Gout in the elderly should know
Gout in the elderly is caused by eating too much protein. This protein breaks down into uric acid which precipitates in the joints, causing acute inflammation of the joints or tissues surrounding the joints. Gout patients usually have high uric acid levels in their blood for a fairly long period of time, on average more than 20 years or more. In particular, the higher the uric acid level, the higher the incidence of the disease and the faster the symptoms appear. In men, this disease occurs about 10 times more often than in women. However, after menopause, women are more likely to experience the disease than men.
What are the symptoms of gout?
The first inflammation of the joints is usually found in men over 30 years old, with an average of 40-60 years old. However, in women, it is usually found after menopause. In the early stages of arthritis, there are usually only 1-2 joints. There will be severe acute inflammation from the initial pain until the inflammation is complete within 24 hours. It mostly occurs 1 joint at a time. The most common joints are the base of the big toe, ankle, midfoot, knee, finger joint, mid-hand joint, wrist, and elbow. If not treated or treated incorrectly, the number of inflamed joints will increase. It will start to be found at the wrist, finger joint, and elbow. The inflammation becomes more severe, more frequent, and longer until it becomes chronic inflammation with no complete recovery period.
Gout in the elderly
In the early stages, arthritis usually does not last long, 2-5 days. Some people may have a fever. In the elderly, sometimes there may be arthritis in several joints at the same time, especially in the joints of both hands from the early stages of the disease, which may have a history of taking diuretics. After the arthritis is gone, most patients will have arthritis again within 6 months to 2 years. If not treated or treated incorrectly, the number of inflamed joints will increase. It will start to appear at the wrists, fingers, and elbows. The inflammation becomes more severe, more frequent, ยูฟ่าเบท and longer until it becomes chronic inflammation with no complete recovery period.
During this stage, tophus nodules are often found under the skin, in the tissues surrounding the joints. The average time from the first onset of arthritis to this stage is 11.6 years. However, if arthritis first appears in older adults, the average time from the first onset of arthritis to the stage of tophus will be shorter. That is, tophus tends to appear earlier and is more likely to appear on the fingers instead of at the base of the big toe, ankles, elbows, or knees first.
What are the factors that trigger arthritis or delay healing?
Factors that trigger arthritis include taking certain medications, such as uric acid-lowering drugs, diuretics, or aspirin. Therefore, you should not start or change these medications while you have arthritis, as this will make your symptoms worse or take longer to heal. Other factors include joint injuries, joint massage, alcohol consumption, surgery, blood loss, fluid loss, and infection, etc.
How is this disease treated ?
Treatment during the period of joint inflammation should rest the joint, avoid squeezing, applying compresses to the joint, and start treatment quickly by using anti-inflammatory drugs. Currently, the most popular drugs are colchicine and non-steroidal anti-inflammatory drugs (NSAIDs). The dosage of colchicine is 1 tablet (0.6 milligrams) taken every 4-6 hours on the first day and reduced to 2 tablets per day on the following days (depending on kidney function. For the elderly, the dosage may need to be reduced, especially on the first day). Take for 3-7 days or until the joint inflammation is completely gone. Side effects are diarrhea or nausea, vomiting. If these symptoms occur, stop taking the drug.
For NSAIDs, it can be given as well. It should be selected as a drug with a short half-life and fast action. It will be given for 3-7 days or until the inflamed joints are healed. Contraindications to the use of anti-inflammatory drugs are those with stomach ulcers, impaired kidney function, or liver disease, etc. If it is necessary to use it, the risk factors must be assessed, especially in the elderly. In addition, there should be no changes in uric acid levels during this period. For example, patients who are taking uric acid-lowering drugs should not stop taking them or change the dosage. Or if they have not taken uric acid-lowering drugs before, the doctor should not start uric acid-lowering drugs during this period.
Foods you should eat
Elderly people with gout can eat unlimited foods low in purines, such as milk, eggs, various grains, various fresh vegetables, fruits. Foods with moderate purines can be eaten in small amounts (if eaten together, should not exceed 100 grams per day), such as meats such as pork, lean beef, red snapper, squid, crab, peanuts, oatmeal, legumes such as peas, stink beans, cauliflower, and spinach.
Foods you shouldn’t eat
It’s not just chicken that should not be eaten, but people with gout should also avoid these foods.
- Poultry meat such as duck, chicken, various animal organs , heart, pancreas, kidneys, catfish, mackerel, anchovies, sardines, fish eggs, shrimp, shellfish, shrimp paste.
- Vegetables high in purines, such as mushrooms, acacia, cha-om, sesbania, and bamboo shoots.
- Various beans such as red beans, chickpeas, mung beans, soybeans
- Beer, yeast bread, bone broth
Other recommendations Gout is often associated with other comorbidities, such as high cholesterol, high blood pressure, diabetes, and obesity. Therefore, it is necessary to always undergo diagnosis and treatment of the disease. You must lose weight and control your weight, drink enough water, and avoid drinking alcohol. As for food, gout patients do not need to limit their diet to poultry, animal organs, or vegetable tops because these types of foods have little effect on causing arthritis. However, you must limit your diet to control blood pressure or fat, etc. In addition, gout patients should always have their kidney function and urinary tract stones assessed.