Characteristics of Gout Disease

Myth circulating in society now mean that the joint pain of gout. This understanding needs to be clarified because not all complaints of joint pain caused by uric acid. Misconception is exacerbated by advertising herbal / traditional medicine.

Rheumatic diseases of many kinds. Not all complaints of joint pain or swollen joints that mean uric acid. To be sure to check the laboratory.

Exactly is meant by uric acid is the acid form crystals that are the end product of purine metabolism (derived form nucleoprotein), which is one component of the nucleic acid contained in the nucleus of body cells. Naturally, there purines in the body and found in all foods from living cells, i.e. from plant foods (vegetables, fruits, nuts) or animal (meat, organ meats, sardines).

So is the result of uric acid metabolism in the body, whose levels are not excessive. Everyone has uric acid in the body, as in any normal metabolism of uric acid is produced. While the triggers are foods and other compounds that contain lots of purines. Actually, the body's supply of purine compounds for 85 percent of daily needs. This means that the needs of the purine diet is only about 15 percent.

Unfortunately, this fact is still not widely known by the public. As a result, many people like to generalize all the food. People ate whatever he wanted, without considering the content in it. Food sources of animal products usually contain very high.Product purine-containing foods high in purines are less good for certain people, who have talent disorder of uric acid. If you eat these foods without any calculation, the amount of purines in the body can pass through the normal threshold.

Some foods and drinks that are known to increase uric acid levels are alcohol, hearing fish, eggs, and offal. Hearing or similar fish (sardines), and organ meats are a source of potential compounds. Belonging not only gut the innards, but all other parts contained in the stomachs of animals - such as liver, heart, tripe, and spleen.

CONSUMPTION innards aggravate the enzyme hypoxanthine for purine process. As a result many of the rest of uric acid in the blood, in the form of granules and accumulate around the joint so that creates a feeling very sick. Offal is one of the tempting dishes, including soup tripe, liver sauce, satay heart, spleen, and crackers. But one of its effects, if the body of excess purine compounds is the owner of the self-experienced pain in the joints.

Cause
Gout disease gout disease is classified into primary and secondary gout.

On primary gout disease, 99 percent of its cause is unknown (idiopathic). Is associated with a combination of genetic factors and hormonal factors that causes a metabolic disorder that can result in increased production of uric acid or it could be caused by the reduction in expenditure of uric acid from the body.

Secondary gout is caused partly because of the increased production of uric acid because of the nutrients, that eating foods with high purine levels. Purine bases are one of the organic compounds that make up nucleic acids (acid from the cell nucleus) and are included in the group of amino acids, protein-forming elements.

Increased production of uric acid could also be due to diseases of the blood (bone marrow disease, polycythemia), drugs (alcohol, cancer drugs, vitamin B12). Other causes are obesity (overweight), skin diseases (psoriasis), high triglyceride levels. In people with diabetes is not well controlled levels usually found ketone bodies (a waste product of fat metabolism) are rising. Ketone bodies that rise will also cause elevated uric acid.

Anyone can get gout. Therefore, we need to be aware of the symptoms.

Arthritis due to increased blood levels of uric acid or gout arthritis called arthritis arthritis. Acute gouty arthritis is caused by inflammation of the tissue reaction to the formation of urate crystals. In the most cases of gout history of the disease and the clinical picture is specific, so sometimes the diagnosis can be directly enforced.
Someone said to suffer from uric acid (gout) if the conditions meet several requirements and typically very classical course of their illness, such as having the typical symptoms of gout, have a typical course of the disease gout, uric acid found in high levels in their blood, and the results of microscopic examination of joint fluid or tofus (lumps of uric acid) found uric acid crystals in the form of needles.

More men

Generally, the uric acid is attacked by men, whereas in women the percentage is small and only appear after menopause.

Uric acid levels of men tend to increase with increasing age. In women, an increase that started since the time of menopause.

Why uric acid tends to be experienced men? This is because the female hormone estrogen which has helped the disposal of uric acid through urine. While in men, uric acid is higher than women because they do not have the hormone estrogen.

So for a woman to have hormone estrogen, then the controlled disposal of uric acid involved. When it does not have estrogen, such as menopause, then the women exposed to uric acid.

If an increase in uric acid passes through the threshold can be tolerated, the question will arise first in the kidneys, joints, and urinary tract

Normal levels of

Uric acid in the laboratory examinations performed in two ways, enzymatic and Engineering Ordinary. Normal uric acid levels by an enzymatic test a maximum of 7 mg / dl. While the technique usually, the maximum normal value of 8 mg / dl. When the results showed uric acid levels exceed the normal standard, patients have hyperuricemia possible.

Normal uric acid levels in men and women differently. Normal uric acid levels in men ranged from 3.5 to 7 mg / dl and in women from 2.6 to 6 mg / dl. Above normal levels of uric acid called hyperuricemia.

The classical course of the disease usually begins with an attack or a person has had a history of high uric acid level checks above 7 mg / dl, and higher and higher.

If so, likely to be the greater of gout. Usually 25% of people who will be high uric acid gout. When uric acid levels but no symptoms of the joints is called the initial stage. On each person is different. There are many years did not appear at all the symptoms, but there are symptoms that appear in the age of 20, 30, or 40 years.

Clinical Overview

Emerged as an attack of gout arthritis joint inflammation that arises repeatedly.

Typical symptoms of arthritis, gout attack is acute attack usually is monoartikular (strike only one joint) with symptoms of swelling, redness, severe pain, heat and movement disorders of the affected joints that occur suddenly (acute), which reached a peak of less than 24 hours. The most frequent location of the first attack is the base of the big toe joint. Almost in all cases, the location of arthritis in peripheral joints and especially rare in the central joint.

