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Sunday, June 8, 2014

What Is Gout?

GOUT

 Gout is a known health problem among people when they have excessive contains of uric acid in the body. It is known as hyperuricemia where the overload of uric acid will then result in tiny crystals of urate being formed. This will then be deposited into the body tissues which commonly happen around the joints that will then cause inflammation. When this happens repeatedly and on a long-term basis, it becomes arthritis.

Prevalence
Gout is widely regarded as a progressive and chronic disease which if not treated in time will cause a lot of pain, particularly in the joints for the person. Chronic gout will continuously grow and when there are too much deposits of hard lumps of uric acid that are formed around the joints, it could lead to very serious complications like kidney stones and joint destruction.

Uric acid is the element which is found in a lot of food we eat. It is derived after purines are broken down in our body. Painful arthritis is also known as a gout attack and that will happen when there is an abnormality in handling the uric acid within the body system. More serious repercussions would include kidney stones and even problems that will eventually lead to kidney failure.

In this context, gouty arthritis is an inflammation of the joint which is extremely painful. In more obvious situations, the person will experience a red, tender and swollen joint. Today, gout problems have become widespread where it is reported to be affecting about 1 to 2% of total population in certain communities.
The main causes of gout are due to the abnormality in handling uric acid in the body. This is very common especially among the obese and those who are experiencing excessive weight gain. Alcohol consumption is another known cause for gout while people with high blood pressure and abnormal kidney functions might experience this problem as well.

The main symptoms of this health problem are when there are swollen areas around the joints which are the most obvious method. That said, gout is a treatable disease where medications are usually prescribed to treat an acute attack of gouty arthritis. However, it is very important that this problem is treated in a long term basis so that it does not reoccur. Fluid intakes are the most basic step that one should take while a gout diet can be planned with minimal purine-contained food types.

Prevention
The best way to prevent gout from developing in the body is through the diet. This can be done by practicing a diet which will reduce the developing of uric acid in the body. By limiting meat, poultry and fish which are high in purine, it will help in minimizing gout attacks. Red meat is among those known to be most common reasons for gout. Saturated fats must be reduced as well. This is most commonly found in processed food like burgers, chips and fried chicken. Apart from that, the diet must be watched in terms of limiting foods with complex carbohydrates while the body should be kept hydrated at all times while taking supplements which are rich in glucosamine would surely help.

Diagnostics
The best way to know if you have a gout attack is when your joints start to ache for no obvious reason. This is most common among those who are not actively involved in activities or sports. However, further examinations can validate if the problem is more serious than expected. A person with a gout problem can face mild to severe pain which could come from a bump around the joints. You will then need to carry out a joint fluid analysis otherwise known as an arthocentesis which will determine if there are uric acid crystals around that joint area.

Statistics
Gout problems usually occur among adults. This problem is seldom faced by those below 18 years of age as it usually takes time to develop stemming from years of unhealthy diet. In a recent study carried out on the occurrence of gout, it has been found that 76% of those surveyed that experienced a gout attack were not actively or physically involved in sports or exercising. This shows that gouts tend to occur among people who do not walk or move about much which could regulate better blood circulation within the body.

Gout Penyakit Eksklusif Lelaki

Gout Penyakit Eksklusif Lelaki

Gout adalah penyakit eksklusif untuk lelaki dan jarang sekali berlaku kepada wanita. Jika ada pun, kemungkinan berlaku hanya selepas wanita mengalami menopaus.

Apabila gout menyerang, kaki akan menjadi bengkak, panas dan amat sakit hingga ada sesetengah pesakit tidak boleh berjalan. Gout kronik berupaya untuk mengganggu kehidupan harian yang normal. Paling digeruni adalah kecacatan sendi dan otot, sama ada kecacatan ringan atau berat.

Kajian menunjukkan bahawa pesakit gout juga berisiko untuk mendapat penyakit sistem kardiovaskular serta berupaya menyebabkan kegagalan ginjal.

Penulis mendapatkan pandangan Pakar Perunding Rheumatik, Dr. Anwar Samhari Mat Arshad dari Hospital Pakar KPJ Pulau Pinang mengenai penyakit yang digelar 'Disease of King' ini.

Bagaimana serangan gout berlaku?

>> Akibat pemendapan kristal asid urik dalam rongga sendi. Lama kelamaan akan menyebabkan kristal garam dan mencetuskan rasa sakit sendi teramat sangat. Selalunya bermula dari sendi ibu jari kaki dan menular ke sendi lain.

>> Serangan gout berpunca dari peningkatan kadar asid urik dalam darah (hyperuriceamia).

Jenis-Jenis Gout:

Gout boleh dibahagikan kepada empat peringkat;
1 - asimptomatik (tiada simptom)

2 - akut, simptom gout berlaku secara cepat dan tiba-tiba; biasanya hanya menyerang tisu lembut pada beberapa sendi.

