Gout ba or OA lang: for patients
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A short lecture for lay on the different common arthritides, with focus on gouty arthritis
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Gout ba or OA lang: for patients
- 1. GOUT BA or OA lang? Allan D. Corpuz, MD, FPCP, DPRA Section of Rheumatology Department of Medicine ITRMC
- 2. Ano ang rheumatology? • Arthritis like Gout, Rheumatoid Arthritis, Osteoarthritis, Spondyloarthritis • Musculoskeletal/Soft Tissue Rheumatisms like Tendinitis, Bursitis, Fasciitis • Autoimmune and Connective Tissue Diseases like Lupus, Scleroderma, Myositis • Vasculitis
- 3. HINDI lahat ng rayuma ay gout • Mayroong mga 100 klase ng rayuma • Hindi lang joints ang nirarayuma • Ang rayuma ay maaring isang: – Arthritis like Gout, Rheumatoid Arthritis, Osteoarthritis, Spondyloarthritis – Musculoskeletal/Soft Tissue Rheumatisms like Tendinitis, Bursitis, Fasciitis – Autoimmune and Connective Tissue Diseases like Lupus, Scleroderma, Myositis – Vasculitis
- 4. Dahil HINDI gout lahat ng rayuma… • Hindi sila pare-pareho ng presentasyon • Iba-iba rin ang gamot ng bawat rayuma • Hindi dahil nawawala ang sakit sa pain reliever ay okay na • May mga rayuma na nakakamatay or nakaka-disable • Dapat lahat ng rayuma ay kinokonsulta sa isang RHEUMATOLOGIST
- 5. TOP 4 na Arthritis • OA (Osteoarthritis) • Gout • RA (Rheumatoid Arthritis) • SPA (Spondyloarthritis)
- 6. OA ang pinakamadalas • Tuhod, Kamay • Balakang • Likod • Sakit ng matanda (40 pataas) • Masakit halos araw-araw • Di halos namaga • Mababang level ng sakit • Masakit pag ginagalaw • Naninigas pag hindi naigalaw • Masakit sa pagtayo, pagbaba, pag-squat
- 7. Ang RA ay deforming at disabling • Autoimmune • Masakit araw araw • May halong pamamaga • Di sapat ang pain reliever • Didikit or madedeform ang joints
- 8. Ang SPA ay maraming klase • Maaring sumunod sa UTI or pagtatae (Reactive Arthritis) • Maaring makita sa mga bata (Juvenile form) • Maaring magsimula as chronic low back pain (Ankylosing Spondylitis) • Maaring may kasamang rashes (Psoriatic arthritis)
- 9. Pero Gout ang pinakamasakit • Nakakaapekto sa BIG joints; usually SINGLE joint sa una, dumadami habang tumatagal • Episodic (meaning: hindi araw-araw) • Madalas sa lalaki, mga 20 pataas • Bihira sa babae, unless postmenopausal • Namamaga, minsan mapula, sobrang sakit kahit mahipan lang • Mawawala, babalik
- 10. The 5 stages of gout • Asymptomatic hyperuricemia: mataas uric acid, walang arthritis • Acute Gout: simula ng arthritis, maiksi ang tagal, di madalas • Intercritical Gout: quiet phase • Chronic Gout: dumadalas ang atake, humahaba ang tagal • Chronic Tophaceous Gout: nagkakabukol na
- 11. Podagra ang usual na unang atake
- 12. Minsan nagtutubig ang tuhod
- 13. Bumubukol pag tumatagal • Pag hindi nagamot or inom lang ng inom ng pain reliever, nawawala ang sakit pero di ang problema (Chronic Tophaceous Gout)
- 14. Di dapat pinapa-operahan ang mga bukol • Maaring hindi gumaling • Maaring maimpeksyon • Nagagamot ito ng oral medications
- 15. Sa gout lang may bawal na pagkain • Hindi lahat ng rayuma may bawal na pagkain • Gout lang ang common na metabolic arthritis
- 16. The Gouty Diet
- 17. Food Group Low Purine 0-50mg purine/100g Eat as desired Moderate Purine 50-150 purine/100g Eat in moderation High Purine 150-825mg purine/100g Avoid eating Breads, Cereals & Grain Products White Bread Corn Bread Noodles/Pasta Macaroni Popcorn Spaghetti White Rice Crackers Puddings/Custards Rice Wheat Bread Oatmeal Wheat bran Wheat germ Brown Rice Whole grains Sweetbreads Yeast (Baker’s and Brewer’s) Fruit All Fruits and Fruit Juices Vegetables Most vegetables (except those noted in next column) Vegetable soups made w/o meat stock Asparagus Cauliflower Spinach Mushrooms Green Peas Meats, Poultry, Fish, and Protein Foods Eggs Peanut Butter Nuts (Walnut,Almond, Peanut) Lean Meat (beef, pork, lamb) Poultry without skin Tofu Fish Shellfish (shrimp, crab, oysters, clams) Sardines Mackerel Anchovies Herring Organ Meats (liver, kidney, brain, heart, intestines) Meat Extracts Mincemeat Dried beans (red bean, munggo bean, soybean, black eye peas, lentils, etc) Mussels Scallops Milk and Milk Products All low fat or fat free milk and dairy products Cheese Others Carbonated beverages Chocolate Coffee and Tea Fats and Oils Condiments Salt Olive/Pickles Meat Soups and Broth Beer and Alcoholic Products Gravies
- 18. Eating During Acute Attack Eating in Remission Consume 8-16 cups of fluid daily, at least half water Abstain from alcohol (discuss with M.D.) Avoid fruit juice and sugared soft drinks (diet sodas are okay) Limit animal foods of meat, fish, and poultry to 4 to 6 oz./day Eat protein in moderation: low-fat or nonfat dairy, tofu, eggs, and nut butters, such as peanut butter or almond butter, are preferred Consume 8 to 16 cups of fluid daily, at least half water Limit alcohol intake (discuss with M.D.) Limit/avoid fruit juice and sugared soft drinks (diet sodas are ok) Consume a healthy low-fat diet, with moderate amounts of protein.Visit MyPyramid.gov and click on MyPyramidPlan link for daily intake guidelines Maintain a healthy body weight.Avoid fasting or high-protein diets for weight loss