Gout is one of the oldest known rheumatic diseases. Gouty arthritis, in addition to being an inflammatory rheumatic disease, is also a metabolic disease. It may occur together with diabetes, hypertension, goiter, arteriosclerosis and heart diseases. Therefore, the risk of heart attack and stroke is increased in gout patients. It is more common in men and post-menopausal women.
As a result of the inability of the enzymes involved in protein metabolism to function adequately, the proteins we ingest through food are degraded into urea and excreted from the body, slowing down, and most of the ingested proteins remain at the level of uric acid. Our body also has a protein cycle. During cell renewal, during the programmed cell death phase (apoptosis), all our cells disintegrate and the released proteins are involved in protein metabolism. For this reason, in carcinogenic events where cell death accelerates, etc. In this case, the body's protein load increases and if complete destruction is not achieved, uric acid accumulation occurs. Again, in cases where the kidneys do not function adequately (renal failure) or when substances such as alcohol are used that slow down the excretion of uric acid from the kidneys, uric acid accumulates in the body. Uric acid is a large molecule and cannot remain in the circulation for a long time. When it reaches the small vessels (capillary) it passes into the tissue. The presence of uric acid in the tissues, although it should not be there, stimulates our immune system and inflammation begins. Following this, gouty arthritis or tophus deposits develop. It may cause kidney stones in the future.
Gout is a disease that progresses with attacks. There is a genetic predisposition. The disease is triggered and an attack occurs when a heavy meat meal or large amounts of alcohol is consumed. Some blood pressure medications, aspirin, diuretics and chemotherapy drugs may also cause uric acid accumulation and attacks.
Joint involvement is extremely painful and has a sudden onset. It most commonly affects the big toe joints, which is called podogra. This finding is diagnostic. It can cause inflammation in all joints in the body. The painting starts suddenly. It is very painful, so much so that it is not possible to wear shoes or keep the foot under the duvet at night.
The priority in its treatment is to relieve the patient's symptoms and relieve him/her. Simultaneously Anti-inflammatory medications are started to prevent inflammation. The person's diet and medications are regulated. If it is not possible to keep the uric acid level in the body within normal limits with diet to prevent new attacks, drugs that increase uric acid excretion from the kidneys and reduce its reabsorption are used. It is also necessary to keep other accompanying diseases such as diabetes, high blood pressure, atherosclerosis, and thyroid gland diseases under control.
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