3 - interkritikal

4 - kronik -serangan gout boleh berlaku berulang-ulang yang dipanggil polyarticular gout. Pesakit akan berasa amat sakit, kejang dan kaki berubah bentuk. Ada juga yang mungkin menghadapi masalah kaki bengkak, merah, panas dan demam.

Tofus

Pengumpulan asid urik boleh dilihat melalui pembentukan benjolan kecil di permukaan kulit yang dipanggil tofus. Pada keadaan yang lebih serius, tofus yang terlalu besar mungkin pecah dan mengeluarkan bahan seperti kapur. Selain kaki, gout juga boleh berlaku pada anggota badan yang lain seperti buku lali, lutut, tangan dan pergelangan tangan.

Jumlah tofus berkait rapat dengan berat badan dan kadar asid urik di dalam badan manusia. Tofus akan berkurangan apabila kadar asid urik berada di bawah paras empat mg/dl, dan menjadi lebih besar berat jika paras asid urik berlebihan dari 11 mg/dl.

Bagaimanapun, bukan semua sakit sendi disebabkan kristal asid urik kerana pemendapan kalsium pirofosfat dihidrat juga boleh menyebabkan kesakitan pada pergelangan kaki, lutut dan pergelangan tangan - yang dipanggil gout palsu atau pseudogout.

Risiko

>> Jantina - lelaki lebih berisiko mendapat gout pada kadar 90 peratus.

>> Gaya hidup - Individu yang banyak minum minuman keras terutama bir dikatakan lebih berisiko mendapat gout.

>> Obesiti - individu yang mempunyai berat badan lebih 66 kilogram daripada berat badan normal.

>> Sesetengah penyakit - tekanan darah tinggi yang tidak dikawal, diabetes, hiperdislipidemia (paras lemak dan kolesterol yang tinggi) dan arteriosklerosis (penyempitan salur darah)

>> Individu yang menjalani pembedahan atau mendapat sakit tenat secara tiba-tiba.

>> Ubat tertentu - ubat mengawal tekanan darah dan kemoterapi juga dikenal pasti boleh meningkatkan paras asid urik dalam badan.

>> Genetik - kajian mendapati satu daripada empat pesakit datang daripada keluarga yang ada masalah gout.

>> Umur - gout biasa menyerang pesakit tua tetapi kini banyak kes membabitkan pesakit berumur 30 hingga 50 tahun. Manakala bagi wanita, kebanyakan kes bermula selepas umur putus haid.

Bila Sepatutnya Mendapatkan Rawatan?


Dapatkan rawatan doktor dengan segera apabila sendi berasa panas, bengkak dan sakit kerana jika tidak dirawat masalah ini akan bertambah buruk serta boleh menyebabkan kerosakan sendi.

Rawatan

Buat masa sekarang, tiada rawatan khas untuk menyembuhkan gout tetapi masalah ini boleh dikawal dengan mengambil ubat penahan sakit bukan steroid (NSAIDs) seperti endomethacin, diclofenac atau ubat penahan sakit generasi baru seperti celebrex dan arcoxia.

Individu yang kerap mengalami serangan gout akan dibekalkan dengan ubat allopurinol oleh doktor untuk mengimbangkan paras asid urik dalam badan yang perlu diambil sepanjang hayat.

Beberapa ubat yang dicadangkan bagi rawatan jangka panjang termasuk uricosuric (probenecid dan sulphinpyrazone).

Manakala untuk serangan mendadak, pesakit boleh mengambil ubat antiinflamatori bukan steroid (NSAIDs), colchicine (untuk serangan yang kurang kerap) dan corticosteroids.

Untuk pesakit darah tinggi yang juga mengalami gout, disarankan untuk mengambil ubat darah tinggi yang dipanggil Losartan yang juga berkebolehan untuk menurunkan paras asid urik. Sejenis ubat anti-kolesterol yang dipanggil Lipanthyl juga mempunyai fungsi yang sama.

Diet Untuk Pesakit Gout:

>> buah ceri dan strawberi didapati mampu mengurangkan asid urik.

>> elakkan makanan tinggi purin iaitu yang berasal dari sumber protein

>> hadkan memakan daging kepada satu hidangan sehari

>> kurangkan memakan organ dalaman haiwan, sardin dan ikan bilis dan hasil daging.

Makan Secara Sederhana:

>> asparagus, kacang lentil, kacang pea, cendawan, bunga kobis dan bayam.

>> minum banyak cecair, terutamanya air, untuk mencairkan dan membantu proses penyingkiran asid urik.

>> berhati-hati dengan ubat seperti aspirin, diuretik, vitamin C.


Ditulis oleh:
Bintu Rasyada A. Rahman

Dipetik dari:
http://www.utusan.com.my/