All Your Questions About Gout, Asked & Answered

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Today, gout is the most common inflammatory arthropathy in the United States, where it affects approximately 4% of adults. To confirm the diagnosis, your healthcare provider may test the fluid in the inflamed joint . But not finding the crystals doesn’t mean that you don’t have gout. Your healthcare provider will use other tests and exams to diagnose gout.

Do tomatoes cause gout?

Since diet can play a role in increased blood levels of uric acid, it is worth paying attention to the foods that trigger you. Tomatoes are one food that many people with gout identify as being a trigger for gout flare-ups. Tomatoes contain two potential gout triggers: glutamate and phenolic acid.

A family history of gout increases the likelihood of the condition developing, as does being overweight. One misconception is that only people who eat poorly or drink alcohol in excess suffer from gout. In fact, people who eat healthy food and refrain from alcohol can still develop the condition. More than 50 percent of gout attacks start in the big toe, but gout can occur in any joint. Knees, ankles, feet and fingers are other common sites.

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When the body has high levels of uric acid, or hyperuricemia, uric acid crystals can concentrate in the joints. However, many people with higher uric acid levels never get gout. Doctors place gout under the umbrella term “arthritis” — a broad range of joint diseases and joint pain. Some forms of arthritis inflame joints, while others don’t. The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients.

Allopurinol has since become the most frequently used uric acid lowering drug in clinical practice. Microscopic tophi may be walled off by a ring of proteins, which blocks interaction of the crystals with cells and therefore avoids inflammation. Naked crystals may break out of walled-off tophi due to minor physical damage to the joint, medical or surgical stress, or rapid changes in uric acid levels. When they break through the tophi, they trigger a local immune-mediated inflammatory reaction in macrophages, which is initiated by the NLRP3 inflammasome protein complex. Activation of the NLRP3 inflammasome recruits the enzyme caspase 1, which converts pro-interleukin 1β into active interleukin 1β, one of the key proteins in the inflammatory cascade. An evolutionary loss of urate oxidase , which breaks down uric acid, in humans and higher primates has made this condition common.

Finished: Out With Gout

Gout is caused initially by an excess of uric acid in the blood, or hyperuricemia. Uric acid is produced in the body during the breakdown of purines – chemical compounds that are found in high amounts in certain foods such as meat, poultry, and seafood. It is the most common form of inflammatory arthritis in men, and although it is more likely to affect men, women become more susceptible to it after the menopause. Purines are also found in certain foods, including red meat and organ meats, such as liver.

For years, gout patients were told they had to follow a purine-restricted diet to stave off attacks, but those diets weren't very effective and people had a difficult time sticking to them. Now the easier-said-than-done advice is to lose weight, and also to cut back on alcohol, especially beer. Big meat and seafood eaters may be told to curb their appetites and instead eat more low-fat dairy foods.

Colchicine

The cause is high levels of uric acid in the blood, or hyperuricemia. Crystals accumulate, causing flare-ups or attacks of painful inflammation in the joints. Gout symptoms can include sudden, severe pain in one or more of any of your joints, often at night. That joint will become inflamed and red, and a simple touch will hurt badly.

And the memory of the last attack is bound to fade, no matter how excruciating it might have been. Like allopurinol, it's been on the market for decades, so it has a long track record. Probenecid works by increasing uric acid excretion by the kidneys so it can trigger the development of kidney stones and is not a good option for people with kidney problems.

Common Myths About Gout

They, however, may work less well than usual doses of NSAIDS. The high cost of this class of drugs may also discourage their use for treating gout. Febuxostat is only recommended in those who cannot tolerate allopurinol. There are concerns about more deaths with febuxostat compared to allopurinol. Febuxostat may also increase the rate of gout flares during early treatment.

If caught and treated early, people with gout can live a relatively normal life. Some patients do not respond to treatment because they fail to follow protocols, have alcoholism, or are undertreated by physicians. Depending on the stage of gout, your family doctor will prescribe medication to either help with the pain and swelling or to prevent further attacks. Medication to help relieve pain and swelling are NSAIDS, specifically Indomethacin, colchicine and possibly corticosteroids. These drugs are often prescribed for acute gout attacks.

Cell lysis from chemotherapy for malignancies, especially those of the hematopoietic or lymphatic systems, can raise uric acid levels, as can excessive exercise and obesity. About 90% of patients with gout develop excess urate stores because of an inability to excrete sufficient amounts of uric acid in the urine . Most of the remaining patients either overconsume purines or produce excessive amounts of uric acid endogenously . A few have impaired intestinal elimination of uric acid. Furthermore, multiple joints can be involved with chronic gout, and these joints can become damaged over time if gout is left untreated.

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All Your Questions About Gout, Asked & Answered