Diagnosis And Management Of Gout

Content

• For Patients
• Subscribe To Medicinenet's Arthritis Newsletter
• Prevention Of Recurrent Attacks
• Risk Factors
• The Rheumatologist's Role In The Treatment Of Gout
• How Do Doctors Diagnose Gout?

In many cases, the first attacks occur in the joints of the big toe, but gout can affect many other joints. Pseudogouthas similar symptoms to gout and is often confused with gout. Like gout, it is caused when painful crystals form in the joints. Unlike gout , pseudogout happens when there is too much calcium in the body. If you’re overweight, you are likely to have higher-than-normal uric acid levels, a primary risk factor for developing gout. That’s why weight loss is an important part of a gout diet.

What fruit is bad for gout?

Fructose is what gives some fruits (and vegetables) their natural sweetness. Researchers report a correlation between foods high in fructose and gout symptoms, which can include chronic pain. These fruits include apples, peaches, pears, plums, grapes, prunes, and dates.

In order to be effective, these medicines must be taken continuously. This will help your body get rid of excess uric acid and will keep the uric acid level from rising again. because excess uric acid can builds up in the urinary tract and crystallize there.

For Patients

Many complementary and alternative medicine approaches for managing gout focus on diet, weight loss, and exercise. When the joints detect the crystals, the body sees them as foreign entities or bacteria. The body sends white blood cells and other infection-fighting cells to the area to combat the crystals, which results in the symptoms listed above. After the first gout attack, the next one may not occur for months or even years. Sometimes gout causes an infection, which will cause a fever.

Without treatment, the tophi may form in the cartilage of the external ear or the tissues around the joint . Progressive crippling and destruction of cartilage and bone is possible. With refractory gout, uric acid levels remain high with standard treatment and symptoms become chronic, which means long-term or permanent. Gout happens when uric acid, a normal body waste, gets too high in the blood.

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If excessive uric acid is produced by the body or if uric acid is not eliminated effectively by the kidneys, it can form deposits of crystals in the joints. In most cases, long-term medications for lowering uric acid will be used to treat gout and prevent flares gout. Called tophi, these lumps are actually mounds of uric acid crystals. Tophi are most common in chronic gout patients, so you’d probably notice joint pain long before getting to this point. If you do develop tophi, you should know that these aren’t permanent deformities, says Dr. Huffstutter. With proper treatment you can dissolve these crystals so they’ll disappear.

Prevention Of Recurrent Attacks

Hypouricemic therapy may also be used for patients with tophi and a higher recurrance rate. Dietary restriction of high-purine foods is a less effective treatment technique but is still recommended. Other treatment possibilties include hydration greater than 3 liters per day. Alkalinization of urine, extracorporeal shock wave lithotripsy, and surgical excision may also be beneficial. Drugs such as allopurinol and febuxostat help limit the amount of uric acid your body makes. Side effects of allopurinol include fever, rash, hepatitis and kidney problems.

Typically it affects one joint at a time, although it can also involve many joints. Use of this site constitutes acceptance of Skinsight's terms of service and privacy policy. The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. After an acute attack, skin overlying the affected joint may peel and shed. If this occurs on a toe joint, the area may be more likely to develop a fungal infection (athlete's foot).

Risk Factors

People who develop gout likely have some genetic predisposition combined with other risk factors or conditions — such as kidney disease or diabetes — that cause uric acid to build up in the body. Left untreated, acute gout flares can result in chronic gout or gouty arthritis. This can cause long-term damage to the joints and kidneys, debilitating joint pain, kidney stones, and painful clusters of uric acid under the skin called tophi. Seek prompt medical care if you have symptoms of gout, such as severe joint pain, swelling, burning or redness, or you notice changes in joint shape. Gouty arthritis is a common cause of a sudden onset of a painful, hot, red, swollen joint, particularly in the foot at the big toe. Gouty arthritis is reportedly the most common cause of inflammatory arthritis in men over the age of 40.

Is Onion bad for gout?

If you have gout, dishes like chopped liver and liver and onions are best avoiding, along with other organ meats like kidney, heart, sweetbread, and tripe, since they're high in purines.

Why some people with high uric acid levels will develop gout and others won’t is unknown. 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. If gout symptoms have occurred off and on without treatment for more than 10 years, uric acid crystals may have built up in the joints to form gritty, chalky nodules called tophi. If tophi are causing infection, pain, pressure, and deformed joints, your doctor may be able to treat them with medicine. If this doesn't work, your doctor may recommend surgery to remove them.

The Rheumatologist's Role In The Treatment Of Gout

Other conditions which can mimic gout, should be definitively ruled out through crystal identification in joint fluid whenever possible. There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout.