Gout: causes, symptoms, treatment, what foods should not be eaten?

Gout Disease - Causes, Symptoms, Treatment, and Foods to Avoid

Gout is a group of symptoms that occur due to high levels of uric acid in the blood, accompanied by symptoms that result from the deposition of uric acid in the form of urate crystals in the joints or surrounding tissues of the joints.

This causes sudden inflammation of the joint or surrounding tissue, or the formation of urate crystal nodules within and beneath the skin surrounding the joint. If severe, it can lead to kidney stones.

Causes:

Gout is caused by the abnormal accumulation of uric acid in the body. Uric acid is derived from the breakdown of purines, which are dietary nutrients that the body synthesizes and are found in many types of food. Normally, the body breaks down purines and converts them into uric acid. In normal individuals, the kidneys perform the task of excreting uric acid, preventing its accumulation in the body. However, when there is an excessive accumulation of uric acid, it can lead to severe pain in the bones and around the joints.

In men, uric acid levels should not exceed 8 milligrams per deciliter, while in women, they should not exceed 6 milligrams per deciliter. This condition can be hereditary.

Symptoms:

Symptoms of gout include pain, swelling, redness, and heat, especially in the big toe joint, which is the most commonly affected joint. The pain may be intermittent or chronic and can occur in several joints.

Other joints that are commonly affected include the ankle, knee, wrist, fingers, and elbow. It is more common in men than women. In those who have had gout for a long time, kidney stones may develop.

Gout pain often occurs at night, and the pain increases gradually. Several factors such as alcohol consumption, obesity, high blood pressure, and certain medications can trigger gout attacks.

Food for Gout Patients

The food that gout patients consume can be divided into 3 groups according to the amount of purine in the food.

1. Foods with purine greater than 150 milligrams should be avoided or eliminated by gout patients.

These include: liver, boiled beef soup, broth, kidneys, extracts from concentrated meats, anchovies, fish sauce, shrimp paste, sardines, yeast, and fermented foods from yeast (such as beer), clams, tuna, some fish, chicken, duck, birds, and fish roe. Alcoholic beverages such as beer and liquor should also be avoided as they can cause elevated uric acid levels.

2. Foods with moderate purine content (50-150 milligrams) can be consumed in limited quantities by gout patients.

These include: beef, tripe, pork, fish, crab, shrimp, clams, soy beans, black beans, red beans, green beans, vegetables, asparagus, spinach, mushrooms, cauliflower, and acacia leaves.

3. Foods with low or almost no purine content (0-50 milligrams) can be consumed by gout patients without restriction.

These include: rice, all types of rice noodles, vermicelli, egg noodles, sandwich bread, macaroni, corn, crackers, eggs, milk and milk products (butter, ice cream), vegetable oil, coconut milk, butter, lard, vegetables, all types of fruits, chestnuts, cashew nuts, various Thai and western sweets such as cakes and cookies, and beverages such as coffee, tea, cocoa, and chocolate.

Treatment for gout during an acute attack involves taking pain relievers like paracetamol or other pain medications. For joint inflammation, Colchicine 0.6 mg should be used until the pain subsides. If the patient experiences diarrhea, the medication should be stopped immediately. Anti-inflammatory medication should also be taken during this time.

During an attack, it is important to rest and drink plenty of water to prevent uric acid crystals from forming. Elevating the affected area and avoiding standing or walking is also recommended. It is important not to massage or put pressure on the affected joint.

For long-term management of gout, medication should be taken as prescribed by a doctor. Drinking plenty of water can also help prevent kidney stones and reduce the concentration of uric acid in urine. Avoiding alcohol is important as it can lead to the accumulation of uric acid in the body. It is also recommended to avoid animal-based foods that are high in purines, as purines are broken down into uric acid in the body.

Regular follow-up with a doctor is necessary to monitor the condition, and weight management is important for overall health.

Best wishes from the Department of Orthopedic Surgery