Gout disease, which can occur due to excessive consumption of foods that cause uric acid elevation, alcohol and some drugs, and which is more common in men than in women, is a rheumatic disease seen in some people in which a substance called uric acid in our blood is above 6 mg.
Cerrahpaşa Faculty of Medicine, Head of Rheumatology Department and Rheumatology Specialist Prof. Dr. Vedat Hamuryudan told Özgür Gökmen Çelenk from Posta Newspaper about the unknown about gout.
Proteins such as meat, fish, chicken and eggs that we take into our bodies are broken down by passing through the stomach. After our body uses the protein for itself, it expels the last residues in the form of uric acid through the kidneys. However, as we age, our blood uric acid level rises and this acid begins to collapse in the tissues.
Since our big toe is the farthest point of the body, it is a cold place and therefore 90 percent of patients with gout start from the big toe. Dr. To better understand the accumulation of uric acid from the dough, he gives the following example.
When you add sugar to the tea, it dissolves, when you add a little more, it melts again. But when it reaches a certain point, saturation occurs and the sugar no longer melts, it starts to collapse. While uric acid circulates dissolved in the blood up to a certain point, after a certain point it begins to collapse in the form of crystals. Just as sugar sinks to the bottom, uric acid also goes and sinks to the bottom of the body, the big toe.
prof. Dr. Hamuryudan states that the first gout attack occurs especially in people aged 45-50 and slightly overweight, usually after returning from an evening feast. Accordingly, the attack proceeds as follows.
The person goes to bed after dinner and goes to bed.
2 hours later ‘What happened to my big toe, did I hit it?’ she wakes up in pain.
Pain worsens within minutes or hours.
The big toe is red, hot.
This is the first attack that the patient with gout faces.
Stating that the first attack of gout patients can usually last up to 72 hours, Rheumatology Specialist Prof. Dr. Hamuryudan states that after this attack passed, a quiet period was entered.
However, if the lifestyle is not regulated, the attack recurs and the same picture continues to occur.
Stating that the frequency of gout attacks increases unless treated, Prof. Dr. Hamuryudan explains that the patient, who had previously recovered in 3 days, now has gout complaints for 10 days.
Moreover, while gout affects only the thumb, it starts to affect the joints over time and the attacks last much longer.
Untreated gout can lead to heart attack and kidney failure!
In untreated gout, large and small chalk-colored swellings called typhus begin to appear in the early periphery of the ear.
Stating that advanced gout is no longer just a joint disease, uric acid will also collapse in the kidneys and veins. Dr. Hamuryudan states that gout will cause arteriosclerosis and even heart attack and kidney failure over time.
Disturbance in enzymes that remove uric acid from the body
Excessive consumption of foods that cause uric acid elevation (High consumption of protein sources such as meat, fish, chicken, eggs, etc.)
Alcohol (fermented beverages such as beer and high alcoholic beverages such as raki and whiskey)
Food and drinks prepared with corn syrup (fructose)
Some medications (Some blood pressure medications that increase uric acid levels in people)
Gender (more common in men than women)
Stating that patients with gout often have other problems, Prof. Dr. Vedat Hamuryudan states that these patients have higher sugar, blood pressure, cholesterol and triglyceride levels.
Some blood pressure medications can raise uric acid and cause a gout attack. For this reason, gout can also be seen in patients receiving blood pressure treatment.
If gout cannot be controlled, it is necessary to review the drug treatment in blood pressure patients. Because some blood pressure medications raise uric acid, while others lower it.
Not being at ideal weight, overweight
Consume more meat, offal, shellfish
Consumption of fermented beverages such as beer and high alcoholic beverages such as raki and whiskey
Consumption of foods and beverages prepared with corn syrup (fructose)
Treatment of gout is divided into attack treatment and preventive treatment.
Anti-inflammatory drugs, painkillers, colchicine obtained from crocus leaves, and sometimes cortisone are used to relieve the attack of the patient who comes with pain.
In the meantime, putting an ice pack on the swelling can reduce pain and swelling.
A treatment that lowers uric acid is given to prevent this crisis from happening again.
These consist of drugs that inhibit enzymes that lead to the formation of uric acid in the blood.
It is necessary to be very careful when starting drugs.
If a high dose is given suddenly, the sudden decrease in uric acid also causes a gout attack.
Medicines need to be used regularly.
The patient needs to pay attention to his diet and lose weight apart from medication.
The most common mistake in drug therapy
prof. Dr. Vedat Hamuryudan explains the most common mistake made during drug therapy as follows:
You give uric acid-lowering medication, the patient uses it, the goal is to keep the uric acid lower than 6 mg. After that, a person says, ‘Your uric acid has dropped, stop the medication’ and the patient comes back with an attack after a while.
For this reason, the patient should be in constant contact with his doctor.
In the treatment of gout, neither only medicine nor only diet…
prof. Dr. Vedat Hamuryudan also makes the following statement about the treatment of gout for those who say, “If I don’t take medicine, just pay attention to my diet, or “I only use my medicine, I live my life”:
Even if you follow the strictest diet in the world, you can only reduce the uric acid level by 1 unit. For example, it goes from 9 to 8. That’s not enough either.’ It is not possible to say ‘I take my medicine and live my life’. Patients need to live regularly. Not only high uric acid level but also sudden fluctuations in uric acid level is a problem. For example, the month of Ramadan has come, you have started fasting, your uric acid level drops suddenly and you have a crisis. Or you went to a feast in the evening, you eat everything, the uric acid spikes, which leads to a crisis.
How should gout patients be fed?
prof. Dr. Vedat Hamuryudan states that pulses and dairy products are generally prohibited in patients with gout, but this is not the right approach.
“Because gout patients are usually overweight, what needs to be done should be to control the weight with a balanced diet,” he says, and lists his recommendations as follows:
Always consume half of what you eat.
Limit not only red meat, but also chicken and fish.
Consume half a serving of meat per day or 2-3 times a week.
Especially stay away from offal. Just be so good at a good meal that you’re heartbroken. For example, a fork…
Absolutely avoid alcohol.
Although wine may seem a little more innocent than alcohols such as beer, raki, whiskey, consume it very rarely and only 1 glass.