GOUT

Gout is a disorder of purine metabolism in which abnormally high level of uric acid accumulates in the blood (Hyperuricemia).

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As a consequence, sodium urates are formed and deposited as tophi in the small joints and surrounding tissues.

In the chronic gout, a classic site is the helix of the ear & more common site is the large toe or elbow.

Gout is characterised by the sudden and acute onset of localized arthritic pain that usually begins in the big toe and continues up the leg.

Uric Acid is normally excreted in the urine. The range of uric acid is 2-7 mg/100 ml. If the level of uric acid in the body is above 7 mg/100 ml, gout develops and the levels of acid may go upto 20 mg/100 ml.

Factors related to the development of Gout:

1. Hereditary

2. Gender and Age are related to the risk of developing gout. It is more common in men and that too, common in adults than in children.

3. Being overweight also increases the risk of developing gout.

4. Drinking too much Alcohol can also lead to gout as it interferes with the removal of uric acid from the body. Beer intake appears to increase uric acid levels and subsequently the risk of gout.

Symptoms:

1. Sudden unexpected burning pain, swelling, redness, and stiffness in the joint may occur.

2. Low grade fever.

3. The Crystal's inside the joints cause intense pain whenever the affected area is moved. The inflammation of the tissues around the skin also causes skin to be swollen, tender and sore if it is even slightly touched.

Gout affects joints such as ankle, heel, knee, wrist, elbow, fingers and spine.

Guidelines for Dietary Management:

1. Diet of low purine intake.

2. All meats, fish, poultry containing moderate to high amounts of purine, pulses and lentils need to be avoided.

3. Avoid red meats, oysters, peas, beans, alcohol (Beer and Wine).

4. Intake of fluid must be encouraged to assist with the excretion of uric acid and to minimize the possibility of renal stone formation.

5. The diet should be relatively high in carbohydrates and low in fat.

6. Take refined cereals, carbohydrates with low glycemic index & limit dairy products.

7. Avoid excess consumption of tea, coffee, pickle & papad.

8. Limit use of vegetables/fruits like cabbage, flower, brinjal, cucumber, tomato, spinach & mango.

MONITOR AND UPGRADE VITAMIN B12 AND D3.

ALSO, *CONSUME MAXIMUM NATURAL VITAMIN C FOR URIC ACID CONTROL.