Among many rheumatisms, gout is actually a relatively simple one. The cause is clear, the pathology is simple, and the treatment is easy... Some people will definitely refute that if gout is so simple, why are so many patients suffering from gout? So far, gout is indeed not curable, but it is not difficult to prevent acute attacks and control the development of the disease. The main reasons why many patients are still out of control are the following reasons!
The cause is clear, but many people are wrong in their understanding!
The basis of gout is high uric acid. The uric acid concentration in the blood is too high, exceeding its saturated solubility , and crystals are precipitated. The crystals flow with the blood and are deposited in joints, kidneys, etc., resulting in gout arthritis , uric acid kidney disease , etc. This is gout! What we often call gout mainly refers to gout arthritis.
According to the causes of high uric acid, gout is divided into three types, namely:
- -generated type - due to external factors such as diet, uric acid production increases, accounting for about 10%;
- excretion reduction type - due to kidney excretion uric acid dysfunction, resulting in a decrease in uric acid excretion; accounting for about 60%;
- mixed type - has both the above two conditions;
Like primary hyperuricemia (caused by non-drug or other diseases, etc.), uric acid production increases, the main clear reason is abnormal hereditary purine metabolic enzymes; reduced uric acid excretion, the main clear reason is polygenic hereditary disease . Many gout patients wonder: I am obviously thinner and lighter than others, so why do I have a higher uric acid but not others? Because of heredity, some things are destined by heaven!
Many patients believe that gout is eaten, which is a one-sided understanding of !
Indeed, long-term intake of a high-purine diet can increase blood uric acid levels. If it is accompanied by reduced uric acid excretion, it may lead to a significant increase in blood uric acid levels and even cause acute attacks of gout, which is secondary gout. However, this exogenous purine intake only accounts for a small part of the causes of high uric acid, and those who develop high uric acid into gout only account for a small number of people with high uric acid (about 11%). Therefore, it is unreasonable to prevent and treat gout by controlling diet!
Some people also say that gout is a kidney problem, just replenish the kidneys. Is this right?
is not right. The kidney function of patients with hyperuricemia is actually normal, and there is no organic renal disease. It is just a problem with uric acid excretion. If uric acid excretion is not treated for treatment, blindly taking some kidney-tonifying measures will have no effect on the condition. What's more, eating pork waist and sheep waist to " to replenish shape " not only does not work, but animal viscera is a high-purine food. Eating too much will aggravate high uric acid and gout. The prevention and treatment of gout should actually be divided into two parts: one is the prevention and treatment of acute gout, and the other is the prevention and treatment of high uric acid. We will talk about it in detail in the third part.
The pathology is simple, but many people ignore the harm!
When the blood uric acid level remains high for a long time, the urate concentration in the blood is higher than the saturated solubility, urate crystals will be precipitated. In addition to freeing in the blood, crystals will also deposit at the site where the blood flows through. Theoretically, in patients with hyperuricemia, urate crystals can be deposited in most parts of the blood flowing through, and the joints are the first to be affected! The chances of urate deposition in each joint are different. Generally, the more the distal joint, the slower the blood flow rate and the lower the temperature, the easier it is for the joints that meet these conditions to precipitate crystals and deposition occurs. Therefore, about 70% of the first joints of gout are the first metatarsophalal joint, that is, the big toe!
Some people think that gout is foot pain, which is incorrect. Because as the uric acid level remains high for a long time, the incidence of gout will increase. In addition to the toes, insteps, heels, ankles, knee joints, fingers, elbows, etc. are all areas that are prone to involvement.
What makes gout scared patients the most is that they are in pain during an attack.Urate crystals deposited in joints cause certain chemical and physical stimulation to the joints, synovial membranes, and joint cavity under the influence of factors such as overeating, joint cold, involvement, soft tissue damage, alcoholism, excessive exercise, staying up late, and decreased immunity. This causes certain chemical and physical stimulation to the joints, synovial membranes, and joint cavity, leading to the onset of acute synovitis. This is gout!
Acute gout usually occurs suddenly in the middle of the night, and the joints suddenly become red, swollen, hot, and painful, and the pain is severe, resulting in joint limitations. In severe cases, even the pain is so painful that it is rolling around and unable to sleep all night!
Because acute gout left a deep impression on patients, pain has become the biggest "business card" of gout, so many people mistakenly believe that gout is just joint pain !
In fact, pain is not the most serious harm of gout. As the urate level continues to rise, gout recursive attacks, joint structure damage, gout stone and gout kidney disease are the greater harm of gout!
Gout recurs, and the joints are damaged by acute synovitis again and again, which will cause damage to the cartilage in the joints. Each time the injury occurs, it will aggravate one point, which will promote the degeneration of the joints. Osteoarthritis may be combined over time.
