Gout

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GoutMany people who experience joint pain think they have gout. However, practice shows that in our country gout is extremely rare. In the overwhelming majority of cases, such pains are caused by other reasons: rheumatism, brucellosis, damage to the peripheral nervous system and some other diseases.

Gout, which in Greek means "a severe illness in the legs", was already known in ancient times to the Egyptians and Arabs, it was described by the doctors of ancient Greece and Rome. Scientific inheritance of this disease began about two hundred years ago, but to date, not everything has been fully clarified. However, it has been established that gout is a metabolic disease. The metabolism of some people for various, not always clear reasons begins to gradually change. In such cases, they speak of a certain predisposition to metabolic disturbances. Such predispositions are called diathesis. Gout is one of the manifestations of the so-called uric acid diathesis. With it, the amount of uric acid in the blood rises, and its excretion in the urine is delayed. Uric acid salts are deposited in cartilage, joints, skin and other tissues.

Overweight people are more likely to get gout, and women are much less likely than men.

Gout is accompanied by typical sharp joint pain (most commonly the big toe). Usually, an attack begins suddenly at night. But it is not always strong - sometimes there is only a slight increase in sensitivity, redness of the skin over the joint, after which it slightly swells. An attack can develop in several joints at once or affect them one after the other. Pronounced seizures are extremely rare today.
One of the characteristic signs of gout is tofi. This is the name of the deposits of uric acid salts, which in the form of nodules no larger than a coffee bean are formed on the earlobes and in the curls of the auricles. Tofi also occurs around the joints, along the tendons, causing pain in them, limiting mobility and often disfiguring them. But they appear on the ears much earlier. As for the crunch in the joints, it happens not only with gout, but also with many other diseases.

GoutThe appearance of gout is closely related to improper, or rather excessive, nutrition. Often this disease appears simultaneously with obesity, caused primarily by the excessive consumption of meat products. In India, where the majority of the population eats only plant foods, gout is almost unknown. In England, where meat food predominates, this disease until recently was extremely common, especially among wealthy people.

The development of the disease is facilitated by the abuse of alcoholic beverages. In addition, any drink is accompanied by a snack, which most often consists of meat or fish dishes and smoked meats. “In the years of famine and in the post-war period,” wrote one German scientist, “when meat consumption declined, gout disappeared from hospital wards. The number of drunkards and booze has also been reduced to a minimum ... With the return to a meat-rich diet, gout reappeared, especially in Bavaria. "

Diet is critical to preventing and treating gout. In people who are prone to obesity, it can prevent the development of the disease. If tofi, crunching and minor joint pains have already appeared, then proper nutrition is the main remedy. It is also important for common metabolic diseases of the joints of a gouty nature.

What should be the diet?

As already shown, gout is the result of metabolic disorders associated with excessive accumulation of uric acid in the blood. Uric acid is formed from complex chemical compounds called purine bases. These compounds are found in many foods. Therefore, people with gout should follow a diet in which as little purine bases as possible enter the body.

The internal organs of animals are especially rich in purines: liver, kidneys and others, as well as smoked meats and sausages. These foods should be completely eliminated from the diet. There are many purines in the meat of young animals and birds, in fish, especially small fish, in sprats, sardines, in canned fish and smoked meats. Relatively less purine substances are found in lamb and chicken meat, and very little in cod.

The method of cooking meat and fish plays an important role. If they are boiled, then a significant amount of purines pass into the water. In this regard, meat and fish broths, sauces and gravies are sharply limited in the diet. Soups for patients should be made with vegetable, dairy, and sauces - with milk, sour cream or vegetable broth. Meat and fish should be eaten boiled. The meat can be stewed, but the resulting juice should not be consumed. The amount of meat and fish should be generally limited in the diet (no more than 100 grams 2-3 times a week).

It is better to eat meat or fish food in the first half of the day, because during the day uric acid is excreted from the body faster. At night, the secretion of uric acid decreases.

Many purine substances are found in mushrooms, so mushroom dishes and soups in the diet should be limited. Eggs contain a very small amount of purine substances. It would seem that they can be eaten without restriction. In fact, this is not the case. With diseases of a gouty nature, the work of the liver is very often disrupted, often stones appear in the liver and gallbladder. Eggs contain a number of substances (cholesterol - in the yolks, cystine - in proteins), which, when consumed excessively, burden the liver and contribute to the formation of stones. Therefore, it is recommended to use eggs only for cooking and, moreover, not more than one egg per day.

Milk, curdled milk, kefir, cottage cheese and other dairy products should be an obligatory part of the daily menu. These foods contain trace amounts of purines. In addition, they contribute to better liver function.

Cereals, noodles and pasta can be eaten in normal amounts (about 80 grams per day), but too much of these foods can lead to obesity, which is common with gouty conditions. With a tendency to obesity, the amount of cereal and pasta dishes in the diet should be reduced by about 2 times. It is necessary to eat as little as possible peas, beans and other legumes, as they contain a significant amount of purine substances.

Bread and various flour products, as well as cereals, contain almost no purines and it is necessary to limit their amount in the diet only for obesity. In such cases, it is better to eat bread made from wholemeal flour, which has a lower calorie content.

Vegetables and herbs, fruits and berries are very useful. Contrary to popular belief, you can also eat tomatoes. Avoid only sorrel, spinach, radish, asparagus, brussels sprouts, and from berries - raspberries. Virtually purine-free salad, cucumbers, White cabbage, carrots, potatoes. However, for obesity, the amount of very sweet fruits and potatoes should not exceed 200-300 grams per day. You should also limit the amount of sugar, sweets, sweets (40-50 grams per day).

It is recommended to exclude fat from the diet, as it burdens the liver; you need to eat butter and vegetable oil. The total amount of oil in the daily diet, especially with obesity, should not exceed 50-60 grams.

Alcoholic drinks and smoking are definitely prohibited.

Chocolate, cocoa, coffee, tea contain a special type of purine substances (methylpurines), from which uric acid is not formed in the body. But excessive consumption of these products is undesirable due to the fact that tea and coffee stimulate the nervous system, and chocolate and cocoa contain oxalic acid, which is harmful for patients with uric acid diathesis. For the same reason, you should not abuse spices and hot seasonings - mustard and pepper.

It is very important to drink enough liquid every day (soup, weak tea, milk, fruit juices, compotes, jelly). This promotes the release of uric acid from the body. With a healthy cardiovascular system, you need to drink at least one and a half to two liters per day.

Salt food should be moderate, avoid pickles, herring, smoked meats, spicy varieties of cheese, such as feta cheese... Salt prevents the dissolution and removal of uric acid salts. It is also harmful "long-term use of alkaline mineral waters - every 2-3 months it is necessary to take a monthly break.

With exacerbation of gouty joint pain, as well as obesity, you can resort to the so-called unloading diets, which are prescribed by the doctor.

For the prevention and treatment of gout, the general hygiene regimen is of great importance. Regular morning exercises, walks in the fresh air, engaging in non-tiring sports improve metabolism and promote the excretion of uric acid from the body. Physiotherapy, medications, bath and mud treatments are also used. All these funds are prescribed by the doctor depending on the patient's condition.

Professor M. S. Marshak, "Health" magazine, 1957


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