Rejekine. In society now circulating the myth that aching joints mean uric acid. This understanding needs to be clarified because not all complaints of joint pain caused by uric acid. Misconception is exacerbated by advertising herbal / traditional medicine.
Rheumatic diseases of many kinds. Not all complaints of joint pain or swollen joints that mean uric acid. To be sure necessary lab tests.
Exactly is meant by uric acid is the acid in the form of crystals which are the end product of purine metabolism (derivative form nucleoprotein), which is one component of nucleic acids contained in the nucleus of body cells. Naturally, the purine present in our body and found in all foods from living cells, ie from plant foods (vegetables, fruits, nuts) or any animal (meat, organ meats, sardines).
So is the result of uric acid metabolism in the body, whose levels are not excessive. Everyone has uric acid in the body, because in any normal metabolism of uric acid is produced. While the triggers are foods and other compounds that contain lots of purines. Actually, the body provides 85 percent of purine compounds for the needs of every day. This means that the needs of purines from the diet is only about 15 percent.
Unfortunately, this fact is still not widely known by the public. As a result many people like to generalize all the food. People ate whatever he wanted, without considering the content in it. Food sources of animal products usually contain very tinggi.Produk purine foods high purine containing less good for certain people, who have talent impaired uric acid. If you eat these foods without any calculation, the amount of purines in the body can pass through the normal threshold.
Some foods and drinks that are known to increase uric acid levels are alcohol, fish hearing, eggs, and offal. Hearings or similar fish (sardines), and the innards are a source of potential compounds. Offal belonging not only the intestine but all other parts contained in the stomachs of animals, such as liver, heart, tripe, and spleen.
CONSUMPTION innards aggravate the enzyme hypoxanthine to process purines. Consequently, many of the rest of uric acid in the blood, which is shaped grains and accumulate around the joint so it creates a feeling very sick. Offal is indeed one of the tempting dishes, including soup tripe, liver sauce, satay heart, spleen and crackers. But one of the impact, if the body of excess purine compounds then the owner of the self experiencing pain in the joints.
Causes of Uric Acid
Gout gout classified into primary and secondary gout.
In primary gout, 99 percent of the cause is unknown (idiopathic). Allegedly associated with a combination of genetic factors and hormonal factors that cause metabolic disturbances that may result in increased production of uric acid or it could be caused by the reduction in expenditure of uric acid from the body.
Secondary gout is caused partly because of the increased production of uric acid due to nutrients, ie eating foods with high purine levels. Purine bases are one of the organic compounds that make up nucleic acids (acid from the cell nucleus) and included in the group of amino acids, the building-blocks of proteins.
Increased production of uric acid could also be due to diseases of the blood (bone marrow disease, polycythemia), drugs (alcohol, cancer medications, vitamin B12). Other causes are obesity (overweight), skin diseases (psoriasis), high triglyceride levels. In people with diabetes are not well controlled levels typically found ketone bodies (waste product of fat metabolism) are rising. Ketone bodies that rise will also cause elevated uric acid.
Everyone can get gout. Therefore, we need to be aware of the symptoms.
Arthritis due to increased blood uric acid levels with arthritis called gout or arthritis arthritis. Acute gouty arthritis is caused by an inflammatory reaction of tissues to the formation of urate crystals. In most cases of gout history of the disease and the clinical picture is specific, so sometimes the diagnosis can be directly enforced.
Someone said to suffer from uric acid (gout) if the conditions meet several requirements and usually once a classical course of their illness, such as having the typical symptoms of gout, have a typical course of the disease gout, uric acid found in high levels in their blood, and the results of microscopic examination of joint fluid or tofus (lumps of uric acid) uric acid crystals found in the form of needles.
More men
Generally, the uric acid is attacked by the men, whereas in women the percentage is small and only appear after menopause.
Uric acid levels of men tends to increase with increasing age. In women, an increase that began in the menopause.
Why uric acid tends experienced by men? This is because the female hormone estrogen has helped disposal of uric acid through urine. While in men, uric acid tends to be higher than women because they do not have the hormone estrogen serve targeted.
So long as a woman has estrogen, then go uncontrolled disposal of uric acid. When it does not have estrogen, such as menopause, then women exposed to uric acid.
If an increase in uric acid passes through the threshold that can be tolerated, the question will arise first in the kidneys, joints, and urinary tract
Normal levels of
Uric acid in the laboratory examination done in two ways, enzymatic and Engineering Ordinary. Normal uric acid levels by an enzymatic test a maximum of 7 mg / dl. While the technique Ordinary, normal values up to 8 mg / dl. When the results showed uric acid levels exceed the normal standard, patients have hyperuricemia possible.
Normal uric acid levels in men and women are different. Normal uric acid levels in men ranged from 3.5 to 7 mg / dl and in women from 2.6 to 6 mg / dl. Uric acid levels above normal is called hyperuricemia.
The classical course of the disease usually begins with an attack or a person has a history of high uric acid check above 7 mg / dl, and higher and higher.
If so, likely to be of gout is getting big. Usually 25% of people who will be high uric acid gout. When the high uric acid levels but no symptoms of attack is called early-stage joint. In every person is different. There are many years did not show symptoms, but there are emerging symptoms at the age of 20 years, 30 years, or 40 years.
Clinical Overview
Emerged as an attack of gout arthritis joint inflammation that arises repeatedly.
Typical symptoms of arthritis gout attack is acute attack usually monoartikular (attacking one joint only) with symptoms of swelling, redness, severe pain, heat and movement disorders of the affected joints that occur suddenly (acute), which reached a peak of less than 24 hours. The most frequent location in the first attack is the base of the big toe joint. Almost in all cases, the location of arthritis in peripheral joints and especially rare in the central joints.
