Gout (gout)

Gout (gout)'s disease overview

What is gout?

Gout (gout) , also known as a leprosy, is a disease due to a disorders of purin metabolism in the kidneys, making it impossible for the kidneys to filter uric acid from in the blood. Uric acid is often harmless and formed in the body, then will be eliminated through urine and feces. For people with gout, the amount of uric acid in the blood is accumulated over time. When this concentration is too high, the small crystals of uric acid are formed. These crystals are concentrated in joints and cause inflammation, swelling and pain for patients.

Gout is characterized by recurrent acute arthritis, patients often suffer from sudden pain in the middle of the night and swelling of the joints when the acute inflammation broke out, especially the joints in the big toe, but It can also affect other joints on the legs (such as knees, ankles, feet) and less common in the joints (hands, wrists, elbows), even the spine can also be affected .

Is gout dangerous?

Although gout can make people stress, pain and insomnia, gout is a benign disease and can be controlled by drugs as well as preventing the acute period by changing the diet. >

Based on the severity, gout is divided into 3 stages:

Stage 1: The level of uric acid in the blood has increased but has not appeared symptoms of gout. Typically, patients only notice the first symptom of gout after kidney stones.

Stage 2: Uric acid concentration is now very high, resulting in the formation of crystals that appear in the toe (tophi nodules). Tophi nodules often manifest slowly, decades after the first gout but sometimes earlier. Once appeared, it is easy to increase the number and mass and can ulcer. Tophi nodules are often seen on the ear cartilage and then the elbow, big toe, heel, back of the feet and heel tendon.

During this period, the patient will feel joint pain but the pain will not last. Some time later, the patient will experience other symptoms of gout with intensity and frequency increasing.

Stage 3: Symptoms of the disease will not disappear and uric acid crystals will attack many joints.

Most people with gout are only in phase 1 or 2, very rare people have progressed to stage 3 due to the symptoms of gout have been properly treated in the stage. Paragraph 2.

Causes of Gout (gout)'s disease

Cause of gout consists of two main causes: Nguyen Phat (most cases) and secondary

Nguyen Phat:

95% of cases occur in men, the common age is 30-60 years old.

unknown reasons.

Food diet contains many purin such as liver, kidney, shrimp, crab, egg yolk, mushrooms ... are considered to worsen the disease.

Secondary

due to genetic disorders (genetic causes): rare.

Due to increased uric acid production or reducing uric acid elimination or both:

Renal failure and diseases that reduce the purification of uric acid of glomerular acid

Blood diseases: Acute leukemia

Use diuretics such as diuretics Furosemid, thiazid, acetazolamid, ...

use cell inhibitors to treat malignant diseases

use antacids such as ethambutol, pyrazinamid, ...

Symptoms of Gout (gout)'s disease

Gout symptoms often occur suddenly and at night. In some cases, gout has no initial signs. The manifestations of gout often occur when the patient has had acute or chronic gout.

The main symptoms of the disease include:

Sudden, severe pain, swelling

More painful joints when touching

Red swollen joints

The surrounding joints warm up

Most manifestations of gout usually last for several hours in 1–2 days. However, in severe cases, pain may occur within a few weeks.

If people with gout do not take gout medication regularly, the symptoms of the disease will be more serious.

Tophi lumps: This disease is characterized by a crystal accumulation under the skin. Typically, these blocks will appear around the toes, knees, fingers and ears. If not handled properly, U Tophi will be greater.

joint damage: If the patient does not use gout medication, joints may be permanently damaged. This condition will increase the risk of bone damage and other joints.

Kidney stones: If not treated properly, uric acid crystals not only accumulate around the joints but also accumulate in the kidneys causing kidney stones.

People at risk for Gout (gout)'s disease

Gout incidence is about 1/200 adults. The disease can affect people, regardless of age and gender. However, men from 30–50 years old and women in the postmenopausal period often suffer from this disease more. The disease rarely occurs in young people and children.

