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.

GoutApabila 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?

l 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.

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

Jenis-jenis gout:

Gout boleh dibahagikan kepada empat peringkat; -asimptomatik (tiada simptom), -akut -simptom gout berlaku secara cepat dan tiba-tiba; biasanya hanya menyerang tisu lembut pada beberapa sendi.

l interkritikal

l 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

l Jantina – lelaki lebih berisiko mendapat gout pada kadar 90 peratus.

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

l Obesiti – individu yang mempunyai berat badan lebih 66 kilogram daripada berat badan normal.

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

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

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

l Genetik – kajian mendapati satu daripada empat pesakit datang daripada keluarga yang ada masalah gout.

l 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:

l buah ceri dan strawberi didapati mampu mengurangkan asid urik.

l elakkan makanan tinggi purin iaitu yang berasal dari sumber protein

l hadkan memakan daging kepada satu hidangan sehari

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

Makan secara sederhana:

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

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

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

10 thoughts on “Gout penyakit eksklusif lelaki

  1. Gout Overview
    Gout is a condition characterized by an abnormal metabolism of uric acid. People with gout either produce too much uric acid, or more commonly, their bodies have a problem in removing it. There are a number of possible consequences of this buildup of uric acid in the body, including acute and chronic gouty arthritis, kidney stones, and deposits of uric acid (tophi) in the skin and other tissues. Gout may occur alone (primary gout) or may be associated with other medical conditions or medications (secondary gout).
    Gout Causes
    Uric acid is generated as the body’s tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid (10%). Other patients with gout do not effectively eliminate their uric acid into the urine (90%). Genetics, gender, and nutrition (alcoholism, obesity) play key roles in the development of gout.

    •If your parents have gout, then you have a 20% chance of developing it.

    •British people are five times more likely to develop gout.

    •American blacks, but not African blacks, are more likely to have gout than other populations.

    •Intake of alcoholic beverages, especially beer, increases the risk for gout.

    •Diets rich in red meats, internal organs, yeast, and oily fish increase the risk for gout.

    •Uric acid levels increase at puberty in men and at menopause in women, so men first develop gout at an earlier age (after puberty) than do women (after menopause). Gout in premenopausal women is distinctly unusual.
    Attacks of gouty arthritis can be precipitated when there is a sudden change in uric acid levels, which may be caused by

    •overindulgence in alcohol and red meats

    •trauma

    •starvation and dehydration

    •IV contrast dyes

    •chemotherapy

    •medications

    ◦diuretics and some other hypertensive medications

    ◦aspirin

    ◦nicotinic acid

    ◦cyclosporin A

    ◦allopurinol and probenecid

    Gouty arthritis is considered in people who have a sudden onset of a hot, red, swollen joint. It is diagnosed by detecting uric acid (monosodium urate) crystals in the joint fluid. These crystals can accumulate over the years in the joint and trigger repeated bouts of inflammation. Repeated “attacks” of gouty arthritis can damage the joint and lead to chronic arthritis. Fortunately, there are effective medications to treat gout.

  2. Gout Symptoms
    The first symptom of gouty arthritis is typically the sudden onset of a hot, red, swollen joint. The most common joint involved is at the base of the big toe, but almost any joint can be involved. In some people, the acute pain is so intense that even a bed sheet on the toe causes severe pain. Acute gouty arthritis at the base of the big toe is referred to as podagra.

    Even without treatment, the first attacks stop spontaneously after one to two weeks. While the pain and swelling completely go away, gouty arthritis almost always returns in the same joint or in another joint.

    With time, attacks of gouty arthritis can occur more frequently and may last longer. While the first attacks usually involve only one or two joints, multiple joints can be involved simultaneously over time.

    Kidney stones are more frequent in patients with gout.

    Uric acid crystals can form outside joints. Collections of these crystals, known as tophi, can be found in the earlobe, elbow, and Achilles tendon (back of the ankle). Typically, these tophi are not painful but can be a valuable clue for the diagnosis as the crystals that form them can be removed with a small needle for microscopic examination.
    Exams and Tests
    Joint aspiration

    •This is the most important test. It is the ultimate method of being certain of a diagnosis of gouty arthritis, as opposed to other causes such as an infection in the joint.

    •A needle is inserted into the joint to withdraw a sample of fluid for testing.

    •The fluid is examined to see if there are gout crystals or bacterial infection present. Sometimes other crystals can be found in the joint fluid, such as calcium pyrophosphate, which is caused by an entirely different condition called pseudogout (“like gout”).
    Blood tests

    •Your doctor may obtain a blood sample to look at your cell counts, uric acid levels, kidney function, etc.

    •Unfortunately, the level of uric acid in your blood cannot be reliably used to make a diagnosis of gout. It is normal in approximately 10% of people during an acute attack of gouty arthritis. Moreover, uric acid levels are elevated in 5%-8% of the general population, so the presence of an elevated level does not necessarily mean that gout is the cause of an inflamed joint.
    Radiographs

    •X-rays are primarily used to assess underlying joint damage, especially in patients who have had multiple episodes of gouty arthritis.
    Self-Care at Home
    •Take medications as prescribed.

    •While a joint is hot and swollen, you may want to use a cane or similar support to keep your weight off that joint.

    •It may be helpful to keep the swollen joint elevated above your chest as much as possible.

