Ukubona lezi zimbangela ze-gout kungakusiza uvikele ukuqhuma

Imfundo Yezempilo

Uvuka ngobusuku obubodwa ubuhlungu obuhlabayo kuzwane lwakho olukhulu. Ijoyini livuvukile futhi liqinile. Lapho uyolala, uzizwa uphilile. Manje usezinhlungwini. Kwenzakalani?

Ungahle ube ngomunye we 8.3 million baseMelika nge-gout, uhlobo lwesifo samathambo olungadala ukuvuvukala nobuhlungu obukhulu. I-Gout ibonakala nge amalangabi abuhlungu , okuvame ukwenzeka ebusuku, okungahlala amasonto ambalwa, ubuhlungu obukhulu kakhulu buvame ukwenzeka emahoreni angama-24 okuqala. Ezinye izimpawu zegout zibandakanya isikhumba esifudumele, esibomvu esizungeze ilunga elithintekile.

Gout kwenzeka lapho kunenqwaba ye-uric acid egazini (isimo sezempilo esibizwa nge-hyperuricemia). I-uric acid ingumkhiqizo odoti owenziwa lapho umzimba wephula i-purine, ikhemikhali elenziwa ngumzimba kodwa lokho kutholakala nasezinhlobonhlobo zokudla. Kubantu abaningi, i-uric acid eyeqile ikhishwa emchameni. Kepha kwabanye, i-uric acid iyakha (mhlawumbe ngoba ukukhiqizwa kwayo kuyanda, ukuqedwa kwayo kunciphile, noma inhlanganisela yakho kokubili). Lokho kwakha kuholela ekwakhekeni kwamakristalu afana nezinaliti ahlala azungeze amalunga, ikakhulukazi uzwane olukhulu nezitho ezingezansi, okudala ukuvuvukala nokubhoboza ubuhlungu bamalunga. Ngokusho kwe-Arthritis Foundation, ukugcina amazinga e-uric acid egazini angaphansi kuka-6 mg / dl kubalulekile ukuvimbela ukuhlaselwa yi-gout.

Uma kukhulunywa ngokuvimbela i-gout, ukubona izimpawu, ukwenza konke okusemandleni akho ukugwema izimbangela, nokuthola ukwelashwa kusenesikhathi yizinyathelo zokuqala okufanele uzithathe. I-Hyperuricemia ne-gout yizinkinga zezokwelapha zesikhathi eside, kusho ULynn Ludmer, MD , umqondisi wezokwelapha we-rheumatology eMercy Medical Center eBaltimore. Ngokuhamba kwesikhathi, i-gout engalashwa ingaholela ekuvukeleni okungapheli nokulimala ngokuhlanganyela, okungaba unomphela.

Izimbangela ezi-8 ezivamile ze-gout

Sekungamakhulu eminyaka odokotela becabanga ukuthi i-gout ibangelwa ikakhulu ukudla. Eqinisweni, i-gout yayivame ukubizwa ngokuthi isifo samakhosi ngoba yayihlotshaniswa nokudla okunesisindo sokudla okunothile nenyama kanye notshwala — ukudla okwakunganikezwa isigaba sabacebile kuphela.

Ososayensi manje sebazi ukuthi imbangela enkulu ye-gout yizakhi zofuzo futhi ukuba nomlando womndeni waleso simo kuyisici sakho esikhulu sengozi. Abantu kufanele baqonde ukuthi i-gout inofuzo hhayi 'iphutha labo' ngenxa nje yokudla kwabo, ukuphawula UTheodore R. Fields, MD, FACP , isazi samathambo esibhedlela saseNew York City for Special Surgery. Izinguquko zokudla nezindlela zokuphila zizosiza nakanjani, kepha yizibalo ezimbalwa kuphela zeziguli ezinele.

