Gout, a major disease for the elderly

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Gout is a disease that has been part of our history for a long time. In 2640 BC, the Egyptians defined a disease that showed acute inflammation of the big toe joint as ‘Podagra’. Later, the Greek physician Hippocrates called this disease ‘The Unwalkable Disease’, which has symptoms that are consistent with gout today.

In ancient times, gout was called the Disease of Kings or the Arthritis of the Rich because it was a disease caused by eating too much food and drinking too much alcohol, which were the lifestyles of the rich. Therefore, there was a trend for men in the past to eat and drink to make themselves get gout.

The word gout comes from the Latin word ‘gutta’ which means ‘to flow down or drip’, referring to the phlegm that flows down and accumulates in the joints, โปรโมชั่นพิเศษจาก UFABET สมัครตอนนี้ รับโบนัสทันที causing pain and inflammation in various joints throughout the body.

What is gout?

Gout is more common in men than women. It is caused by the accumulation of uric acid in various joints of the body, especially joints with a low temperature of about 20 degrees Celsius, such as the joints of the fingers, ankles, and big toes (Metatarsophalangeal Joint). Some people may have high uric acid in the blood but do not show symptoms, which we call Asymptomatic Gout. When there is acute pain or Acute Gout Attack, there will be symptoms of arthritis, pain, swelling, redness, heat, and the pain may last for 3 to 10 days. If the patient does not receive treatment and the pain continues, it will lead to chronic gout, leading to the formation of tophi, which will rub and damage our joints.

When uric acid levels in the blood are high, uric acid precipitates around the joints, inducing inflammation and the formation of substances C3a and C5a, which can attract white blood cells to the area of ​​inflammation. This produces substances such as Interleukine-6 ​​and TNF-alpha, which cause more and more inflammation, destroying joints, tendons and cartilage.

Diagnosis of gout
  1. Aspiration of fluid in the joint or tophi to examine for uric acid crystals.
  2. There is pain, swelling, redness and heat in the joints.
  3. Measure blood uric acid levels (men have values ​​greater than 7 mg/dL and women have values ​​greater than 6 mg/dL).
Medical treatment by a specialist doctor

Drugs used for treatment are divided into two main groups.

  1. Anti-inflammatory drugs for joint pain include nonsteroidal anti-inflammatory drugs (NSAIDS), colchicine, and short-term corticosteroids.
  2. Drugs to prevent gout attacks. Important drugs that reduce uric acid production, such as Allopurinol (Xanthine Oxidase Inhibitors) and drugs that increase uric acid excretion through the kidneys (Probenecid), etc.
Causes of gout
  • Obesity: When the body has an increased amount of fat, it results in increased uric acid production and decreased uric acid elimination by the kidneys.
  • Slow or less than normal uric acid elimination from the body due to kidney failure or taking certain medications, such as diuretics or aspirin.
  • Drinking alcoholic beverages increases uric acid levels in the blood. Research shows that drinking 1-2 alcoholic beverages per day increases the risk of having a gout attack by 36% and the chance increases by 51% when drinking 2-4 alcoholic beverages per day.
  • Eating foods high in purines, such as animal organs, seafood, shellfish, fish and some types of meat, or eating too much meat.
  • Beverages containing fructose, such as soda and fruit juices, can increase uric acid levels in the blood.
  • Chronic diseases such as diabetes, high blood pressure, kidney disease, thyroid disease, cancer, or patients receiving chemotherapy, which causes cell damage in the body.
  • Stress: Because increased stress hormones cause inflammation in the body and trigger gout.
  • Genetic history, such as relatives having a history of gout, results in abnormalities in the formation and excretion of uric acid. Currently, research has found that gout can be detected from genetic codes, such as the SLC2A9, ABCG2, FAM35A genes, etc.
How to reduce uric acid levels in the blood
  • Maintain a healthy weight and maintain body fat mass within the normal range, with men having less than 28% and women having less than 32%.
  • Drink enough water, at least 2 liters, to help the body excrete uric acid through urine.
  • Avoid foods that increase uric acid levels, including:
    • All types of alcoholic beverages, especially beer
    • All types of animal organs, veal, venison, pheasant, turkey, bacon.
    • Fish and seafood include sardines, anchovies, mackerel, herring, tuna, salmon, trout, shellfish, etc.
    • Foods and beverages high in fructose, such as sweetened water, fruit juice, and honey.
  • Choose to eat low-fat meat in the right amount because eating too much meat can cause high uric acid levels in the blood.
  • Eat low-sugar fruits and vegetables. Research shows that eating vegetables high in purines does not increase the risk of gout. Eating fruits and vegetables also helps reduce inflammation in the body.