The attack, which occurred suddenly meant a sudden. Because it could have happened, during the day until bedtime no complaints, but at midnight the patient suddenly woke up because of extreme pain. If this attack comes, the patient will feel so much pain even though his body is only exposed to a blanket or even a breeze.
The trip is very typical of gout and had 3 stages. The first stage is called acute gouty arthritis stage. At this stage the patient will experience a typical arthritis attacks and attacks will disappear without treatment within 5-7 days. Because of rapidly disappearing, then often people with suspected leg sprain or an infection so it does not suspect the disease gout, and not doing further investigation.
In fact, doctors who treat sometimes do not expect people with gout disease. Since the first attack is a short time and heal itself, often the patient went to the sequence and timing recovery handyman thought it was because of the sequence / massage. In fact, without any treatment or sorted first attack of this will go away.
After the first attack, the patient will go on interkritikal gout. In this situation the patient was in good health for a certain period. The period between a person and another person is different. There is only one year, some are up to 10 years, but the average ranges from 1-2 years. The length of this phase term causes a person to forget that he had suffered an attack of gout or arthritis first attack first thought had nothing to do with gout.
The second phase called the stage of acute intermittent gout arthritis. After passing through the interkritikal gout for years without symptoms, the patient will enter this stage, characterized by the typical arthritis attacks. Furthermore, patients will often under attack (relapse) is the distance between one attack and subsequent attacks more and more meetings and longer, the attacks grew longer, and the number of joints are affected more and more.
The third stage called the stage of chronic gouty arthritis bertofus. This stage occurs when the patient has suffered for 10 years or more. At this stage the lumps will occur around the joints are often inflamed called tofus. This Tofus form hard lumps containing a powder like chalk deposits of monosodium urate crystals. Tofus this will cause damage to the joints and surrounding bone. Tofus on foot when the size is large and will cause many people unable to use the shoes again.
Risk Factors
Risk factors that cause people stricken with gout is diet, obesity, and ethnicity.
In the world, ethnic highest prevalence in the Maori people in Australia. The prevalence of Maori people stricken with the disease is very high uric acid, whereas in Indonesia the highest prevalence in the population and the highest beach in Manado-Minahasa region because fish eating habits and consume alcohol.
Alcohol causes the disposal of uric acid through urine, so that part is reduced uric acid persisted in the blood. High consumption of marine fish also result in uric acid.
Intake into the body also affect uric acid levels in the blood. Foods that contain high purine is converted into uric acid. High purine mainly found in organ meats, seafood: shrimp, squid, mussels, crab, anchovy.
IF according to the results of laboratory examination of uric acid levels are too high, we need to pay attention to the food problem. Food and beverages are always consumed whether a precursor to uric acid. In obese people, uric acid is usually increased while spending less. So for safety, people are usually advised to lose weight.
The most important thing to note is that high uric acid in the blood, without us knowing it will damage the internal organs, especially kidneys, because the filter will clog. Clogged filter will affect the appearance of kidney stones, or could eventually lead to kidney failure.
Uric acid is also a risk factor for coronary heart disease. Suspected of uric acid crystals will damage the endothelium (inner lining of blood vessels) coronary. Therefore, anyone that high uric acid levels should try to lower it so the damage does not spread to organs of the body.
Management
Management of gout arthritis:
• Relieves arthritis (with medication and rest the affected joint).
• Setting the body of uric acid (with diet and medication).
The main goal of treatment of gout arthritis are:
• Treating the acute attack is good and right
• Prevent attacks of acute gouty arthritis test
• Prevent severe joint abnormalities due to accumulation of urate crystals
• Preventing the complications that can occur due to increased uric acid on the heart, kidneys and blood vessels.
• Prevent the formation of stones in the urinary tract.
The sooner someone gets treatment from an acute attack, the sooner recovery.
Treatment can be given anti-inflammatory drugs (antirheumatic) and uric acid-lowering drugs (drugs that speed up / increase spending through the urinary uric acid (probenecid) or drugs that decrease production of uric acid (allopurinol)).
Diabetes management
In addition to offal, food rich in protein and fat is a source of purines. And although high in cholesterol and purines, the food is very useful for the body, especially for children at the age of growth. Cholesterol is important for the precursor of vitamin D, the material forming the brain, nervous tissue, steroid hormones, salts and membrane sel.Orang empendu that good health should not overeat. Meanwhile, for those who already suffer from gout, you should limit yourself to things that could make things worse. For example, limiting foods high in purines and choose a low purine.
Foods that should be avoided are foods that contain lots of high purine. Classification based on the content of purine foods:
Group A: Foods that contain high purine (150-800 mg/100 g food) is the liver, kidney, brain, heart, lung, other organ meats, shrimp, mussels, clams, sardines, herring, meat extracts (shredded, beef jerky ), yeast (tape), alcohol and food in cans.
Group B: Foods that contain purines moderate (50-150 mg/100 g food) is a fish that does not include a class A, beef, shellfish, dried beans, cauliflower, spinach, asparagus, beans, mushrooms, leaves cassava, papaya leaves, kale.
Group C: Foods that contain purines lighter (0-50 mg/100 g food) are cheese, milk, eggs, other vegetables, fruits.
Diabetes management should be done when the uric acid levels exceed 7 mg / dl by not consuming food group A and restrict ourselves to mengonsmsi food group B. Also restrict ourselves to consume fat and are advised to drink plenty of water. If the settings are still there diet symptoms of elevation of blood uric acid, you should consult the nearest doctor for further treatment.
It is also worth noting, do not work too hard, fast response and routinely checked by a doctor. Because once suffered, usually disorders of uric acid will continue.
