knowledge about rheumatic

Not all complaints of joint pain caused by uric acid. Rheumatic diseases of many kinds. Not all complaints of joint pain or swollen joints that mean uric acid. To make sure necessary laboratory tests. Uric acid is an acid that shaped crystals, which is the end result of the metabolism of purines (derived form nucleoprotein), which is one component of the nucleic acid contained in the nucleus of body cells.


Naturally, the purines contained in our body and found in all food from living cells, ie from plant foods (vegetables, fruits, nuts) or animals (meat, offal, sardines).

So is the result of uric acid metabolism in the body, whose levels should not be excessive. Everyone has uric acid in the body, because on any normal metabolism of uric acid produced. While the triggers are foods and other compounds that contain lots of purines. Actually, the body provides 85 percent of purine compounds to the needs of every day. This means that the purine requirement of food is only about 15 percent. Food products containing high purine less good for certain people, who have talent impaired uric acid. If you eat these foods without calculation, the amount of purine in the body can bypass the normal threshold.

Some foods and beverages that are known to increase levels of uric acid is an alcohol, hearing fish, eggs, and viscera. Hearings or similar fish (sardines), and the innards are a potential source of compounds. Which pertained not only the intestinal viscera but all other parts contained in the stomachs of animals, such as liver, heart, tripe, and lymph.

CONSUMPTION innards work aggravate enzyme purine hipoksantin to process. As a result many of the rest of uric acid in the blood, in the form of granules and accumulate around the joints so that creates a feeling very sick. Offal is indeed one of the tantalizing dishes, including soup tripe, liver sauce, satay heart, and lymph crackers. But one of the impact, if the body of excess purine compounds then the owner himself experiencing pain in the joints.

Causes of Uric Acid

Gout disease gout disease is classified into primary and secondary gout.

In primary gout, 99 percent of its 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 reduced expenditure uric acid from the body.

Secondary gout is caused partly due to increased uric acid production due to nutrients, namely eating foods with high purine content. Purine bases is 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 protein.

Increased production of uric acid can also be due to blood disease (bone marrow disease, polycythemia), drugs (alcohol, cancer drugs, vitamin B12). Other causes are obesity (overweight), skin disease (psoriasis), high triglyceride levels. In people with diabetes is not well controlled are usually present levels of ketone bodies (the discharge of fat metabolism) are rising. Objects that elevated ketone will cause uric acid also rising.

Each person can be exposed to the disease gout. Therefore, we need to be alert to the symptoms.

Arthritis disease due to elevated levels of blood uric acid called gout or arthritis Gout arthritis. Of acute gout arthritis is caused by tissue inflammation reaction against the formation of uric crystals.In most cases of gout disease history and clinical picture is specific, so that sometimes the diagnosis can be directly enforced.

Someone said to suffer from uric acid (gout) if the conditions meet certain conditions and usually once a classic history of the disease, such as having typical symptoms of gout, had 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) found uric acid crystals in the form of needles.

Generally attacked uric acid are the men, whereas in women the percentage is small and only appear after menopause. Because the female hormone estrogen has helped disposal of uric acid through the urine. While the men, uratnya acid tends to be higher than women because they do not have the hormone estrogen tersbut.

Uric acid levels men tend to increase with increasing age. In women, an increase that started since the time of menopause.

So long as a woman has estrogen, then go uncontrolled disposal uratnya acid. When it does not have estrogen, such as during menopause, then the women exposed to uric acid.

If increased uric acid passes through the threshold that can be tolerated, the problem will arise first in the kidneys, joints, and urinary tract

Normal Levels

Uric acid in the laboratory examination done in two ways, enzimatic and Techniques Basic. Normal uric acid levels according to test maximum enzimatic 7 mg / dl. While the technique Ordinary, normal values up to 8 mg / dl. When the results showed uric acid levels exceed normal standards, the patient experienced hiperurisemia possible.

Normal uric acid levels in men and women differently. 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 hiperurisemia.

Journey classic disease that usually begins with an attack or a person has a history of high check uratnya acid over 7 mg / dl, and increasingly high.

If so, likely to be gout was bigger. Usually 25% of people who will be high uratnya acid gout. When the high uric acid levels but no symptoms of joint attack is called an early stage. In every person is different. There are many years did not show symptoms, but there are symptoms that appear at the age of 20 years, 30 years old, or 40 years.

Clinical Overview

Emerged as an attack of gout arthritis joint inflammation that arises repeatedly.

Typical symptoms of arthritis, gout attacks are usually monoartikular acute attack (attack 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 location is most often in the first attack is the base of the big toe joint. Almost in all cases, the location of arthritis, especially in peripheral joints and rarely the central joint.

