Tuesday, 20 September 2011

GOUT- A CHRONIC DISEASE

Hi everybody, the prevalence of gout is increasing day by day... yesterday an adorable lady, my suman aunty ask me to write something about gout... she was realy curious to know what this gout is???? What are the dietary recommendations??? And how we can diagnose this condition????

An awareness and nutritional education need to develop among the people of society as its prevalence and incidents are increasing in recent years... so here I am....

GOUT
Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation. Gout is a chronic disease caused by an uncontrolled metabolic disorder, hyperuricemia, means too much uric acid in the blood, which leads to the deposition of monosodium urate crystals in tissue. Uric acid is the end metabolism product of purine, purine being the nitrogen-containing compound that occurs in nucleic acid. It is excreted out mainly by the kidneys, where it passes out in urine. Whenever the normal balance is disturbed by decreased excretion by the kidney or increased production, the blood level of uric acid increases and builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. There are two conditions of Gout, Acute gout is a painful condition that typically affects one joint. Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.

PREVALENCE AND RISK FACTORS
Gout is the most prevalent form of inflammatory arthropathy. It is a true crystal deposition disease caused by formation of monosodium urate crystals in joints and other tissues. It is a common inflammatory arthritis that has increased in prevalence in recent decades. A number of epidemiological studies from a diverse range of countries suggest that gout has increased in prevalence and incidence in recent years and that the clinical pattern of gout is becoming more complex. In particular, the greatest increase has been observed in primary gout in older men. The incidence of gout varies in population with an overall prevalence of less than 1 to 15.3%. The Bhigwan COPCORD survey demonstrated low prevalence of Gout (0.12%) in rural India. In another Indian study gout prevalence was 2%. Gout once called the “disease of kings,” is also seen in women, especially after menopause. Gout affects more than 1% of adults in the USA, and it is the most common form of inflammatory arthritis among men.
Accumulating data support an increase in the prevalence of gout that is potentially attributable to recent shifts in diet and lifestyle, improved medical care, and increased longevity. Gout prevalence increases in direct association with age; the increased longevity of populations in industrialized nations may contribute to a higher prevalence of gout through the disorder's association with aging-related diseases such as metabolic syndrome and hypertension, and treatments for these diseases such as thiazide diuretics for hypertension. Robust epidemiological studies have established risk factors for gout including genetic factors, excess alcohol consumption, purine-rich diet, the metabolic syndrome (obesity, hypertension, hyperlipidemia and insulin resistance), use of diuretics and chronic renal failure. Trends in alcohol use, diet, obesity and the metabolic syndrome in the general population might explain changes in the prevalence and incidence of gout in the community.

The condition may also develop in people with:
• Diabetes
• Kidney disease
• Obesity
• Sickle cell anemia and other anemias
• Leukemia and other blood cancers
The condition may occur after taking medicines that interfere with the removal of uric acid from the body.


SYMPTOMS

Symptoms of acute gout:
• Symptoms usually involve only one or a few joints. The big toe, knee, or ankle joints are most often affected.

• The pain starts suddenly, often during the night

• The joint appears warm, red and are usually very tender. In some people, the acute pain is so intense that even a bed sheet on the toe causes severe pain.

• There may be a fever.

• The attack may go away in a few days, but may return from time to time. Additional attacks often last longer.
After a first gouty attack, people will have no symptoms. Half of patients have another attack.
Some people may develop chronic gout. Those with chronic arthritis develop joint damage and loss of motion in the joints. They will have joint pain and other symptoms most of the time.


Uric acid crystals can form outside joints. Collections of these crystals, known as tophi, can be found in the earlobe, elbow, and Achilles tendon (back of the ankle), or in other tissues. Typically, these tophi are not painful but can be a valuable clue for the diagnosis as the crystals that form them can be removed with a small needle for microscopic examination. Microscopic evaluation of a tophus reveals a nest-like accumulation of uric acid crystals embedded with white blood cells of inflammation.


TREATMENT
Medicines should be taken as soon as possible if you have a sudden gout attack. Consult your physician as soon as possible. Along with specific prescribed medications, it is typically recommended that people with gout reduce their intake of purine-rich foods.


