What are the main causes of gout? What can be done to prevent gout

After suffering from gout, the main physiological change is hyperuricemia, which is mainly due to abnormal changes in the level of uric acid in the body, which causes metabolic problems in the body, and gout can be divided into two categories, one is also Yuan Faxiang ventilation, and the other is secondary gout, so, what is the main cause of gout? What can be done to prevent gout.

1. Etiology and prevention of gout

How does gout come out mostly by "eating".

Mr. Zhang likes to eat by nature, and later his position was promoted, and there were more opportunities for socializing. Big fish, big meat, raw seafood, almost every other day, someone invited, and within a few years, joint pain appeared. Later, the joint pain was so unbearable that I had to go to the hospital. The doctor said that the pain in this joint was indeed related to gluttony. It is no wonder that Mr. Zhang found that the sudden onset of joint pain occurred several times on the night after the banquet. The doctor told him it was called gouty arthritis. Gout is the second most common metabolic disease in human beings after diabetes, and the incidence rate is increasing year by year, especially among young and middle-aged men.

Hot pot beer is the most easily induced

In China, gout has been considered relatively rare in the past, experts recall that in the 80s of the last century, there were only one or two gout patients a year in the outpatient clinic, but in recent years, on the one hand, due to the improvement of medical conditions and the improvement of medical personnel's understanding of gout, gout that has been missed or misdiagnosed as rheumatoid arthritis, rheumatoid arthritis, erysipelas, etc. can be diagnosed in time; On the other hand, with the improvement of people's living standards, the dietary structure has also changed greatly, and the high-purine diet, coupled with the lack of necessary physical exercise and overweight of some people, has made the incidence of gout rise sharply. Clinically, young gout patients in their twenties and thirties also appear repeatedly.

Diet is the main source of exogenous purines and uric acid in patients with gout, and uric acid is mainly broken down from nucleotides in the diet, accounting for about 20% of the total uric acid in the body.

Men take aphrodisiacs every day, causing frequent attacks of gout

A 41-year-old man who had been suffering from gout attacks for nearly half a year later found that every time he took aphrodisiacs, gout attacks would occur the next day, which was confirmed by the hospital to be a rare case of "aphrodisiac induced gout".

Experts pointed out that the man had no family genetic diseases and no problems with blood tests, and he had to go to the outpatient clinic for gout treatment almost every month for half a year, until one day he himself found that every time he took aphrodisiacs, the next day, his right big toe would be red, hot, swollen and painful.

Experts say that there are many reasons for acute gout attacks, hyperuricemia is the main cause, in addition to the goplin diet, drugs may also be one of the causes, and the chance of taking aphrodisiacs to cause gout is less than 2%. As soon as the man stopped taking the drug, the gout did not recur.

Aphrodisiac is a drug developed in the last 20 years, experts say that the cause of aphrodisiac gout is unknown, it should be a patient with gout or hyperuricemia, the probability of sequelae caused by taking aphrodisiac will be relatively high, it is recommended to stop the drug or change the dressing to slow down the inducing rate.

There are foods that gout patients should not eat

1. Animal internal organs: such as pancreas, liver, kidney, bone marrow, and large intestine (high in purines). Vegetables: soy products, beans, shiitake mushrooms, spinach, etc.;

Reminder: Because spinach and other plants are rich in oxalic acid, it is easy to cause high oxalic acid to increase exponentially, which makes uric acid increase sharply and increases the burden on the kidneys.

2. Seafood, shellfish, etc.

Reminder: Lobster, crab, oysters and other seafood, shellfish aquatic products, high purines, can increase uric acid, so it is not advisable to eat more.

In addition, it is especially important to remind the public to pay attention to the fact that eating hot pot and drinking beer is the most likely to induce gout! This is because the raw materials of hot pot are mainly animal offal, shrimp, shellfish, seafood, and drinking beer, which naturally adds fuel to the fire. addget angryThe soup in the pot is boiled repeatedly, and the purine content in it will be higher.

Surveys have proved that the intake of purines in a hot pot is 10 times or even dozens of times higher than that of a meal. The ethanol contained in the wine can increase the concentration of lactate in the blood, which can inhibit the secretion of uric acid in the renal tubules, which can reduce the excretion of uric acid. A bottle of beer can double the level of uric acid.

Obesity and three highs are easy to cause gout

Studies have found that the average weight of patients with gout exceeds the standard body weight, and the larger the surface area of the person, the higher the serum uric acid level. Blood uric acid levels can decrease when obese people lose weight. This suggests that chronic excessive intake and overweight are associated with persistently elevated serum uric acid levels.