The attack, which occurred suddenly mean all of a sudden.Because it could happen, during the day until bedtime no complaints, but at midnight patient woke up suddenly because of profound pain. If this attack comes, the patient will feel great pain even though his body is only exposed to a blanket or even gusts of wind.

Travel gout is very distinctive and has 3 stages. The first stage is called stage of acute gout arthritis. At this stage of arthritis sufferers will experience a typical attack and the attack will disappear without treatment within 5-7 days. Because of rapidly disappearing, so often people with suspected leg sprain or be infected, so do not expect gout disease and did not do further investigation.

In fact, doctors sometimes treat patients suspected of developing the disease gout. Because the attack was the first time a short time and heal itself, often patients examined at the sequence and timing recovery workers think it was because the sequence / massage. In fact, without treatment or even ordered the first attack this time 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.Duration of time between a person and other people differently.There is only one year, some are up to 10 years, but averaging around 1-2 years. The length of this phase term causes one to forget that he once suffered from gout or arthritis attack first attack first thought had nothing to do with gout.

The second phase is called the phase of intermittent acute gout arthritis. After passing through interkritikal gout for years without symptoms, the patient will enter this phase, characterized by the typical arthritis attacks. Furthermore, patients will often get an attack (relapse) is the distance between one attack and subsequent attacks increasingly tight and long, attacks increasingly long, and the number of joints are affected more and more.

The third stage is called the chronic stage of gout arthritis bertofus.This stage occurs when the patient has suffered from pain for 10 years or more. At this stage there will be bumps in the vicinity of inflamed joints are often referred to as tofus. Tofus is a hard lump containing powder such as chalk, which is deposits of monosodium uric crystals. Tofus this will cause damage to the joints and surrounding bone. Tofus on foot when the large size and many will cause people not to use a shoe again.

Risk Factors

Risk factors that cause people stricken with gout disease are diet, obesity, and ethnicity.

In the world, the tribes of the highest prevalence in the Maori people in Australia. Prevalence of Maori people stricken with the disease is very high uric acid, while in Indonesia the highest prevalence in the population and the highest beach in Manado, Minahasa out of habit or eating fish and consuming alcohol.

Alcohol causes the disposal of uric acid through the urine was reduced so that the acid uratnya participate persist in the blood.Consumption of sea fish also lead to high 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, clams, crab, anchovy.

IF according to laboratory results uric acid levels are too high, we need to consider the problem of food. 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 if a high uric acid in the blood, without us knowing it will damage the body's organs, especially kidneys, because the filter will be clogged. Clogged filter will affect the appearance of kidney stones, or eventually can lead to kidney failure.

Gout is also a risk factor for coronary heart disease. Allegedly uric acid crystals will damage the endothelium (inner lining of blood vessels) coronary. Therefore, anyone who uratnya high acid levels should try to drop him for the damage did not spread to the organs of the body.

Management

Management of gout arthritis:

• Relieves arthritis (with medication and rest the affected joint).

• Regulating the body's uric acid (with diabetes management and medication).

The main goal of treatment of gout arthritis are:

• Treat acute attack is good and true

• Prevent replay attack of acute gout arthritis

• Prevent severe joint disorder due to accumulation of uric crystals

• Prevent complications that can occur due to increased uric acid on the heart, kidneys and blood vessels.

• Prevents formation of stones in the urinary tract.

The sooner someone gets treatment after an acute attack, the faster the cure.

Treatment can be given nonsteroidal 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 the production of uric acid (allopurinol)).

Diabetes management

In addition to offal, food rich in protein and fat is a source of purine.And even though high cholesterol and purines, the food is very good for the body, especially for children at the age of growth.Cholesterol is important for prekusor vitamin D, the material forming the brain, nerve tissue, steroid hormones, salts and membrane sel.Orang empendu that good health should not overeat. And those who are already suffering from gout, you should limit yourself to things that could make things worse. For example, limiting high-purine foods and choose low-purine.

Foods that should be avoided is that many foods contain high purine. Classification based on 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 class A, beef, shellfish, dried beans, cauliflower, spinach, asparagus, green beans, mushrooms, leaves cassava, papaya leaves, watercress.

Group C: Foods that contain purines lighter (00-50 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 groups A and limit themselves to mengonsmsi food group B. Also restrict ourselves to consume fats and are advised to drink plenty of water. If there are low-fat diet with symptoms of elevated 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 regularly checked by a doctor. Because once suffered, usually disorders of uric acid will continue.