    •Ice packs can be helpful in relieving pain and reducing inflammation.

    •Maintaining adequate hydration is key for minimizing attacks.

  3. Medications
    While some medications are used to treat the hot, swollen joint, other medications are used to prevent further attacks of gout. With any of these medications, call your doctor if you think you are having problems from them or if they are not working.

    Medicines used to treat acute gout and/or prevent further attacks are as follows:

    •nonsteroidal antiinflammatory drugs (NSAIDs)

    ◦Examples include indomethacin (Indocin), ibuprofen (Advil), and naproxen (Aleve). Newer drugs such as celecoxib (Celebrex) can also be used. Aspirin should not be used for this condition.

    ◦High doses are needed to control the inflammation and can be tapered off within a couple of weeks.

    ◦Tell your doctor about your other health-care problems, particularly if you have a history of peptic ulcer disease or intestinal bleeding, if you are taking warfarin (Coumadin), or if you have problems with your kidney function.

    ◦The primary complications of these medications include upset stomach, bleeding ulcers, and decreased kidney function.
    •colchicine

    ◦This medication is given in two different ways, either to treat the acute attack of arthritis or to prevent recurring attacks.

    ◦To treat the hot, swollen joint, colchicine is given rapidly (up to once an hour until symptoms improve, side effects develop, or a maximum of 10 doses is reached). While this approach is often effective, most people develop nausea, vomiting, or diarrhea and so it is seldom used for this purpose.

    ◦To help prevent an attack from coming back, colchicine can be given once or twice a day. At this frequency, diarrhea is much less likely to occur. While the chronic use of colchicine can reduce the attacks of gout, it does not prevent the accumulation of uric acid that can lead to joint damage even without attacks of hot, swollen joints.

    ◦Tell your doctor if you have any problems with your kidney or liver function.
    •corticosteroids

    ◦Corticosteroids such as prednisone are generally given when your doctor feels this is a safer approach than using NSAIDs.

    ◦When given as pills, a high dose is used initially and is tapered off within a couple of weeks. It is important to take these medications as prescribed to avoid problems.

    ◦Some complications with the short-term use of corticosteroids include altered mood, elevated blood pressure, and problems with control of glucose in patients with diabetes.

    ◦Corticosteroids can also be injected into the swollen joint. Resting the joint temporarily, after it is injected with steroids, can be helpful.

    ◦Occasionally, corticosteroids or a related compound, corticotropin (ACTH), can also be injected into the muscle.
    Medicines in addition to low-dose colchicine used to prevent further attacks of gout and lower the level of uric acid in the blood include the following

    •probenecid

    ◦This medication helps the body eliminate excess uric acid through the kidneys and into the urine.

    ◦You should drink at least 2 liters of fluid a day while taking this medication (to help prevent uric acid kidney stones from forming).

    ◦Advise your doctor if you have kidney problems or a history of kidney stones or if you are taking aspirin. You may need to take allopurinol instead.

    ◦There are a number of drug interactions with probenecid, so you should advise your doctor of your other medications. If you are prescribed a new medication, let your doctor know that you are taking probenecid.
    •allopurinol

    ◦This medication decreases the formation of uric acid by the body and is a very reliable way to lower your uric acid level.

    ◦Advise your doctor if you have kidney problems. Allopurinol can be still used, but the dose may need to be adjusted.

    ◦Common side effects include stomach pain, headache, diarrhea, and rash.

    ◦Discontinue allopurinol if you develop a rash or a fever, and call your doctor.

    ◦A very rare risk of allopurinol hypersensitivity exists. This problem can cause a severe skin rash, fever, kidney failure, liver failure, bone marrow failure, and can be fatal.

    ◦Advise your doctor if you are taking azathioprine, 6-mercaptopurine, or cyclophosphamide; dose adjustments of allopurinol may be needed.

    ◦Ampicillin is more likely to cause a rash if you are taking allopurinol.

  4. my mum ade gout,but msh d peringkat awl lg la..then, she try noni..alhamdullilah berkesan. masa mula2 amek noni 2..dia rasa bdan lenguh2,sengal2 then after 1 week sengal2 2 da ilang.. sape2 ade gout try la noni, insyaallah berkesan. mencuba yang terbaik untuk kesihatan x salah kan… pape ptanyaan email je mieyaki_hami@yahoo.com

  5. Suami saya dapat gout sebulan lepas dan saya risau tentang penyakit tu. Kalau boleh bagilah menu atau resepi untuk pesakit gout. Terima kasih

  6. Gouty arthritis definitely must be considered a horrid problem, my man is suffering from it for many months now. It puts a lot of stress on me, watching a beloved friend and member of the family experience pain on a regular basis. Sticking with a good diet routine made for prophylaxis and making use of the most effective treatment options is in my opinion crucial. Personally, I would suggest everybody who now notices initial signs of hyperuricemia to by any means take this absolutely serious. Better speak with a doctor as soon as you can and alter your food intake to prevent the outbreak of the disease. It is anything but fun! Search for effective therapy options and steer clear of high purine meals, beer etc to take prophylactic measure!

  7. setiap penyakit ada ubatnya…hanya usaha dan kesabaran yang tentukannya disamping keizinanNya…saya sedia membantu dalam merawat penyakit gout dll hingga sembuh..untuk maklumat lanjut sila hubungi saya 012 9567830 ( man )

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