Kepha yize izakhi zofuzo ziyingcuphe enkulu yokuthola i-gout, kunabanye abanikeli, kufaka phakathi:

1. Ukukhuluphala ngokweqile

Lapho ukala ngokwengeziwe, izinso zakho kufanele zisebenze kanzima ukuqeda imfucuza efana ne-uric acid emzimbeni wakho. Kokukodwa funda , eshicilelwe kulo magazini I-arthritis ne-Rheumatology , abantu ababekhuluphele ngokweqile babenengozi engama-85% enkulu yokuba ne-hyperuricemia (eyandulela i-gout) uma kuqhathaniswa nabantu abanesisindo esinempilo. Abantu abakhuluphele babenamathuba afinyelela kuzikhathi ezi-3.5 ngaphezu kwabantu abanesisindo esijwayelekile ukuba ne-uric acid eningi kakhulu. Abaphenyi baphinde bathola ukuthi amacala angama-44% we-hyperuricemia abangelwa isisindo esedlulele sisodwa.

2. Ukudla okuthile

Ngenxa yokuqukethwe okuphezulu kwe-purine, okunye ukudla kungakhuphula amazinga e-uric acid egazini. Kubandakanya:

• inyama ebomvu
• Ukudla okunamafutha, njengebhekoni
• Inyama yezitho zomzimba — ngokwesibonelo, izinso, isibindi, nokuvuvuka komzimba
• Ukudla kwasolwandle okuthile, kufaka phakathi i-salmon, isardine, nama-anchovies; nezimbaza, njengezimbaza
• Isiraphu yamabele ephezulu ye-fructose (etholakala kuhlu lwemikhiqizo, ikakhulukazi iziphuzo ezinoshukela njengama-sodas)
• Iziphuzo ezidakayo, ezifaka igawuthi hhayi nje ngenxa yokuqukethwe yi-purine, kepha ngoba futhi kwenza kube nzima ngezinso ukukhipha i-uric acid eyeqile

Kungakanani lokhu kudla okulungile onakho? Asiphikisani nokuphuza ngezikhathi ezithile ngesikhathi esikhethekile noma inani elincane lenyama ebomvu noma imfanzi, kodwa okuncane kungcono, kusho uDkt. Fields. Kuyinkinga enkulu, ngakho-ke seluleka ukuba nokuncane ngangokunokwenzeka. Ngenhlanhla, ukudla kwe-gout kungukudla okunempilo, ngakho-ke kuyinzuzo ephelele kwezempilo ukulandela ukudla okunobuthi be-gout.

3. Umfutho wegazi ophezulu

Abantu abane-high blood pressure (hypertension) bane- Ukuphinda oku-2-to-3 kukhuphukile ingozi yokuthuthukisa i-gout. Ngokwe-American Heart Association, umfutho wegazi ophakeme ongalawulwa ungakwenza buthaka, nciphisa, futhi wenze lukhuni imithambo yegazi ezithwala igazi emzimbeni wonke, kufaka phakathi imithambo etholakala ezinso. Lokho kwenza kube nzima ngezinso ukwenza umsebenzi wazo wokukhipha imfucuza efana ne-uric acid emzimbeni. Ngaphezu, i- isisu (imishanguzo esetshenziselwa ukwandisa ukuchama) evame ukubekwa ukwelapha umfutho wegazi ophakeme ingaba nomthelela enkingeni ngokuthi ukunciphisa inani le-urate (inhlanganisela ye-uric acid) ekhishwe emchameni.

