April 20 is World Gout Day, and this year is the 8th "Gout Awareness Day". Gout, as a lifelong disease, is bound to bring great suffering to patients. Therefore, on the occasion of World Gout Day, in order to let people know about the disease and its harm early, prevent and control it as soon as possible, and reduce the occurrence of complications. In this live broadcast, Yu Dongming, director of the Laoximen Street Community Health Service Center in Huangpu District, Shanghai, was invited to explain how to prevent and treat gout.
What is uric acid, hyperuricemia, gout?
Uric acid is the end product of purine metabolism, which is mainly produced by the decomposition of nucleic acids and other purine compounds decomposed by cell metabolism and purines in food by the action of enzymes.
The saturated concentration of uric acid at 37°C in the body is about 420 μmol/L (7 mg/dl), beyond which urate crystals are formed and deposited in a variety of tissues, including kidneys and joint synoviums, causing tissue damage. At present, hyperuricemia is defined as hyperuricemia > 420umol/L (7 mg/dl), and hyperuricemia can be divided into primary hyperuricemia and secondary hyperuricemia.
People with hyperuricemia have urate crystal deposits that lead to arthritis (gouty arthritis), uric acid nephropathy, and kidney stones called gout.
Which joints can gout damage?
It is often first presented in the first metatarsophalangeal joint or joints such as the ankle and knee. Onset is abrupt and peaks within 24 hours. The initial episode usually involves a single joint and resolves spontaneously over a few days to weeks, while recurrent episodes involve a gradual increase in the number of joints involved, prolonged duration of symptoms, and shortening intervals between arthritis attacks.
Does hyperuricemia equal gout?
Hyperuricemia usually does not progress to gout, but a small number of patients may present with symptoms such as acute arthritis, gout kidneys, and tophi that develop gout.
What is Tophi?
Tophi is a lump formed by urate crystals deposited in tissues, with a hard texture, often appearing in the first metatarsophalangeal joint, forearm extensor surface, knuckle joint, elbow joint and other parts. Tophi can be as small as a sesame seed or as large as an egg or larger, and when squeezed, it can burst or form a fistula, resulting in a discharge like white tofu residue.
Daily precautions for hyperuricemia/gout
1. Control the total calories in the diet and limit the intake of high-purine foods, such as animal offal, thick soup, hot pot, pig, beef, mutton and other red meat; scallops, river crabs, Jiwei shrimp, sardines, yellow croaker and other rivers and seafood; apples, oranges, longans, lychees, grapefruits, persimmons, pomegranates and other fruits with high fructose content; shiitake mushrooms, straw mushrooms, asparagus, seaweed, kelp and grain germ plants.
2. Drinking more than 2000ml of water every day is used to increase the excretion of uric acid, limit drinking alcohol and drink less or no sugary carbonated drinks, and you can appropriately drink alkaline sparkling water to alleviate the harm of uric acid to the body.
3. Be cautious with drugs that inhibit the excretion of uric acid, such as thiazide diuretics.
4. Avoid predisposing factors and actively treat related diseases. Blood uric acid levels should be closely monitored, especially during radiation therapy or chemotherapy.