Do you know? Open the door┋If you don’t treat gout, you will go crazy

Contributors: Sai Mire Maimaiti Tuersun, a master's student in rheumatology and immunology at the First Clinical Medical College of Xinjiang Medical University; Sun Jiao, a resident physician in the Department of Rheumatology and Immunology at the First Affiliated Hospital of Xinjiang Medical University.

Review expert: Luo Li, chairman of the Clinical Immunology Branch of the Xinjiang Immunology Society, vice president of the Xinjiang Uygur Autonomous Region Immunology Society, director, professor and chief physician of the Department of Rheumatology and Immunology, the First Affiliated Hospital of Xinjiang Medical University.

New Year's Day is coming soon, and the Spring Festival is just around the corner. At this special moment, relatives and friends gather together, and the rich dishes on the table are undoubtedly the top priority. In the interweaving of laughter and language, we share the joy brought by food. When it comes to eating, chicken, duck, fish, spicy hot pot, abalone, sea cucumber, shark's fin, and fish maw are always indispensable on the table... In addition to making people gain weight, some people will unfortunately usher in a new experience - gout.

What is gout?

Gout is a crystal-related arthropathy caused by monosodium urate (MSU) deposition and is directly related to hyperuricemia caused by purine metabolism disorders and/or decreased uric acid excretion.

The prevalence of hyperuricemia in our country is as high as 13.3%, which means that one in 10 people suffers from hyperuricemia, and about one-third of them will develop gout. The male to female ratio of gout patients is as high as 15:11.

What are the causes of gout?

The culprit of gout - high uric acid!

Uric acid is a metabolic waste of the human body. Under normal circumstances, it will be excreted from the body with urine and feces, and those that have not been excreted from the body will remain in the blood. Regardless of gender, as long as the blood uric acid level exceeds 420μmol/L twice on different days, it is called hyperuricemia. When uric acid crystals in the blood are deposited in the synovium of the joints and cause synovial inflammation, gout will occur.

But it does not mean that high uric acid will definitely lead to gout. 5%-18.8% of hyperuricemia will develop into gout. In short, as long as the uric acid level in the blood exceeds the standard, it is hyperuricemia, and when patients with hyperuricemia experience joint swelling and pain, it is gout. High uric acid levels may not necessarily cause gout, but gout is definitely caused by high uric acid. How high the uric acid level is to cause gout varies from person to person. Some people will develop the disease when the blood uric acid level is 400-500, while others have no symptoms when it reaches 700-800.

What are the symptoms of gout?

In one word, it is pain. It is so painful that it is heart-wrenching and beyond words. Even a man of eight feet is tortured to tears, and a burly man keeps asking for excessive doses of painkillers. A gust of wind blowing through a joint will cause joint pain, so it is called gout. In summary, the characteristics of the acute stage of gout are: redness, swelling, heat, and pain in a single joint .

The first few attacks usually affect only one joint, last for a few days, and usually resolve on their own within 2 weeks. Commonly affected joints include the feet (especially the big toe joint), ankles, knees, wrists, etc. The joints will experience severe pain, redness, swelling, and may be accompanied by a localized sense of heat. However, if the condition worsens and is not actively treated after an attack, it will lead to more frequent attacks and may affect multiple joints.

Repeated attacks may lead to worsening of gout and chronic development, eventually leading to deformity of the affected joints. Finally, as urate crystals continue to accumulate around joints and tendons, causing damage, joint movement is gradually limited.

How to stay away from gout?

First of all, patients with hyperuricemia should insist on follow-up in specialist clinics. Whether drug intervention is needed requires doctors to make a comprehensive judgment based on blood uric acid levels, previous history of gout attacks, and whether there are underlying diseases such as hypertension, diabetes, and coronary heart disease.

In terms of daily life, pay attention to diet control, drink plenty of water, exercise, control weight, avoid strenuous exercise, catch cold, quit smoking, etc.

(1) Control your diet and drink more water : Uric acid comes from endogenous metabolism (accounting for 80%) and exogenous uric acid (accounting for 20%). Controlling your diet can reduce uric acid by 10%-18%, which can reduce acute attacks of gout. Therefore, gout treatment requires controlling your diet. Do not eat high-purine foods, such as animal offal, deep-sea fish, sugary and alcoholic beverages, such as pork liver, tuna, and cola. Also avoid insufficient water in the human body. If the body is dehydrated, urination will naturally be less, so there is no way for uric acid to go out! If you want to help uric acid escape, drink more water to promote the excretion of uric acid.

(2) Daily life : Maintain a regular work and rest schedule, avoid staying up late, exercise appropriately for more than half an hour every day. Aerobic exercise should be chosen, such as brisk walking, jogging, Tai Chi, swimming, dancing, etc. Obese people should lose weight slowly and maintain a normal weight.

( 3) Keep your joints warm and avoid overheating : Gout likes to attack you at night and in cool weather, so keeping warm is very important. Excessive sweating can cause dehydration, which will naturally increase the concentration of uric acid in the blood. Once the uric acid level rises, gout will be awakened again.

Can gout be cured? Will it come back?

Gout is a lifelong disease that cannot be completely cured, but the blood uric acid level can be controlled to avoid gout attacks. If the disease is actively treated after it is discovered, and through standardized medical treatment and lifestyle adjustments, a low-purine diet is usually taken, and the weight is kept within a healthy and stable range, most gout patients can gradually return to normal life, and the probability of recurrence is relatively low.

The recurrence of gout is related to the fluctuation of uric acid levels. If patients do not pay attention to developing good living habits when gout is clinically cured, such as overeating, staying up late for a long time, being obese or overweight, it is easy to cause repeated attacks of gout and even cause gout stones, joint deformities, and uric acid kidney stones.

Finally, we would like to warn all gout patients to change their unhealthy lifestyles. High uric acid and gout are preventable and treatable, so don’t let it become a lifelong disease.

References

1. Huang Yefei, Yang Kehu, Chen Shuhong, et al. Practice guidelines for patients with hyperuricemia/gout[J]. Chinese Journal of Internal Medicine, 2020, 59(7):9.

The pictures are from the Internet. If there is any infringement, please contact us and we will delete them in time.