Hyperuricemia is recognized as a risk factor for hypertension, and patients with hyperuricemia are susceptible to hypertension, with gout occurring in 12%-20% of patients with hypertension. About 25% to 50% of people with gout have high blood pressure.

Gout how painful is the swelling and pain of the lateral joint of the big toe

What exactly is gout? According to experts, gout is a metabolic disorder caused by high uric acid in the blood. Purine nucleotides in the normal human body are metabolized and finally broken down into uric acid, which is excreted from the body in the urine. Under normal conditions, the synthesis and decomposition of purines are relatively stable, so that the concentration of uric acid in the blood is maintained at 2%-6%. If the purine is decomposed too much and uric acid is formed too much, or due to kidney disease, uric acid is excreted too little in the urine, and the concentration of uric acid in the blood rises to more than 8%, it is called hyperuricemia, and persistent hyperuricemia often causes various symptoms of gout.

Why does high uric acid in the blood cause joint pain? This is because excess uric acid is deposited in the joints and surrounding tissues as urate crystals, causing localized leukocytosis, which engulf the precipitate as a foreign substance. The white blood cells that have engulfed urate quickly die and disintegrate, and release substances that damage the joint tissue, causing inflammation such as joint pain and fever.

Patients with acute arthritis often develop suddenly, wake up in the middle of the night, and may be accompanied by chills and fever. The first part is often the big toe of the foot, the joint is red and swollen, burning and swollen, can not cover the quilt, the foot is stretched out, if there is a slight wind blowing or a little touch, move the toe, immediately pain like a drill. But it will disappear automatically within a few days or weeks, and this phenomenon of "coming and going like the wind" is called "self-limiting". After a pain, it seems that the inflammation of the joints has disappeared, and like normal people, in fact, the crystals of uric acid have not disappeared, and they continue to play tricks, and gradually the joints become swollen and stiff, and the flexion and extension are not favorable.

Generally speaking, such an attack of acute gouty arthritis is a prominent symptom in the early stage of gout, and in the middle of gout, due to the repeated attacks of acute arthritis caused by joint damage, the joints appear to varying degrees of bone destruction and dysfunction, forming chronic gouty arthritis, and slowly forming a "tophi" like a stone, and may also form gouty nephropathykidney stone。 In the late stage of gout, significant joint deformities and dysfunction appear, and kidney function will also be significantly reduced, and even may appearuremia。

How to prevent gout, manage your mouth well, drink plenty of water

Gout, like diabetes, is a lifelong disease, but modern treatments can enable most patients to lead a normal life if diagnosed early and treated as prescribed. Treatment of gout is mainly to reduce flare-ups by controlling a high-purine diet. Avoid eating high-purine foods and consuming excessive alcoholic beverages as much as possible. When you start to feel a little uncomfortable in your joints, you should see a doctor and have a check-up right away, don't wait until it's too late.

First, it is still necessary to control the diet, control foods high in purines, and reduce the number of acute attacks of arthritis. Try to eat less mixed foods such as meat, seafood and vegetables in hot pot, because purines have high hydrophilicity, the soup contains very high purines, and should be eaten less. Strictly avoid alcohol, especially alcohol.

Second, drugs that affect uric acid excretion, such as penicillin, tetracycline, diuretics, vitamin B1 and vitamin B2, are prohibited or reduced.

Third, it can be seen clinically that the onset of gouty arthritis is often related to long-distance walking, joint sprain, discomfort in wearing shoes and excessive exercise, which may be related to urate shedding after local tissue injury. Therefore, patients with gout should pay attention to the combination of work and rest, avoid fatigue, mental stress, infection, surgery, wear comfortable shoes, and avoid joint damage. People with gout are generally not encouraged to participate in strong sports such as running or go on long walks and trips.

Fourth, patients with gout should ensure regular daily life and rest, so that the three meals are fixed and the exercise time is fixed. Generally, exercise is set half to an hour after a meal, when the diet is gradually absorbed, blood uric acid has begun to rise, exercise is conducive to the utilization of blood uric acid, help reduce postprandial hyperglycemia.

Fifth, develop a good habit of drinking more water. Insist on drinking a certain amount of water every day, generally about 2000 to 3000 ml per day.

Sixth, control weight, gout patients should control their weight, the total daily calories should be reduced by 10%~15% compared with normal people, do not eat too many snacks, and do not eat too much and too full at each meal. However, the heat should be gradually reduced, and excessive weight loss can cause ketoacidosis, which can precipitate an acute attack of gout.