4. Imithi ethile

Ngaphezu kokuchama, ezinye imithi ezingakhuphula inani le-uric acid noma zinciphise ukuphuma kwazo zifaka:

• I-aspirin yomthamo ophansi
• Imithi yokuzivikela emzimbeni — ngokwesibonelo, leyo esetshenziselwa ukuvimbela ukwenqatshwa kwezitho ekufakweni kweziguli
• Izidakamizwa ezisetshenziselwa ukwelapha isifo sofuba
• I-Nicotinic acid, esetshenziselwa ukwelashwa i-niacin ukuswela (i-niacin i-vitamin B)

5. Isifo sikashukela

Inkemba esika nhlangothi zombili: IGout Education Society uphawula ukuthi ukumelana ne-insulin (okuyisici esikhulu sengozi yesifo sikashukela soHlobo 2) kungaholela ekutheni kube nokugula futhi ukuba namazinga aphakeme kakhulu e-uric acid egazini lakho kungaholela ekumelaneni ne-insulin. Leli qembu libika ukuthi u-26% wabantu abane-gout bane-Type 2 diabetes.

6. Ubulili

Abesilisa bane- ingozi ephindwe kane wokuthuthukisa igout kuqhathaniswa nabesifazane. Kubukeka sengathi i-hormone yesifazane i-estrogen isiza abesifazane ukuthi bagcine amazinga e-uric acid ehlolweni, kepha lokho kuvikela kuqala ukufiphala uma ukushaya kokuya esikhathini kanye namaconsi e-estrogen. Kunemibono yokuthi kungani i-estrogen ingavikela abesifazane, kufaka phakathi ukuthi izinso zingakhipha i-uric acid eningi lapho kukhona i-estrogen, kuchaza uDkt Ludmer.

7. Iminyaka

Ubungozi be-Gout buvame ukukhula ngokukhula. Lokho mhlawumbe kungenxa yokuthi izinto eziningi eziyingozi ezihambisana ne-gout — isifo sikashukela, ukukhuluphala ngokweqile, nomfutho wegazi ophakeme — zivame ukukhuphuka njengoba sikhula. Abesilisa kungenzeka kakhulu ukuthi bathuthukise i-gout phakathi kweminyaka engama-40-60. Kwabesifazane, uneminyaka engama-60-80 ubudala. Abesifazane bayakwazi ukunqanda lesi sifo isikhashana ngenxa yemiphumela eshiwo ngenhla yokuvikela i-estrogen.

8. Ukuhlukumezeka kwamalunga

Abantu abalimele noma abahlinzwa ejoyintini kungenzeka bathuthukise i-gout kuleyo ndawo. Siyazi ukuthi ingcindezi engokomzimba ingasusa ama-gout flare, kusho uDkt. Fields. Isibonelo, abanye abantu bathola i-gout flare ngemuva kokugijima. Kucatshangwa ukuthi ukuhlukumezeka ezinzwaneni ezinkulu empeleni kukhipha amanye amakristalu e-uric acid emgqeni ohlangene angene kuketshezi oluhlangene, abangele ukuvuvukala.

Ungakuvimbela kanjani ukuhlaselwa yi-gout

Akukho ongakwenza nge-genetics yakho, kodwa ungenza izinguquko zokuphila ngendlela enempilo ezingasiza ekunciphiseni amathuba okuthuthukisa i-gout. Kubandakanya:

