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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
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
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