Risk factors include:

Diet too much protein and seafood

Age and gender: The disease appears more in men and the elderly

Drink a lot of beer for a long time

obesity

Families who have been gout

new injury or new surgery

Excessive weight gain

Hypertension

Abnormal kidney function

Using some drugs that can be the cause of uric acid accumulation in the body such as aspirin, diuretics, chemotherapy, drugs that can impair The immune system like cyclosporine

Having diseases such as diabetes, impaired renal function, heart disease, atherosclerosis, blood vessel obstruction, infectious diseases, hypertension

Dehydration

Prevention of Gout (gout)'s disease

Living habits help limit the progression of gout:

Listen to the doctor's instructions, not to arbitrarily take the drug without prescribed or prescribed drugs.

Re -examination on schedule to monitor the disease as well as health status.

Good treatment for secondary gout diseases such as renal failure, metabolic diseases, ...

Daily exercise

Maintain a reasonable weight

Special need to maintain a reasonable diet:

Avoid eating internal organs, especially liver, sardines

Avoid eating seafood and red meat

eat low saturated fat and low -fat products

Eat lots of fiber -rich foods such as cucumber, cassava, tomatoes, ...

Alternative use of natural sugars in vegetables and cereals

Drink plenty of water: Drink from 2.5–3 liters of water per day

Reduce the use of alcoholic drinks, especially alcohol

Do not drink coffee, tea, carbonated drinks

Diagnostic measures for Gout (gout)'s disease

Gout is often difficult to diagnose exactly because of the symptoms that are similar to other diseases.

The diagnostic measures applied include:

Ask for history

Clinical examination

Subclinical test:

Blood test to measure uric acid levels in the blood

Stomach suction fluid to find uric acid crystals

X-rays of joints

Age ultrasound

CT scan of joints

Diagnosis

can apply one of the following criteria:

Bennet and Wood Standard (1968): The most widely applied in Vietnam due to easy to remember and suitable for the lack of testing (70%sensitivity, 82.7%specificity) Sodium urate in joint fluid or tophi nodules.

or at least 2 of the following factors:

History or currently at least 2 swelling of a joint with sudden onset, severe pain, and completely recovered within 2 weeks.

Pre -history or currently swelling of the joint pain of the big toe with the sudden onset, severe pain, and completely recovered within 2 weeks.

There are tophi notes

Having or is responding well with colchicin (reducing inflammation, analgesic in 48 hours).

Standard of ilar and omeract (2000): 70% sensitivity, specific 78.8%

with urate crystals in joint fluid, and/or:

Find the characteristic urate crystal in the tophi nodules by chemical methods or polarized microscopes, and / or:

There are 6 of the 12 clinical, tests and X-ray manifestations:

Maximum inflammation in one day

There is more than one acute arthritis.

Arthritis at an joint

Red joints

Swelling, joint pain to toe I

Deunar arthritis on one side

Ankill arthritis on one side

visible tophi notes

hyperuricemia (male ≥ 420 mmol/l, female ≥ 360 mmol/l)

Swelling painful joint pain

Follicles under the bone shell, no bone shape on X-ray

Negative bacteria culture

Gout (gout)'s disease treatments

Gout treatment principles

Treatment of arthritis in acute gout.

Preventive recurrence of gout, Urate deposited preventive prevention in tissues and prevent complications through the treatment of blood uric acid syndrome with the target mmol/l (60 mg/l) with gout without tophi and less than 320 mmol/l (50 mg/l) with gout with tophi nodules.

specific treatment

diet - living for people with gout:

Avoid substances with many purines such as animal, meat, fish, shrimp, crabs, ... can eat eggs and fruits. Eat meat no more than 150 grams per day.

Do not drink alcohol, need weight loss, exercise regularly.

Drink plenty of water, about 2-4 liters of water a day

Avoid drugs that increase blood uric acid, avoid factors that onset acute gout such as stress, injury, ...

Medical treatment

Anti -inflammatory drugs: used in acute gout to reduce inflammation

Blood uric acid reduces: used in the chronic phase to avoid recurrence of acute gout

Surgical treatment:

Tophi removal surgery is indicated in the case:

Gout with ulcerative complications

Tophi superinfection

large size tophi, affecting movement or for aesthetic reasons

When surgery is required to use Colchicin to avoid the onset of acute gout and combine blood uric acid lowering.

See also:

Learn about gout

gout - Symptoms, treatment and how to prevent

Who can't eat crabs?

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