LIFESTYLE AND DIET MODIFICATION

• Avoid alcohol

• Reduce purine-rich foods. According to the American Medical Association, purine-containing foods include:

  • Beer, other alcoholic beverages.
  • Anchovies, sardines in oil, fish roes, herring.
  • Yeast.
  • Organ meat (liver, kidneys, sweetbreads). Even lamb, pork, beef, shrimp, scallops, mussles, lobster and canned fish are also harmful.
  • Legumes (dried beans, peas).
  • Meat extracts, consomm√©, gravies.
  • Mushrooms, spinach, asparagus, cauliflower.


• Avoid fatty foods such as salad dressings, ice cream, and fried foods.


• According to the American Medical Association, a balanced diet for people with gout include foods:

  • High in complex carbohydrates (whole grains, fruits, vegetables)
  • Low in protein (15% of calories and sources should be soy, lean meats, poultry)
  • No more than 30% of calories from fat (10% animal fat)

• Increase the intake of low fat dairy products which include skimmed milk, yogurt and such items which protect you against gout attacks. Research is suggesting that certain foods may also prevent gout. In a study published in the New England Journal of Medicine, scientists found that a high intake of low-fat dairy products reduces the risk of gout in men by half. The reason for this protective effect is not yet known. Another study examining the effects of vitamin C on uric acid suggests that it may be beneficial in the prevention and management of gout and other diseases that are associated with uric acid production.

FOODS MUST INCLUDED IN DIET
• Dark berries help in processing uric acid and hence lowering its levels inside the body. Cherries can lower plasma uric acid levels. They contain flavonoid compounds that may lower uric acid and reduce inflammation. Flavonoids called anthocyanins, often found in purple and blue colored berries, help to shut down the enzymes that cause tissue inflammation in the first place. Anthocyanins can therefore prevent and treat many kinds of pain. A study done at the University of California at Davis by Jacob et. al entitled "Consumption of Cherries Lowers Plasma Urate in Healthy Women" proved just that and also showed that there was a decrease in plasma urate after cherry consumption. Bilberry, hawthorn, and blueberries are also high in anthocyanosides

• Fish like salmon and flax seeds are also known to lower the levels of uric acid inside the body. Olive oil is also known to reduce inflammation and enhance the healing process of gout.

• Add Tofu to your daily diet routine instead of meat. A research done by Yamakita J, 1998, published in advances in experimental medicine and biology journal, suggest that tofu is a preferable source of protein, especially in gout patients with uric acid clearance > 6.0 mL/min.

OBESITY AND GOUT
Exercise regularly and maintain a healthy body weight. Lose weight if you are overweight, but avoid low-carbohydrate diets that are designed for quick weight loss. When carbohydrate intake is insufficient, your body can’t completely burn its own fat. As a consequence, substances called ketones form and are released into the bloodstream, resulting in a condition called ketosis. After a short time, ketosis can increase the level of uric acid in your blood. If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.

I HOPE THIS WILL HELP ALL OF YOU TO DIAGNOSE THIS CONDITION AND CREAT AWARENESS AMONG OTHERS TOO...




Image courtesy: whatisgout.net, ayushveda.com, lmg.letmeget.net, gouttreatment.in, naturalhealthcure.org, askdrmakkar.com, healthcave.com, liver-pain.com, arthritishubs.com



16 comments:

  1. So after being deliberately forced at a gun point, i am hereby writing the first (and i know going by the topic it will be the only) comment on your blog ... Overall, as always an eclectic mix of various informations from varied sources which prove to be helpful .. Good Job ..

    Anyway i was just wondering if you could write on the Kind of food that one should take hours before an examination in the morning .. so that the nervous chap doesnt feel sleepy and the food adds to his concentration ?? A nice topic isnt it ?? Go ahead ... Would love to read about it ...