The attack, which occurred suddenly meant a sudden. Because it could have happened, during the day until bedtime no complaints, but at midnight the patient suddenly woke up to extreme pain. If an attack comes, the patient will feel great pain even though his body was exposed to a blanket or even a breeze.

Course of the disease gout is very distinctive and has three stages. The first stage is called acute gouty arthritis stage. At this stage the patient will experience a typical arthritis attacks and attacks will disappear without treatment within 5-7 days. It is fast disappearing, it is often people with suspected leg sprain or an infection, so do not expect the disease to gout and no further investigation.

In fact, doctors sometimes do not treat patients with suspected gout disease. Because of this first attack and heal yourself short time, often the patient went to the sequence and timing recovery handyman thought it was because of the sequence / massage. In fact, without any treatment or sorted first attack of this will go away.

After the first attack, the patient will go on interkritikal gout. In this situation the patient is in good health for a certain period. The time period between a person and others is different. There is only one year, some are up to 10 years, but the average ranges from 1-2 years. The length of the period of this phase causes a person to forget that he had suffered an attack of gout or arthritis of the first attack first thought had nothing to do with gout.

The second phase called the stage of acute intermittent gout arthritis. After passing through interkritikal gout for years without symptoms, the patient will enter this phase, characterized by a typical attack of arthritis. Subsequently the patient will often come under attack (relapse) is the distance between one attack and subsequent attacks increasingly meeting and longer, attacks grew longer, and the number of joints affected more and more.

The third stage called the stage of chronic gouty arthritis bertofus. This stage occurs when the patient has suffered for 10 years or more. At this stage the lumps will occur around the inflamed joints are often referred to as tofus. This Tofus form hard lumps containing a powder like chalk deposits of monosodium urate crystals. Tofus this will cause damage to the joints and surrounding bone. Tofus on foot when the size is big and will lead many people unable to use the shoes again.

Risk Factors

Risk factors that cause the disease gout is diet, obesity, and ethnicity.

In the world, ethnic highest prevalence in the Maori in Australia. The prevalence of the disease Maori people is very high uric acid, while in Indonesia the highest prevalence in coastal population and the highest in the Manado-Minahasa as fish eating habits and alcohol consumption.

Alcohol causes the removal of uric acid through urine, so that part is reduced uric acid persisted in the blood. High fish consumption also lead to gout.

Intake into the body also affect the levels of uric acid in the blood. Foods that contain high purines converted into uric acid. Purines are particularly high in organ meats, seafood: shrimp, squid, mussels, crabs, fish.

IF according to the results of laboratory examination of uric acid levels are too high, we need to pay attention to food issues. Food and drinks are always consumed whether a precursor to uric acid. In obese people, uric acid is usually increased, while spending less. So for safety, people are usually advised to lose weight.
The most important thing to note is that high uric acid in the blood, without us knowing it will damage the organs, especially kidneys, because the filter will clog. Blockage of the kidney filter will affect the emergence of a kidney stone, or could eventually lead to kidney failure.

Uric acid is also a risk factor for coronary heart disease. Suspected of uric acid crystals will damage the endothelium (inner lining of blood vessels) coronary. Therefore, anyone that high uric acid levels should try to lower it so the damage does not spread to organs of the body.

Management
Management of gout arthritis:

* Relieves arthritis (with medication and rest the affected joint).
* Setting the body of uric acid (with diet and medication).


The main purpose of the treatment of gout arthritis are:

* Treating the acute attack is good and right
* Prevent repeated attacks of acute gouty arthritis
* To prevent severe joint abnormalities due to accumulation of urate crystals
* Prevent complications that can occur due to increased uric acid on the heart, kidneys and blood vessels.
* Prevent the formation of stones in the urinary tract.


The sooner someone gets treatment from an acute attack, the sooner recovery.
Treatment can be given anti-inflammatory drugs (antirheumatic) and uric acid-lowering drugs (drugs that speed up / increase spending through the urinary uric acid (probenecid) or drugs that decrease the production of uric acid (allopurinol)).

Diabetes management
In addition to offal, food rich in protein and fat is a source of purines. Yet despite high cholesterol and purines, the food is very useful for the body, especially for children at the age of growth. Cholesterol is essential for vitamin D precursor, the material forming the brain, nervous tissue, steroid hormones, salts and membrane sel. gallbladder that good health should not overeat. Meanwhile, for those who have been suffering from gout, you should limit yourself to things that could make things worse. For example, limiting foods high in purines and choose a low-purine.

Foods should be avoided is that many foods contain high purine. Classification of food based on the content of purines:

* Group A: Foods that contain high purine (150-800 mg/100 g food) is the liver, kidney, brain, heart, lung, other organ meats, shrimp, mussels, clams, sardines, herring, meat extracts (shredded, jerky), yeast (tape), alcohol and food in cans.

* Group B: Foods that contain purines moderate (50-150 mg/100 g food) is a fish that does not include class A, beef, shellfish, dried beans, cauliflower, spinach, asparagus, beans, mushrooms, cassava leaves, papaya leaves, kale.

* Group C: Foods that contain purines lighter (0-50 mg/100 g food) are cheese, milk, eggs, other vegetables, fruits.


Diabetes management should be done when the uric acid levels exceed 7 mg / dl by not consuming food and class A limit themselves to eat food group B. Also restrict ourselves to consume fat and are advised to drink plenty of water. If there is still a low-fat diet with symptoms of elevated blood uric acid, you should consult the nearest doctor for further treatment.

It is also worth noting, do not work too hard, responsive and regularly went to the doctor. Because of all suffering, usually disorders of uric acid will continue.