Gout 痛風

卫教文章

2016-12-14

What is gout?

Since ancient time, gout is named “the disease of emperor”, and it is common within postmenopausal women or men aged in their forties to sixties; also this disorder is genetically inheritable and it happens to young males around their early 20s nowadays.

Gout results from either metabolism malfunctioning of inner body “purine” or poor functioning of renal uric acid excretion, which triggers high serum uric acid (hyperuricemia) depositing within joint; and further induces painful swelling joint and deformity. The longer serum uric acid stays in the blood, the greater chance of gout takes place; but not all patients with hyperuricemia or arthritis procure gout, precise diagnosis is vital.

Serum uric acid level for a normal adult is below 7.0g/dl, and there are 15% of people leveled under high risk group in Taiwan; as to alcoholics, they are 50% higher in chance in reaching high serum uric acid level. For your own health, have your serum uric acid level checked.

The symptoms of gout

There are two clinical stages for articular gout:

Acute gout: The first symptom of gouty arthritis is typically the sudden onset of the hot, red, swollen joint. Any touches could exacerbate such a painful feeling. Most gout attacks occur in the big toes, and joints of foot, ankle, knee, wrist, elbow, and palms. Since it happens during midnight, 80% people have hyperuricemia.
Chronic gout: Tophi are deposits of urate embedded in a matrix composed materials. The deposition area includes pinna of ears, bursas around elbows and knees, subcutaneous area, and even in major organs. Tophi often incurs joint deformity with deposit in joints.

Gout often happens to the following people:

Gout is genetically inheritable and it happens to people with such a family history.

Genetic rationale: if there is family history involving gout and high urine acid genetics; such patients are ten folds higher in risk to have gout and hyperuricemia.
Sex: Males have greater chances of getting gout and so is postmenopausal females who have 10 times higher in chances of getting the disorder.
Age: the predominant ago of gout is from 40 to 60 years of age, but it is affecting males around their 20s nowadays.
Obesity: obese patients have greater chances of getting hyperuricemia because they tend to sweat more and urinate less; as a result, uric acid is deposited within their body.
Diet: if you over consume alcohol and have unbalanced dietary habit and intake too much high purine diet; as a result, you have greater chances of getting gout because of the increased serum uric acid level.

Treatments and self-care

General principle of coping with patients with gout is to control acute attacks, to curb level of serum uric acid, and to prevent tophi formation. Its treatment is often involved with medication and diet.

Medication: non-steroid anti-inflammation drugs have the effect of sterilization and pain relief; other medications are to inhibit uric acid formation and to promote uric acid excretion. If patients are prescribed with Colchicine, there is a chance they might suffer from diarrhea; the problem can be easily solved by reducing the dose.
Exercise: patients should avoid violent sports because it promotes sweating and reduces the amount of serum urine acid excretion; excess lactic acid level could as well hinder uric acid excretion.
Drink more water: drinking more than 2000-4000cc water a day to help excrete uric acid.
Avoid high purine diet: read the chart below and locate group three for purine rich food; patients should consume food containing less purine to reduce formation of uric acid.
Avoid drinking liquor: Once patients consume liquor, it stays within body after metabolism and affects uric acid execration; therefore, they should avoid drinking alcohol.
Maintain ideal body weight: if overweight, reduces a kilogram of your body per month to prevent massive purine generation because of rapid tissue decomposition; however, lose no weight during acute attack. Reduce your intake of high caloric food.

Food containing purine(each 100mg food in this table )

First group(0-25mg)

vegetables, fruit, milk, egg class, honey, fat and nut, sugar and sweet fruit, fruit jelly, rice, noodles, macaroni, lotus root powder (except for cereal). Drink, cheese, roe, trepang, sweet potato, water chestnut, rolled cat, auricularia auricula, melon seed, potato, and sea wise skin.

Second group(25-150mg)

(A)(25-75mg)

Common fish, lobster, fish pill, crab, oyster, chicken, chestnut, husked lotus, ham, gut of beef, dry legumes (red bean, mung bean), pea, kelp, three-color amaranth, dried bamboo shoots, jack bean, bean curd, dried beans, kidney bean, blue Jiang Ts'ai, and mushroom

(B)(75-150mg)

Lean meat, turkey, duck, pigeon, pig, cow, sheep, beef tongue, carp, Cao Yu, mullet, snow fish, perch, big flat fish, carapace class (soft-shelled turtle), pheasant, hyacinth bean, crab, cuttlefish, and peanut

Third group(150-1000mg)

Meat broth, thick bouillon, brain, kidney, liver, sardine, pancreas, bamboo shoots, shiitake mushroom, dike fish (black carp, piece mouth fish), black soybeans, soybean, and porphyra capensi

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Gout 痛風