What should be avoided with rheumatoid arthritis?

Written by Yang Ya Meng
Rheumatology
Updated on November 20, 2024
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Patients with rheumatoid arthritis should avoid the following three categories of food: The first category includes foods that can easily trigger photosensitivity, such as celery, coriander, shiitake mushrooms, seaweed, and leeks; these should be avoided. The second category includes overly warming and tonifying foods, such as dog meat, lamb, and longan; it is best to consume these sparingly. The third category includes high-protein seafood, such as shrimp and crab; these should be consumed in limited quantities because they may exacerbate rheumatoid arthritis symptoms and potentially trigger allergic reactions.

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Difference between arthritis and rheumatoid arthritis

Arthritis is typically osteoarthritis, a chronic inflammation characterized primarily by degenerative changes in joint cartilage, followed by bone proliferation, making it a chronic disease. Early pathological changes include alterations in joint cartilage, such as subchondral bone extrusion, followed by changes in the muscles surrounding the periosteum and joint capsule. Early radiographic examinations can provide a definitive diagnosis. Its symptoms primarily manifest as pain. For rheumatoid arthritis, it generally presents as morning stiffness and joint swelling and pain more severe than in the surrounding area, which can essentially confirm a diagnosis. It usually affects large joints such as the knee, shoulder, or wrist joints, typically presenting as migratory pain. A definitive diagnosis can usually be made by testing for rheumatoid factor, with an anti-O level exceeding 500 units. Additionally, there may be a slight increase in white blood cells, accelerated erythrocyte sedimentation rate, and elevated C-reactive protein. Examination of the synovial fluid shows increased white blood cells and neutrophils. In such cases, using anti-rheumatic drugs might suffice, but it’s also crucial to ensure rest and local heat application. These two types of arthritis fundamentally differ.

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Written by Wang Cheng Lin
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Is the ankle pain due to gout or rheumatoid arthritis?

In clinical practice, the first reason for ankle pain is rheumatic or rheumatoid arthritis, which mainly involves the synovium of the joint in the early stages, causing synovial hyperplasia and effusion leading to pain. The second cause is gout, which is due to dietary habits, such as frequent consumption of greasy or seafood-based foods, and a preference for beer, leading to increased uric acid levels and gout. The third cause is osteoarthritis in middle-aged and elderly people, which leads to degeneration of joint cartilage and pain. The fourth cause is sprains, which can lead to damage to cartilage and ligaments within the joint, causing pain. To determine whether ankle pain is caused by gout or rheumatic arthritis, one can simply visit a hospital for a checkup, such as a uric acid test to see if there is a significant increase in gout uric acid levels. If the uric acid level is significantly elevated, it is likely caused by gout. Additionally, one can check for a rheumatism panel to see if the anti-O test is positive; if it is, it may suggest that rheumatic factors are causing the pain.

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Rheumatology
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Foods to Avoid with Rheumatoid Arthritis

Patients with rheumatoid arthritis should adhere to a light diet and avoid spicy foods, overly nourishing and greasy foods. Specifically, the following foods should be avoided: vegetables such as celery, coriander, shiitake mushrooms, leeks, and seaweed. In terms of meat, one should reduce consumption of warming foods like lamb, beef, and dog meat. Also, it is advisable to limit intake of high-protein seafood such as shrimp, crab, and sea cucumber. Regarding fish, preference should be given to freshwater fish, while the consumption of sea fish should be minimized. These are the foods that should be avoided by those suffering from rheumatoid arthritis.

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Written by Li Jing
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Treatment of Acute Flare-ups of Rheumatoid Arthritis

During the acute phase of rheumatoid arthritis, typical treatment includes absolute bed rest and avoiding intense physical activities, followed by a diet rich in fresh fruits and vegetables containing vitamins. Medication-wise, sodium diclofenac or meloxicam are used, which are non-steroidal drugs that relieve joint pain. If these drugs are not effective, steroids such as methylprednisolone are administered, initially at doses of 20 mg or 40 mg, until the pain eases, then gradually reducing the steroid dosage. During steroid treatment, it's also important to prevent side effects, namely, by supplementing with calcium and incorporating drugs that protect the stomach lining. (The above medications should be used under medical supervision.)

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Is hot compress useful for rheumatoid arthritis?

Rheumatoid arthritis during the acute flare-up phase makes heat application useless; it might even exacerbate the symptoms of joint pain. Normally in daily life, applying heat to the affected joints can assist in treatment. However, during the acute flare-up phase of rheumatoid arthritis, the main symptoms are migratory pain in the major joints of the limbs. Cold application may help alleviate the pain, but heat should definitely not be applied during the acute phase. The development of rheumatoid arthritis is somewhat related to streptococcal infections. Therefore, penicillin antibiotics are generally used for anti-infection treatment. During the acute phase, it is common to also use non-steroidal anti-inflammatory drugs, such as etoricoxib or meloxicam, to relieve symptoms.