Gout

Content

• Myth: Only Wealthy And Obese People Get Gout
• Prevention Of Recurrent Attacks
• Maintaining A Healthy Weight
• Why Is It Important To Treat And Manage Gout?
• Intense Big Toe Pain From Gout: A Classic Symptom Of An Attack

Too much uric acid in the bloodstream is called hyperuricemia. Gout comes fromgutta, Latin for drop, a reference to the belief that it was caused by a drop-by-drop accumulation of humors in the joints. These include coffee, low-fat dairy products and particularly yoghurt, high doses of vitamin C, cherry or lemon juice, soya and lentils. But acidic foods such as tomatoes and oranges cannot cause or worsen gout.

Myth: Only Wealthy And Obese People Get Gout

One of the oldest drugs in therapeutics, colchicine, is used for the acute attack of gout. Perhaps the most important historical advance in the treatment of hyperuricemia was the development of allopurinol, the first xanthine oxidase inhibitor . George Hitchings and Gertrude Elion were awarded the 1988 Nobel prize in medicine for their work in developing allopurinol, azathioprine, and five other drugs. Allopurinol has since become the most frequently used uric acid lowering drug in clinical practice. The Arthritis Foundation cites many different risk factors for gout, including age , family history, gender , as well as many others which may be controllable. Lifestyle factors that may increase the risk for gout include eating a purine-rich diet and drinking alcohol .

Prevention Of Recurrent Attacks

Gout is caused by monosodium urate monohydrate crystals; pseudogout is caused by calcium pyrophosphate crystals and is more accurately termed calcium pyrophosphate disease. • Radiographs are generally not useful for diagnosis of acute gout, but they may show evidence of chronic disease, classically described as “rat bite” or “punched out” erosions. Dairy products, especially low-fat products, may actually protect against gout. Drinking coffee may also have a preventive effect against gout.

Gout can run in families, though, and is more common in males, postmenopausal women, and people who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills that interfere with the removal of uric acid from the body, may also have higher levels of uric acid in the blood. Gout is an extremely painful form of arthritis that affects more than three million Americans each year. Also known as gouty arthritis, the disease is caused by the formation of uric acid crystals in a joint , triggering severe pain, redness, and swelling.

Symptoms Include Excruciating Pain

Patients often ask about why colchicine, which has been available in unbranded form for many years, is now a branded drug (Colcrys®, Mitigare®). This is a result of the FDA effort to review and standardize the production of drugs which have been around a long time and were not previously reviewed by FDA. Not all persons with high urate levels in their blood develop gout, but the greater the degree and duration of hyperuricaemia, the greater the risk of crystal deposition and acute gout attacks. Gout is a common disease and one of the oldest in medical literature.

Is gout a symptom of kidney failure?

Kidney disease can lead to gout
When you have kidney disease, your kidneys cannot filter out uric acid as well as they should. Too much uric acid building up in the body may cause gout. Most people with early stage kidney disease do not know they have it. Gout can be a warning sign of kidney disease.

The medical term for excessive fluid in a joint is a "joint effusion." Uric acid levels in the blood are important to measure but can sometimes be misleading, especially if measured at the time of an acute attack. Levels may be normal for a short time or even low during attacks. Even people who do not have gout can have increased uric acid levels.

People with frequent gout attacks can go on to develop chronic gout, and these people will most likely experience joint damage. They’ll have to take medications long-term to prevent gout attacks. Patients with severe hyperuricemia should avoid foods with high purine content.

Is warm water bad for gout?

Soaking in cold water is most often recommended and considered most effective. Ice packs may also work. Soaking in hot water is typically only recommended when inflammation isn't as intense. Alternating hot and cold applications may also be helpful.

People who have hyperuricemia, but no other problems, usually do not require medications. A period of time when there are no symptoms at all, followed by other acute severe attacks. A sudden onset of joint pain and swelling that goes away after five to 10 days . Some people have one episode and never have any other problems with it.

If any additional questions occur to you during your medical appointments, don't hesitate to ask. Creating your list of questions in advance can help you make the most of your time with your doctor. Write down your symptoms, including when they started and how often they occur. Joint X-rays can be helpful to rule out other causes of joint inflammation.

Among individuals with hyperuricemia, the HR of all-cause mortality was 1.07 and the adjusted HR of cardiovascular mortality was 1.08. Although no evidence has shown that gout or hyperuricemia causes any of these disorders, elevated urate levels have been shown to correlate with elevated blood pressure in adolescents. Among middle-aged men, hyperuricemia is a significant independent risk factor for death from cardiovascular disease. A meta-analysis found an independent association between gout and cardiovascular mortality as well as all-cause mortality. With early treatment, gout should be totally controlled. If attacks recur, successful uric acid adjustment (requiring lifelong use of urate-lowering medication) usually suppresses further activity.

Intense Big Toe Pain From Gout: A Classic Symptom Of An Attack

Many people have high levels of uric acid in the blood but do not have flare-ups of gout; therefore, a blood test alone is not sufficient for diagnosis. “Almost all people with gout will need medication to control their urate,” Dr. Fields says. “To get a good outcome, people with gout need to get their blood urate level below 6.0 mg/dl and keep it there. By doing that, the body will gradually pull the urate crystals out of their joints, and the flares can stop.” Tophi will also gradually disappear. This may include eating foods high in purines, which get broken down into urate, such as red meat and shellfish. Foods high in fructose can also increase the body’s production of urate.

In some cases, you may need surgery to remove extremely large uric acid crystals . Doctors teach many people with gout how to begin treatment on their own. When a gout episode begins, call your doctor and begin taking your medication. Your doctor may suggest that you keep a supply of medication on hand to take at the first sign of trouble.

The key symptom is painful attacks in the joints – often, appearing first in the big toe. Other joints that may be affected include the ankle, foot, knees and, in severe cases, the wrists, elbows and fingers. People with gout may also experience kidney stones and damage to their kidneys. Once joint fluid is obtained, it is analyzed for uric acid crystals and infection. Your doctor may also do a blood test to measure the amount of uric acid in your blood. The major difference between gout and pseudogout is that the joints are irritated by calcium pyrophosphate crystals rather than urate crystals.

Gout Treatment And Prevention

Colchicine If you are unable to tolerate NSAIDS, your doctor may prescribe colchicine, but it must be taken daily. There can be side effects such as diarrhea, nausea, vomiting, and abdominal cramps. Wikipedia's health care articles can be viewed offline with the Medical Wikipedia app. The term "gout" was initially used by Randolphus of Bocking, around 1200 AD. It is derived from the Latin word gutta, meaning "a drop" . According to the Oxford English Dictionary, this is derived from humorism and "the notion of the 'dropping' of a morbid material from the blood in and around the joints".

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