2. Dietary advice for gout patients

1. Control total energy and maintain an appropriate weight

Patients with central obesity are more susceptible to hyperuricemia and gout. If a man's body weight is reduced by 10%, the blood uric acid can be reduced by 19.6mmol/L, but it is also necessary to avoid losing weight too quickly, and obese patients should lose weight gradually to avoid sudden weight loss. Otherwise, the rapid reduction of energy and excessive hunger will easily cause the increase of ketone bodies in the body, increase the production of ketone bodies, prevent the discharge of uric acid from the renal tubules, and promote the acute attack of gout.

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2. Reasonable dietary structure

The daily dietary nutrient structure is adjusted to: protein 10%-15%, fat less than 25%, carbohydrate 50%-60%. Appropriately limit carbohydrates, appropriately increase the intake of unsaturated fatty acids, improve the body's insulin sensitivity, and thus promote the excretion of uric acid. In addition, it is necessary to pay attention to the low-fat diet, the ratio of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids is about: 0.8:1.2:1 (normal people are 1:1:1), and you can choose milk, eggs and other high-quality proteins to make up for the lack of protein intake.

3. Avoid high-purine diets

Limit dietary purine intake to reduce exogenous uric acid production. In the acute phase of a gout attack, it is essential to choose low-purine foods with a purine intake of less than 150 mg per day. During acute attacks, it is advisable to choose milk, eggs, refined flour, vegetables, fruits, and plenty of water. Choose foods with medium and low purine content in the stable phase, and avoid foods with high purine content in both the acute and stable phases.

Red meat and seafood increase the risk of gout, so try not to choose shellfish and fish. Meat should be limited to 100g per day, and it is recommended to boil a small amount of lean meat and poultry meat and discard the soup. It is recommended to consume dairy products daily, preferably low-fat milk. People with gout should not drink yogurt. Eggs and plant protein can be selected as food protein sources.

4. Eat more alkaline foods based on fresh vegetables and fruits

Vegetables and fruits contain more potassium, sodium, calcium, magnesium and other elements, which can reduce the acidity of blood and urine, and can alkalinize urine, thereby increasing the solubility of urate in the urine and facilitating the excretion of uric acid.

Suitable vegetables and fruits are: winter melon, watermelon, diuretic effect, water spinach, cabbage purine value is low. It is not advisable to choose vegetables with high purine content in spinach, mushrooms, and asparagus. Note: Eat less bacteria and algae with high purine content, eat green leafy vegetables after blanching, try not to eat pickles, and try to remove the beans in the beans before eating.

5. Adequate water intake

Patients with gout with normal renal function should drink 2000-3000ml of water per day. Drink a small amount of water several times, about 200ml each time, 10-15 glasses of water per day. Hydrate before going to bed and at night to avoid concentrated urine. Mainly boiled water, mineral water, and weak tea, encourage the consumption of soda, and limit the intake of sweet drinks. If you have a habit of drinking coffee, you can stick to a cup of black coffee before noon every day, but you should avoid the sugar and trans fatty acids that you consume at the same time as coffee.

6. Abstain from alcohol

Beer has the strongest correlation with gout, and the guanine nucleoside content is high, which is most easily absorbed by the human body. Isohtritone, a special ingredient in hops, may have an effect on uric acid metabolism. Although red wine does not increase the risk of gout, it may be related to the fact that unknown ingredients in it cancel out the effects of alcohol and purines.

7. Avoid irritating condiments

The sodium in salt will promote the precipitation of uric acid, and gout patients are often accompanied by high blood pressure, so salt should be limited. Irritating condiments such as chili, pepper, mustard, and ginger should be used with caution, because they will excite the autonomic nerves and induce an acute attack of gout. Minimize fructose intake: e.g. honey (fructose increases the breakdown of adenine nucleotides and accelerates the synthesis of uric acid). In addition, sucrose and beet sugar will produce fructose after decomposition, so they should also be eaten sparingly. Essence of chicken and some umami soy sauce contain nucleotides and are best not eaten.

8. Exercise appropriately

Patients with gout are suitable for aerobic exercises such as walking, swimming, aerobics, and tai chi, and should avoid intense anaerobic exercise, because lactic acid will be produced and ATP decomposition will be accelerated.

9. Appropriate supplementation of vitamins and minerals

Nutrient supplements with various vitamins and minerals can be appropriately supplemented to supplement the loss of animal foods due to restriction. It is particularly important to supplement with B vitamins and vitamin C, B1, B12, and niacin can reduce uric acid excretion, and vitamin C can promote urate dissolution. Note: Vitamin C supplementation is required when taking anti-inflammatory and analgesic drugs and hormone drugs, and high doses of vitamin C should be avoided when taking colchicine.