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The word gout is no stranger to everyone
It is always with hot pot, barbecue,
Beer, irregularities in life, etc. appear together
recently
News about gout has rushed to the hot search
Mr. Yang (pseudonym), 51, who often drinks at dinner parties and loves to eat high-purine foods such as hot pot and animal offal, has been tortured by tophi for more than 20 years, and tophis as large as eggs and as small as sesame seeds are spread all over the body. Especially in one of his hands, the joints have gradually deformed due to tout stones, and they have become a pair of "ginger hands", and the attack is unspeakably painful.
Most people in life know about gout
But few people know about tophi
There are also some people who do not know the relationship between the two
What is gout?
The so-called gout
It is caused by urate deposition
A type of crystal-associated arthropathy
The cause of gout is "hyperuricemia"
It's like the salt concentration in the water is too high
Slowly precipitated out, "uric acid crystals" are formed, causing gout
The natural course of gout generally has 4 stages
Asymptomatic hyperuricemia
Acute gouty arthritis
Intermittent periods
Tophi and chronic gout arthritis, etc
Acute onset of gouty arthritis
Affected joints become hot, dark red, and swollen
It feels like knife cut or bite-like pain
If the treatment is improper
May persist or metastasize to other joints
General principles of dietary treatment of gout
"Three lows and one more"
Three lows: low purine diet; low (weight loss); low salt and low fat diet.
One more: drink plenty of water.)
In addition, it is important to note that in the past, it was advocated that there was no purine or strict restriction of foods rich in purines, but at the same time, the intake of protein was also restricted, which could lead to malnutrition in the long run.
Therefore, the latest recommendation has been changed to: mainly limit foods high in purines.
In other words, dietary restrictions are relatively relaxed, but the strict ones are still as strict.
What is Tophi?
Tophi refers to hyperuricemia, in the course of the onset of gout patients, a hard stone-like nodule that appears, is a crystallization formed by uric acid in the body.
In general, patients themselves can observe or touch subcutaneous bumps, with or without redness, or with masses, or can feel pain, fever, and even feel that joint activity is affected, which is medically called tophi.
Tophi is generally prone to the main parts: pinna, eyelid, joint part of the subcutaneous, typical site in the auricle, but also commonly in the toe fingers, wrists, ankles and elbows and other joints around.
How are tophis formed?
Hyperuricemia and gout are like relatives, but the two can not be equated, hyperuricemia is not necessarily gout, but hyperuricemia patients in the usual bad habits, long-term, will cause gout. When suffering from gout, if there is no active treatment, still irregular life, and can not control uric acid within the normal range, then tophi will appear.
Poor living and eating habits in daily life may lead to the formation of tophi:
Stay up late for a long time
Long-term irregular diet, overeating
Long-term consumption of foods (seafood, animal offal, soy products) (which homopurine converts into uric acid in the human body)
Long-term consumption of high-sugar drinks and a lot of beer
What are the harms of tonic stones to the body?
The harm caused by tophi to patients is generally related to the site where tophi appears.
● Joint parts: can cause the patient's osteoartical destruction, can deform the joints, and in severe cases can cause disability.
● Subcutaneous soft tissue: it can cause lesions in the patient's local skin, which can lead to skin ulceration, and white powdery urate crystals will be discharged from the ulcer site, and the ulcer will not heal for a long time.
● Kidneys: Some patients have gouty nephropathy or uric acid kidney stones, and severe patients can cause uremia.
● Intravascular: Tophi can also cause vascular lesions, causing vascular occlusion, and some patients can also have end-limb vascular occlusion, which can lead to gangrene of the limb, and in severe cases, the limb needs to be surgically removed.
How can it be treated and prevented?
Tophi generally does not require emergency treatment, the main treatment principles are to lower uric acid, alkalinize the urine and relieve the pain of patients, and some patients with severe damage (such as bone, joints) need surgery.
The principle of preventing tophi is mainly to adjust the diet.
● Strictly control diet in daily life: eat less high-purine foods (such as: animal offal, seafood, beans, etc.).
● Maintain good living habits, do not stay up late, ensure adequate sleep, and exercise appropriately.
● Drink more water (ensure that the daily water intake is 1500 ~ 2000 ml), and drink less carbonated drinks and wine in life.
What can people with high uric acid/gout eat?
#1
Do not eat animal offal, eat less red meat
All kinds of animal internal organs, including liver, kidneys, brains, intestines, etc., should not be eaten.
Do not eat thick broth, fish soup, seafood soup, etc.
All kinds of red meat (beef, lamb, pork, etc.), do not eat during the acute attack of gout.
When patients with gout are in remission or hyperuricemia, the intake of red meat is controlled within 50 grams a day, but some peeled white meat can be eaten in moderation.
#2
Eat less seafood
Long-term consumption of a large amount of high-purine seafood is also one of the risk factors for gout.
Try not to eat, the acute phase must not eat there is (high purines):
Seafood with carapace such as shellfish, oysters and crabs;
Some fish, such as carp, crucian carp, yellow croaker, etc.
Can be eaten in small amounts (mesopurine):
Tuna, sea bass and other fish;
Crayfish, river prawns, hairy crabs (except crab yellow) and so on.
#3
Reduce fat intake and lose weight
Fat itself can hinder the kidneys' excretion of uric acid, and a high-fat diet can also lead to obesity and metabolic disorders.
Therefore, to eat "meat", you should choose a low fat content; control cooking oil, vegetable oil 20 to 30 grams / day; peanuts, walnuts, melon seeds and other nuts contain more fat, but also eat less.
In patients who are relatively fat themselves (simple waist and abdomen obesity is also counted), weight loss itself is conducive to the improvement of metabolic disorders, and it is recommended to control weight in the normal range (BMI 18.5 to 23.9 kg/m).
#4
Do not eat refined carbohydrates
Carbohydrates provide 50 to 60% of the total energy, so it is advisable to choose low-GI foods.
Whole grain foods are encouraged to account for more than 30% of the total daily staple food intake, and the daily dietary fiber intake reaches 25 to 30 g.
#5
Strictly refrain from alcohol and do not drink sweet drinks
Patients with acute gout attacks, poor drug control, or chronic tophi arthritis should be strictly abstained from alcohol.
It is well known that drinking alcohol increases the risk of gout attacks, especially beer and relatively little risk of red wine. The specific order is aged rice wine> beer> ordinary rice wine> white wine > red wine.
Gout patients should pay attention to the ingredient list before drinking drinks, reduce drinks with high sugar content (including fructose), and add "fructose syrup", "white sugar", "honey" is best not to drink.
#6
Do not eat dried beans, you can eat tofu and soy milk appropriately
Many people think that people with gout can't eat legumes. But in fact, the pro-uric acid excretion effect of beans > increased blood uric acid synthesis caused by high purine content, so it will not affect the amount of purine in the blood.
In addition, beans are rich in protein, dietary fiber, soy isoflavones and other beneficial substances, which can reduce the risk of cardiovascular and cerebrovascular diseases.
Therefore, gout patients can eat soy products such as tofu and soy milk appropriately, but do not eat dried beans.
Source: Popular Science China, Run Shaw Hospital
Audit: Department of General Medicine, Run Run Shaw Hospital
Compiled by the comprehensive editor of Run Run Shaw Hospital
Copyright belongs to the original author
If there is any violation or infringement, please contact us
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