Gout stone is a product of the long-lasting unhealthy high uric acid, but when the uric acid level in gout patients exceeds 540 micromolars per liter, the chance of gout stone appears greatly. After the appearance of gout stone, it marks the increasing difficulty of reducing uric acid, and gout enters a refractory stage. If the gout stones around the joints continue to grow and harden, they may cause a devastating blow to the joint structure. The skin on the gout stone is prone to friction and ulceration. Once ulcerated, the wound will not heal easily, which may cause infection and even lead to sepsis.
In addition to joints, the kidneys are also a part of the easily deposited urate crystals, because the kidneys are the main way to excrete uric acid. If uric acid is high for a long time, there will be more uric acid gathering in the kidneys. Over time, it will naturally be easy to damage the kidneys. For gout patients with more than ten years of illness, there may be more or less certain renal damage. Especially for gout patients, renal function should be monitored regularly to avoid renal insufficiency due to high uric acid, or even uremia !
Gout stones in the foot of patients
are easy to treat, but many people are not standardized in the treatment!
The treatment of gout is actually very simple. Control high uric acid, cut off the supply of "gout", protect the joints, and do not give gout the chance to "declare war".
We talk about preventing acute attacks and controlling high uric acid.
01 / Prevent acute gout
- Control diet - Avoid overeating, such as eating large amounts of animal offal and seafood, drinking large amounts of alcohol, drinking large amounts of high fructose beverages, etc., which leads to a sudden increase in blood uric acid levels, rapid deposition of urate crystals, and inducing gout.
- Reasonable exercise - Appropriate moderate- and low-intensity aerobic exercise, combined with adequate drinking water, can promote uric acid excretion, but if you engage in vigorous anaerobic exercise , the effect will be opposite, which will lead to an increase in uric acid levels and increase the risk of gout attack. In addition, strenuous exercise or excessive exercise can lead to local joint damage or cumulative strain, and can also induce gout.
- Avoid cold - When the joints catch cold, the local temperature of the joints drops, which will increase the deposition of urate crystals, thereby inducing gout!
- Avoid fatigue - Long-term fatigue and high psychological pressure can also lead to acute attacks of gout. Therefore, friends with gout cannot just eat and move, but should also pay attention to rest, work and rest reasonably, sleep enough, and relax physically and mentally, which can help prevent diseases.
02 / Control high uric acid
First of all, life management is recommended. Clinically, patients with more severe gout arthritis often have one thing in common, which is that their life management is weak. There are many reasons, such as ignoring the harm of gout, being unwilling to avoid eating, not insisting on exercising, and thinking that taking medicine does not require eating...
Simple life management may not help gout patients control their condition, but not doing life management may push gout patients into the abyss of worsening their condition.I believe you understand the reason!
is a cliché. Let’s briefly list several aspects of life management:
- restricts purine intake —mainly targets high-purine foods such as animal offal, seafood, and thick broth;
- restricts alcohol intake —mainly targets beer and white wine ( strong liquor );
- restricts purine intake —mainly targets beer and white wine ( strong liquor );
- restricts purity intake fructose intake —mainly for sweet drinks, ice cream, cakes, etc.;
- exercise reasonably —persist in moderate and low intensity aerobic exercise for about 40 minutes every day;
- drink more water —it is recommended to drink no less than 2000ml of water every day, which increases as appropriate due to the weather or exercise and sweating, and the elderly patients or those with renal insufficiency may reduce it as appropriate.
For gout patients with recurrent gout attacks, high high uric acid, gout stones, and other metabolic diseases such as three highs, and are not uric acid kidney disease, drugs lower uric acid is the main force!
The treatment of uric acid-lowering drugs is actually simpler. There are currently three mainstream drugs:
- allopurinol - Inhibiting uric acid production
- febusterta - Inhibiting uric acid production
- benzbromalone - Promoting uric acid excretion
In addition, it may be necessary to use the drug that alkalinizes urine sodium bicarbonate . These drugs have their own indications. They should be evaluated and used in combination with the specific gout type and their own health status of the patient. Use the drug under the guidance of a regular hospital doctor. Just don't use the drug blindly by yourself.
For patients with uricidal kidney disease, kidney protection treatment should be received. For patients with gout stones, if the stone causes structural damage to the joints, minimally invasive or open gout stone surgery should be used to protect the joints and help control uric acid.
You see, is the treatment of gout very simple? Finally, let’s talk about the clinical cure of gout .
As mentioned in the previous article, gout cannot be cured at present, so we don’t have to worry about the word “ratiotherapy”. If you protect your joints and control uric acid to meet the standards, you can achieve long-term gout without attacks. You may have to be more bland when taking it, but in terms of health, gout patients are not much different from normal people!
If gout patients are combined with gout stone and gout kidney disease, control blood uric acid to 300 micromoles html below 10 per liter. If there are no comorbidities, control blood uric acid to 360 micromoles html below 10 per liter, and keep it for a long time. After the urate crystals in the joints dissolve completely, you can slowly try to reduce the medication and stop the medication. In this state, the probability of acute gout attacks and gout stones will be greatly reduced.
In short, when dealing with gout, you do not ignore or be afraid, change your living habits, and insist on standardized treatment, and it is not difficult to live a normal life!
