Where does gout come from?

Gout is often considered a disease of the rich, the disease is directly related to the daily diet of patients. The disease is common in middle-aged men but in recent years the disease tends to age and increase in dizzying numbers in Vietnam. So what is the cause of the disease and how does the prevention work?

Gout is in crystalline deposition disease group.

Causes of gout

Uric acid (acide urique) is the culprit

Specifically in this disease is the accumulation of monosodium urate crystals in the joints and tendons caused by elevated uric acid levels in the blood . causing peripheral arthritis episodes that are particularly frequent in the limb joints. big toe . This inflammation is caused by white blood cells that are like fighting soldiers in the body to clean up these crystals.

This inflammation can recur repeatedly, causing joint deformity if not treated. Not everyone who has high uric acid in their blood is suffering from a gout attack, but if the blood uric acid level is high and lasts longer, there is an increased risk of gout.

Specifically, the maximum limit that if passed is considered to be hyperuricemia of 420 µmol / l for men, 360 µmol / female.

So why do you have hyperuricemia?

This is because the kidneys are unable to discharge urique acide or because the body produces too much (due to eating, due to diseases such as leukemia, hemolytic anemia, psoriasis .) or due to abnormalities in the cycle. create this acide.

The disease will be manifested by pain in the joints, the joint may be swollen and red, there may be water in the joint, especially the big toe (the finger joint), which is most common, but other joints can be affected. The pain is very badly described and much when the patient does not dare to apply a blanket because just touching it causes severe pain.

A good gout occurs after a minor injury, after a drink. Gout attacks can occur days or weeks and may be self-limiting, but if not treated these attacks will appear more often and cause disfigurement of the joint causing disability.

Risk factors for gout

1. Sex factor : Gout is common in men, in Vietnam, people with gout are 99% male.
2. Age factor : Common gout in the age of 30 - 50 in men, women are often after menopause.
3. Family factor : This factor is caused by genes but can also be due to family members having the same regimen, living habits, eating habits.
4. Living habits : Common in people who have a habit of drinking alcoholic beverages such as alcohol. There are also many other factors that will analyze further in the lower part.
5. Health factors : Gout is related to a number of other metabolic diseases such as diabetes, dyslipidemia . Gout is also associated with obesity. Obese people are five times more likely to develop gout.
6. Influence of some drugs to reduce uric acid waste through the kidney, disorders of uric acid metabolism : Diuretics thiazid, furosemid, aspirin, anti-TB drugs such as pyrazynamid .

The disease occurs due to hyperuricemia after some other diseases called secondary gout . Uric acid in the blood may increase secondary due to the following reasons:

1. Due to consumption of purine-containing foods (liver, heart, meat, fish, mushrooms, shrimp, crabs), drink plenty of alcohol and beer. In fact, these are just triggers of disease rather than direct causes.
2. Because in the body enhance endogenous purine degradation (destruction of many cells, organizations) related to hematological diseases such as polycythemia, myelosuppressive leucemie, hodgkin, lymphoma, multiple myeloma, or due to the use of cytotoxic drugs to treat melanoma.
3. Due to reduced renal uric acid excretion: chronic nephritis, kidney failure causes uric acid excretion to be reduced and stagnation causing disease.

How to diagnose gout?

BSs will allow patients to test the level of uric acid in the blood and according to the parameters of each type of test machine for different numbers, normally less than 7mg / dL. However, the gout is quite typical so sometimes it can be diagnosed through a medical history and examination of a patient because of the high level of uric acid in the blood that helps diagnose but is not specific. If the joint fluid is taken under the microscope to see the needle-shaped urate crystals are the most stable, but rarely done for many different reasons.

Joint x-ray shows a picture of sub-cartilage damage.

Symptoms of gout

When you have the following symptoms, you must pay special attention to gout and should go to the doctor early to find the appropriate treatment regimen for your condition, avoid long-term illness in the untreated condition and make the disease The more severe and the unfortunate complications occur:

1. Feeling warm, painful, swollen and weak in joints, usually the big toe joint. This symptom is called gout . The pain usually starts at night, so much so that just touching the bed cover will hurt to the point of being unbearable. This discomfort increases rapidly, lasting for hours in the night and then decreasing within 2-7 days later.
2. When the gout attacks, the skin around the joint is painful and can flake or itch.
3. The skin is very red and slightly purple around the affected gout joint. That joint may look like an infection.
4. Restricted movement in joints with gout.

How is the disease progressing and can it be cured?

Often, gout attacks can be repelled by existing drugs and if the patient follows treatment and accepts diets, the disease can be prevented but remember that this is a disease that cannot be cured, ie Patients must accept diet and follow up for life.

If not treated or let gout occur many times, it will destroy the joint causing disability, then need to reconstruct joints. About 20% of patients with gout suffer from kidney stones caused by the urate crystal itself, which causes stones to obstruct the urinary tract, which can cause kidney dysfunction, UTI . which can affect lives. Some patients have subcutaneous lumps such as elbows, fish eyes, etc. called tophi, which are caused by deposition of urate crystals when the tank exits a white powder-like substance.

The role of arthroscopy is to clean the joints, cut off synovial joints of joints when repeatedly inflamed, limiting the movement of joints. Once the joint is completely damaged, it can be replaced by an artificial joint.

Foods to avoid when gout

1. Red meat, beef and beef offal .Beef and offal beef such as liver, kidney or cow contain very high levels of purines, so you should avoid eating these foods to prevent gout.Shelled foods and high protein foods will also increase the risk of gout.
2. Wine .Avoiding alcohol to help prevent gout, purine levels in alcohol can cause gout outbreaks.Alcohol reduces the body's ability to excrete uric acid and increases the development of Gout.
3. Vitamin C.Foods that contain high levels of Vitamin C can cause an increase in uric acid production.If you are at risk for gout or have been suffering from gout, you should consult your doctor when taking vitamin C tablets or foods high in vitamin C.

Good food is a way to help prevent gout

How to prevent gout

Gout can be prevented by implementing a healthy and scientifically active diet with the aim of strengthening health, improving the body's resistance to fighting pathogens and maintaining its content. Blood urid levels are moderate. Therefore, to prevent gout you need:

1. Maintain a healthy weight, avoid overweight, obesity .
2. Choose a suitable sport or exercise and exercise regularly every day, at least 5 times a week, for 30 minutes at a time.
3. Implementing a balanced diet , limiting food intake can increase the level of urid acid in the blood.
4. Drinking enough water every day to purify and detoxify the body, can drink more alkaline mineral water to increase the ability to excrete urid.
5. In the daily menu, eat more: cereals, white bread, green vegetables, carrots, cabbage, tofu, fruits.
6. Each day should only eat up to 15g of meat should avoid eating animal organs (pig heart, secretion, liver, kidney, brain, stomach, tongue .), red meats (buffalo, cow, dog, goats), seafood (shrimp, crab, fatty fish).Can eat eggs, milk, cheese, white meat like poultry, lean fish.
7. Limit alcohol, beer, alcoholic beverages and stimulants.
8. Avoid eating hot, spicy foods, limiting spices in the daily meals processing, limiting sour foods such as sour spring rolls, pickled pickles, sour soup, sour fruits, drinking lemonade . for the sake of sour substances make the disease worse.