Winter is here again, with the aroma of hot pot filling the air. Mr. Wang met up with friends for a hot pot feast and drank plenty of beer. He was suddenly awakened by a sharp pain in his foot in the middle of the night. After waking up, his left foot continued to ache intensely, with the joint area appearing red, swollen, and hot. He went to the emergency room, where he was diagnosed with gout. His condition was brought under control through strict dietary management and medication. So, how can eating hot pot cause gout?
Gout is a group of diseases caused by purine metabolic disorders and hyperuricemia. With the continuous improvement of people's living conditions, especially changes in dietary habits, the incidence of gout has significantly increased and shows a year-on-year upward trend. The prevalence of gout increases with age, most commonly affecting adult males aged 30-60, with a male-to-female ratio of about 20:1. In women, it most often occurs after menopause.
It is more common in mental workers and economically well-off social classes. The incidence of gout is also higher in families with a history of the disease. Half of the patients have a history of alcohol consumption. This condition is easily confused with general joint pain, leading patients to seek medical treatment and take medication blindly for a long time without a cure, which can even lead to joint deformities or renal failure. Furthermore, hyperlipidemia, hypertension, obesity, diabetes, arteriosclerosis, and coronary heart disease are often accompanied by hyperuricemia and gout.
When eating hot pot, consuming large amounts of high-purine foods such as animal offal, bone marrow, beef and mutton, seafood, and shrimp can easily trigger a gout attack. Some people mistakenly believe that drinking only the broth and not eating the meat is safe. In fact, the purine content in meat broth is 30 times higher than in a normal diet, which can easily lead to an increase in uric acid, a purine metabolic waste product, in the body. Alcohol consumption also promotes the accumulation of lactic acid in the body, inhibiting the excretion of uric acid. This is the main reason why people who indulge in drinking before a hot pot are prone to gout.
Currently, there is still a lack of etiological treatment and a cure for this disease in clinical practice. Although colchicine or non-steroidal anti-inflammatory drugs can control the condition and provide effective pain relief during the acute phase, they cannot effectively lower blood uric acid levels. In the chronic phase, drugs like allopurinol, probenecid, and benzbromarone can inhibit uric acid synthesis or promote its excretion, thereby lowering blood uric acid levels. However, these drugs have significant side effects, a narrow safe range for use, and most patients cannot adhere to the treatment long-term. Therefore, leveraging the advantages of Traditional Chinese Medicine (TCM) and targeting its pathogenesis characteristics by strengthening TCM treatment during the acute and chronic phases is of great significance for preventing gout recurrence and controlling its progression.
In TCM, gout is attributed to congenital deficiency, or improper diet in later life, combined with the decline of organ function after middle age, leading to deficiency of the spleen and kidneys and the accumulation of dampness and turbidity. This is then triggered by factors such as alcohol consumption, hunger, overeating, exposure to cold, fatigue, emotional distress, trauma, or excessive exercise (such as long periods of walking, sports, hunting, etc.), resulting in the stagnation of phlegm turbidity and blood stasis, obstructing the collaterals, and manifesting as gout. TCM treatment for gout generally involves stage-based syndrome differentiation and treatment, combining internal and external therapies.
During the acute arthritis phase, it is differentiated as a syndrome of damp-heat and blood stasis. The treatment principle is to clear heat and drain dampness, resolve stasis, and unblock the collaterals to relieve pain. Commonly used herbs include Smilax glabra, Dioscorea hypoglauca, Coix seed, Phellodendron bark, and silkworm excrement. This is often combined with external application of Jinhuang ointment, which can significantly improve local joint symptoms and also has the effect of excreting uric acid.
During the intermittent and asymptomatic phases, it is differentiated as a syndrome of spleen and kidney deficiency with intermingled phlegm and stasis. The treatment principle is to tonify the kidneys and invigorate the spleen, and to drain and transform turbidity and stasis. Medicinal herbs include Atractylodes lancea, Atractylodes macrocephala, Smilax glabra, Epimedium, Eucommia, Achyranthes, Salvia miltiorrhiza, Zea mays stigma, and Serissa foetida. These can help improve purine metabolism. After a long course of treatment, blood uric acid levels can decrease, and the therapeutic effect often remains stable after stopping the medication.
Gout is a disease that is prone to recurrence. While using medication, dietary and lifestyle adjustments play an extremely important role in controlling the progression of the disease. It is essential to avoid foods with extremely high purine content, limit protein intake, and increase the intake of alkaline foods and water. Avoid triggering factors such as overexertion, stress, exposure to cold, dampness, and joint injury. Pay attention to keeping warm and avoiding cold.
In addition, it is necessary to have regular follow-up checks of blood uric acid and kidney function to detect and treat problems promptly. As long as these measures can be adhered to, the chances of gout recurrence are greatly reduced, and even patients with a hereditary predisposition to gout can lead a healthy life.