is not usually accompanied by fever and treatment with antibacterial agents is ineffective.
Gout is prone to recurrence, and after repeated attacks, it can involve several joints and lead to joint deformities, and can also cause serious kidney function damage. A few patients start with kidney stones and may have back pain, hematuria and other symptoms.
3, gout patients should pay attention to how the usual diet?
Gout is often complicated by obesity, diabetes, hypertension and hyperlipidemia, patients should observe the following dietary principles.
1) maintain the ideal weight, overweight or obese should reduce weight. However, weight loss should be gradual, otherwise it may lead to ketosis or acute gout attack.
2) Carbohydrates can promote uric acid excretion, patients can eat carbohydrate-rich rice, steamed buns, pasta, etc.
3) Protein can be consumed in proportion to body weight. 1 kg of body weight should be consumed 0.8 grams to 1 gram of protein, and milk and eggs should be the mainstay. If it is lean meat, chicken and duck meat, etc., should be boiled and go to soup to eat, avoid eating stewed meat or marinated meat, especially the old fire soup.
4) Eat less fat, because fat can reduce uric acid excretion. For people with gout and hyperlipidemia, fat intake should be controlled to within 20% to 25% of total calories.
5) Drink a lot of water, 2000ml to 3000ml of water daily, to promote the elimination of uric acid. Here is a small recipe: people who like to drink tea can be used raw papaya half (not to remove the skin and core), raw pu’er 15g boiled water or water as tea, to reduce uric acid has a very obvious effect.
6) Eat less salt, should be limited to 2 grams to 5 grams per day.
7) No alcohol! Alcohol tends to make the body lactic acid accumulation, has an inhibitory effect on uric acid discharge, easy to induce gout, especially try not to drink beer.
8) Use less strongly stimulating seasonings or spices.
9) Limit purine intake. Purine is a component of the cell nucleus, as long as the food containing cells contains purine, animal food contains more purine. Patients should try not to eat offal, bone marrow, seafood, fermented foods, beans, etc. The specific categories are: clams and oysters, bean sprouts, oysters, dried scallops, scallops, chicken liver, sea eels, shiitake mushrooms, pork liver, fallow fish, dried small fish, grass shrimp, oysters.
10) Drugs that inhibit uric acid excretion should not be used: some anti-hypertensives, moderate doses of aspirin, anti-tuberculosis drugs, some antibacterial drugs, etc.
4.What are the misunderstandings in the treatment of gout patients?
Many patients are not able to get professional doctor’s consultation, so that they apply a lot of antibiotics, especially penicillin treatment early. This may be a mistake of lay doctors to diagnose gout as a bacterial infection such as dengue, or it may be a misunderstanding in treatment by lay doctors.
The principles of medication are different between the acute attack and the remission period. As we all know, the pain during acute attack of gout is fierce and severe, so the treatment should be mainly anti-inflammatory and pain-relieving, and non-steroidal anti-inflammatory drugs such as Fotarim with diclofenac are the necessary choice. Hormonal drugs are also sometimes used, especially for severe pain (Depo-Provera injection at the site of severe pain) with significant effect. The remission of an acute gouty arthritis attack does not mean that the condition is cured, and the subsequent treatment should be considered more important. The fact is that the treatment of gout is a strictly standardized process, and only professional and standardized treatment, through a combination of diet, exercise and medication, can avoid a series of irreversible complications in the later stages.
The choice of drugs affecting purine metabolism should be individualized as much as possible according to the differences in metabolic characteristics. The treatment should try to keep the blood uric acid at a low level for a considerable period of time (e.g. more than 3 months), which is beneficial to reduce the damage of uric acid to various tissues and organs and to the appropriate relaxation of daily diet in the future. This is also an aspect of standardized gout treatment. Since many medications used to treat gout have adverse effects on human liver and kidney functions. Therefore, it is a true reflection of a professional physician to weigh the risks and benefits of subsequent drug therapy in a comprehensive manner so that the patient receives the highest benefit.
In conclusion, all gout patients should realize that gout is not a minor disease, and only strict standardized treatment can avoid damage to tissues and organs by uric acid and enjoy life better!