1. Ukwehlisa isisindo uma udinga: Ucwaningo kukhombisa ukuthi ukwehla kwesisindo samakhilogremu ayisikhombisa nje kungaba nomphumela omuhle ku-gout. Olunye ucwaningo lukhombisile 71% ukuhlaselwa okuncane kwe-gout ngokulahlekelwa isisindo .
2. Ukuzivocavoca umzimba: Ukuvivinya umzimba kungakusiza ulawule isisindo sakho, nakho okunganciphisa ubungozi bokugula. I-caveat eyodwa: Ungazivocavoci ngesikhathi se-gout flare.
3. Hlala u-hydrated: I-Arthritis Foundation iyancoma ukuphuza okungenani izingilazi eziyi-8 zotshwala obungaphuzi (okungcono amanzi) ngosuku . Futhi uma uphakathi kokuhlaselwa yi-gout, phinda kabili lelo nani ukusiza ukukhipha i-uric acid eyeqile kusistimu yakho.
4. Nciphisa utshwala: Ikakhulukazi ubhiya, ogcwele ama-purine! Ubhiya owodwa wotshwala ungakhuphula amazinga e-uric acid 6.5%; ubhiya ongadakwa ungawukhuphula u-4.4%.
5. Nciphisa ukucindezeleka: Ochwepheshe abaqiniseki ngempela ukuthi kanjani, noma kanjani uma , ingcindezi ingaholela ku-gout — kodwa bayazi ukuthi ukucindezeleka okungokomzwelo kuvame ukuholela abantu ekudleni nasekuphuzeni kakhulu, ngaleyo ndlela kubabeka engcupheni enkulu yokuthola i-gout.
6. Phinda uhlole ukukhetha kwakho kokudla: Ngaphezu kokunciphisa ukudla okungadala i-gout, cabanga ukufaka ukudla okungasiza ekukhuthazeni ukukhishwa kwe-uric acid kanye / noma okunezinto ezilwa nokuvuvukala. Ngokusho kwe-Arthritis Foundation, okunye kwalokhu kudla kufaka:
   • Ubisi olunamafutha amancane
   • Ikhofi
   • Ukudla okunothe ku-vitamin C (khetha lokho futhi okuphansi ku-sugar fructose okwenzeka ngokwemvelo, njengezithelo ezisawolintshi kanye nama-strawberry)
   • Amaprotheni angewona inyama, njengophizi, udali, tofu, nemifino eluhlaza eluhlaza
   • Ama-cherries we-tart

Ukwelapha i-acute gout attack

Uma uhlangabezana nobuhlungu be-gout, bona umhlinzeki wakho wezokunakekelwa kwempilo. Noma ungawudingi umuthi, ungakhuluma ngokudla nokuncipha kwesisindo okungenzeka futhi uxoxe ngokuthi i-gout idinga ukuphathwa okunolaka ngokwengeziwe, uDkt Fields weluleka.

Amakhambi asekhaya

Izinyathelo zokuzisiza ezinganciphisa ubuhlungu be-flare acute zifaka:

• Iqhwa futhi uphakamise ukujoyina okuthintekile
• Phuza amanzi amaningi
• Nciphisa umsebenzi

Imithi

Kubantu abanama-flare amabili noma ngaphezulu we-gout ngonyaka, noma i-gout enomlando we amatshe ezinso noma ukuncipha kokusebenza kwezinso, noma i-gout ne-tophi [amadiphozithi e-uric acid ngaphansi kwesikhumba azungeze amalunga afana neziqu zemifantu], lapho-ke badinga i-uric acid yabo yehliswe ngemithi, kuchaza uDkt. Fields.

Ukwelapha izimpawu zakho, umhlinzeki wakho wezokunakekelwa kwempilo angancoma:

• Izidakamizwa ezingezona ukuvuvukala (Ama-NSAID) ukunciphisa ubuhlungu nokuvuvukala
• I-Colchicine , eyehlisa ukuvuvukala kanye ne-uric acid eyengeziwe
• Corticosteroids ukunciphisa ubuhlungu nokuvuvukala. Lezi zingathathwa ngomlomo noma zinikezwe ngomjovo.

Ukusiza ukwehlisa amazinga e-uric acid emzimbeni wakho nokuvikela ukuhlaselwa esikhathini esizayo, ungathola le mithi elandelayo yomlomo:

• Okungenzeka (probenecid)
• I-Uloric (febuxostat)
• I-Zyloprim (allopurinol)

Noma ungathola i-Krystexxa (pegloticase), umuthi we-IV infusions.

Iziguli kufanele zibe nomqondo ovulekile lapho zixoxa ngamathuba okuphuza umuthi we-gout nodokotela wazo, uDkt Fields weluleka. Ithuba lokuthi ‘welapheke’ i-gout liphakeme kakhulu, uma uhlala emithini efana ne-allopurinol.