    ReplyDelete
    Replies
    1. Hi Rakshit. Some personal sharing here. I read articles title “To Those Having Gout Problem” mentioned that a special gout remedy call gout papaya green tea extract extremely good to help cure gout issue. See the article at:
      http://kidbuxblog.com/to-those-having-gout-problem/

      Delete
  2. hey bro... i know what u r feeling right now... not dont worry one day you will thank me that u read this article.....thank u for your comment...

    and what you are suggesting is a nice topic... i will definately work on it for u.... okassss...tc bro....

    ReplyDelete
  3. you know what... I totally agree with what Rakshit said here... that would be a good topic to write on...

    That said, as usual a nice writeup and one that I hope will be good for everyone

    I can see that you have not been regular with the posts... why so?

    ReplyDelete
  4. thank u bhaiya.... actually bhaiya was just busy with my conferences.... there were 3 in line, and i had paper presentation in all of them... that why i was realy busy.... nd bhaiya 1 gud news too... i got best paper presentation award in a national conference of nutrition society of India...thats why i was not able post my new articles... but now working on new lines.... :)

    ReplyDelete
  5. Good article with intesting insights Mahak...Keepit up

    ReplyDelete
  6. hello....

    thank u so much... i m glad u like it....
    welcome to my blog and feel free to explore....

    ReplyDelete
  7. For more information or to schedule an appointment,for more about permanent lip augmentation gurgaon and cosmetic surgery.

    ReplyDelete
  8. Great information. For more information about gout treatments you can see this.
    Gout Treatment

    ReplyDelete
  9. Wonderful article- Amit Arora

    ReplyDelete
  10. Gout is a big problem which effect the joints of body. Gout problem increase due to uric acid when it increase in our blood it makes blood circulation slow and slowly slowly it generate gout problem. This article has a great information about Natural Gout treatment. Natural way is the best way to Reduce Uric Acid.
    Gout Treatment

    ReplyDelete
  11. Gout is often a challenging disorder that triggers continuous struggling for anyone who have it. The sorts of medicine that medical doctors usually prescribe to gout clients have only non permanent effects. They even have perilous uncomfortable side effects that induce individuals much more trouble. The writer, Lisa McDowell describes the attainable reasons for gout and sheds new light-weight to the critical link between gout and diet regime. In her e book, Out With Gout buyers will master: a number of effortless techniques to curing gout, how they will eradicate the underlying reasons behind their gout and ways of coping with unpleasant gout indications,

    The Out With Gout eating plan (small in urine, so the human body by natural means generates fewer uric acid) and gives wholesome and tasty recipes that assist customers get charge of their gout. All in all, Treatment Gout Now could be a comprehensive and easy-to-read e-book that can help people address gout obviously. With the enable of the guidebook gout sufferers will establish new lifestyle habits that will help them get rid of gout the moment and for all. Out With Gout will not be a homeopathic solution, nor a faith-based procedure. It is just a true remedy that may enable all sufferers discover precisely what is producing their ache, and end it permanently. It doesn’t demand health-related know-how or special equipment. All gout sufferers should do is read and are aware of it to get rid of their gout permanently. Read more at http://tinyurl.com/destroygoutnow

    ReplyDelete
  12. Gouty arthritis attacks me last 5 months and now I fell that it's getting worse. This horrible disease makes me feel uncomfortable. I am unable to do what I want to do because the pain was excruciating. I can't walk without the help of my staff. I am searching some natural medications that will help me for relieving my gout. I'm currently using UBB Gout be gon that recommended by doctors. It's nice and it works. I want to try this remedy for the faster healing. This for this article.

    ReplyDelete
  13. Great post.......this was very nice thanks for the post

    ReplyDelete
  14. Hi ,

    We are very interested in your blog content

    Will you be available to take a freelancer work about gout for our blog? We will willing to pay a good rate.

    Look forward to your reply. Your response will be much appreciated.




    Thanks & Regards,
    shengjm70@yahoo.ca

    ReplyDelete
  15. Pineapple is supposed to be very good for treating severe cases of gout. Pineapples contain a compound known as bromelain, which helps neutralize the effects of uric acid that accumulates in the blood. More Info: https://goo.gl/WsHSNE

    ReplyDelete