Health Fitness

Gout: a disease of indulgence

Gout develops when the level of uric acid in the blood is too high. In the past it was known as Patrician’s disease because it was considered a disease of over-indulgence among the wealthy. High purine diet can affect taste and red meat is high in purines. The rich ate red meat while the poor could only buy grain.

Gout is effectively a male disease up to the age of 50. It starts around the age of 30 and peaks between the ages of 40 and 50. It is rare in premenopausal women. Hippocrates wrote about gout as a disease of men and postmenopausal women and urate crystals were found in the big toe of an Egyptian mummy.

Taste can be classified into primary and secondary. In primary taste, the body produces too much uric acid or cannot effectively excrete it to maintain a normal blood level. These patients benefit significantly from dietary changes. Secondary taste develops as a result of other factors. Some medical conditions can raise the level of uric acid and trigger gout. These include kidney disease and myeloproliferative disorders. In leukemia, the imbalance is due to excessive uric acid production, and in kidney disease, uric acid excretion is impeded. Medications can affect uric acid levels in the blood. These include diuretics, especially thiazide diuretics, aspirin, and cytotoxic drugs. Gout is also linked to obesity and alcohol.

The sharp taste usually develops at night. 70-90% of acute gout develops in the big toe and usually affects the first metatarsophalangeal joint. This is called podagra. Within hours, the pain becomes severe and throbbing. The big toe swells and may feel hot. It is extremely painful to the touch and even the touch of the bed cover can cause excruciating pain. The acute episode resolves on its own but may take more than a week. Medicines can shorten this time.

Since the introduction in 1951 of probenacid and allopurinol in 1963, chronic gout is rare, apart from noncompliant patients. Before these medications were introduced, chronic gout caused great distress among patients. The acute taste was frequent and severe. In addition, urate crystals separated in other joints, kidneys, and other organs, leading to polyarthritis, kidney stones, heart disease, and tophi.

Diet and weight loss play an important role in taste control. A low intake of purines can reduce the level of urate in the blood by up to 20%. Foods high in purines include meat, especially liver and other organ meats, hot dogs and other processed meats, shellfish, milk, eggs, and certain beans. Alcohol increases the possibility of taste. Beer is the worst culprit. Contains guanosine. This chemical is converted by the intestinal flora into uric acid.

Today, with exams and tests done for insurance purposes, we are seeing a group of people with high uric acid with no signs of gout. These people need to be monitored. Once all potential factors that can influence gout are eliminated or reduced and diet and weight loss are established, if the uric acid level remains high, maintenance therapy in the form of allopurinol is recommended to maintain uric acid. blood uric acid level within normal range. This prevents urate crystals from breaking up in important parts of the body.

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