Tet season, beware of gout

Many people will be surprised, what does gout have to do with Tet, does Tet cause gout? In fact, although these days do not cause gout, this is a miserable season for gout patients who have, are, and have not yet discovered the disease.

In the days leading up to Tet, people are busy preparing for Tet and also take the time to attend year-end parties and welcome the new year. Among those who attend lavish parties with beer, wine and all kinds of snacks, there will be people who suddenly feel severe pain and swelling in their big toes, ankles or knees that night or the next day. Go to the doctor, the doctor will explain that it is due to gout.

What is gout?

Gout (goutte in French) is a group of diseases that deposit crystals, specifically monosodium urate crystals in the joints due to high uric acid in the blood... causing peripheral arthritis of the limbs, especially in the big toe. This inflammation is caused by white blood cells - likened to soldiers in the body - when they clean up urate crystals. Acute gout can last for several days or weeks and can subside on its own, but if left untreated, it will appear more often, causing deformity and destruction of the joints, leading to disability. Increased uric acid in the blood is due to the kidneys not being able to excrete it or the body producing too much (due to diet, due to diseases such as lymphoma, hemolytic anemia, psoriasis...) or due to abnormalities in the cycle of creating this acid.

Gout diagnosis method

The clinical presentation of acute gout is quite characteristic and can usually be diagnosed by history taking and examination of the patient, typically inflammation of the metatarsophalangeal joint - big toe with high blood uric acid levels. The clinical diagnosis is reasonably accurate but not sufficient to make a decision, unless uric acid crystals can be demonstrated. High blood uric acid, although valuable in diagnosis, is not specific.

Blood uric acid levels are usually high > 7mg/dL. Although not all people with uric acid in the blood have gout, the higher the uric acid level in the blood and the longer it lasts, the more likely they are to have gout. Some patients have normal uric acid test results (because they may have taken medication before) but their knees are still swollen and when knee arthroscopy is performed, uric acid crystals are found to be deposited inside the joint, causing inflammation of the knee synovial membrane.

The best way to confirm the diagnosis of gout is to aspirate fluid from the affected joint and examine it under a microscope to see the needle-shaped monosodium urate crystals or tophi. However, in practice, this method is only really performed when necessary.

In addition: Gram stain and culture of joint fluid because gout is often associated with infection. X-ray of the joint shows fibrotic lesions under the cartilage or tophi in the late stages. Test blood glucose and lipids, because gout is often associated with hyperglycemia and hyperlipidemia.

Disease progression

The disease often begins with acute gout. Acute gout is defined as arthritis with the deposition of urate crystals in the joints, leading to acute inflammation and eventually tissue damage that destroys the joints and causes disability. Acute gout can be pushed back with medication and diet. However, this is an incurable disease, the patient must abstain and monitor the disease for life. If left untreated or gout occurs repeatedly, it will cause joint destruction to disability, requiring joint reconstruction surgery.

Patients with acute gout attacks that are continuous or persistent, many years later will develop chronic gout with tophi. Tophi are often considered a late complication of gout. These are lumps found under the skin in joints, synovial sacs, cartilage, bones in many places in the body, formed by the deposition of urate crystals. Tophi can break out of the skin, with white or pale yellow-white blood.

Complications

About 20% of gout patients have kidney stones due to the deposition of urate crystals (which are a component of gout) as well as calcium crystals that cause stones. Stones can block the urinary tract, leading to urinary tract infections and can cause kidney failure, urinary tract infections ... affecting life.

For gout patients, on Tet holiday, you can raise your glass for fun, but should not drink too much beer or alcohol.

For gout patients, on Tet holiday, you can raise your glass for fun, but should not drink too much beer or alcohol.

Decreased glomerular filtration rate. The severity of gout is also related to the rate of ischemic heart disease. Disability due to severe damage to joints.

Preventive treatment

Repel acute gout attacks and prevent gout attacks with drugs such as: colchicine (has pain-relieving and anti-inflammatory effects, used to treat and prevent acute gout attacks), allopurioid (inhibits the formation of uric acid), non-steroidal anti-inflammatory drugs, and other pain relievers.

Diet of foods with too much purine, such as: meat, animal organs, some seafood, oatmeal, soybeans ...; can drink a little alcohol (at least 3 days of complete abstinence each week), avoid drinking strong dark beer; drink plenty of water and alkalize urine with sodium bicarbonate; quit smoking; exercise; lose weight.

Monitor uric acid levels regularly. However, do not abstain excessively because medications can be used to speed up uric acid excretion.

Arthroscopic surgery has the role of cleaning the joint, cutting the synovial membrane of the joint when it is repeatedly inflamed, causing thickening and limiting joint movement. When the joint is completely damaged, it can be replaced with an artificial joint.

According to Family.net