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Tuesday, October 26, 2021
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Gout describes a type of arthritis that is characterized by the formation of sodium urate crystals in and around joints. The condition is the most common form of inflammatory arthritis, affecting around 1.5 percent of people in the UK. Any treatment that decreases levels of uric acid in the blood can trigger an acute flare-up (mobilization flare-up).
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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.
Many people experience gout flare-ups when they consume more alcohol than usual or when they drink for a prolonged period of time. Gout flare-ups are caused by an overabundance of uric acid. Uric acid is a compound created when the body breaks down purine-rich foods, including liver, mackerel, dried beans, and anchovies. High concentrations of uric acid make it more likely to crystallize, causing pain. Your physician may recommend blood tests to measure the levels of uric acid and creatinine in your blood. For people with more advanced stages of gout, doctors may order a CT scan or an X-ray to check for joint damage.
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Uric acid also can deposit in the urinary tract, causing kidney stones. Colchicine (Colcrys®, Mitigare®) has a role in both the prevention and treatment of gout attacks . See details about colchicine for attacks of gout in Table 2. An attractive feature of colchicine is how specific it is. For example, it can resolve an attack of gout, but it doesn't help a flare-up of rheumatoid arthritis. In the past, colchicine was also used intravenously in addition to its oral use.
Sometimes additional pain relievers are needed to control pain. Gout with joint damage increases the risk of developing osteoarthritis. Take nonsteroidal anti-inflammatory drugs when symptoms begin. Talk to your health care provider about the correct dose.
It is possible to have a normal uric acid level while you are having severe gout pain so this is not always a reliable indication of the presence of gout. As mentioned above, this joint is most commonly the MTP joint at the base of your big toe. The affected joint becomes swollen, warm, and red within eight to 12 hours. Most of the time the attacks occur at night and last 3-10 days.
What foods cause gout?
Foods and drinks that often trigger gout attacks include organ meats, game meats, some types of fish, fruit juice, sugary sodas and alcohol. On the other hand, fruits, vegetables, whole grains, soy products and low-fat dairy products may help prevent gout attacks by lowering uric acid levels.
Aspiration of synovial fluid immediately decreases the pressure in the joint and the needle leaves a pathway or track that acts as a vent for continued drainage after the needle is removed. Gout attacks are more common at night for a variety of reasons, which researchers believe may include lower body temperature, dehydration, and low cortisol. Ensuring you are adequately hydrated before bed and maintaining a comfortable temperature throughout the night may help. If you are overweight, your body produces more uric acid and your kidneys have a more difficult time excreting uric acid. You are more likely to develop gout if other members of your family have had it. NSAIDs and colchicine are first-line treatment for gout.
These medicines decrease the elevated levels of uric acid in the blood. Hyperuricemia often is caused by using diuretic medications ("water pills"). Diuretics are used to get rid of excess body fluid and to lower high blood pressure. However, diuretics can hamper the kidneys' ability to remove uric acid, thus raising uric acid levels in the blood.
Gout is considered a chronic disease, meaning it does not have a cure and will usually last your whole life. This condition and its complications occur more often in men, women after menopause, and people with kidney disease. Gout is strongly linked to obesity, hypertension , hyperlipidemia and diabetes. Because of genetic factors, gout tends to run in some families. Patients may need medications to lower their elevated blood uric acid levels that predispose to gout. Uric acid-lowering therapy helps prevent future acute attacks of gout and gradually dissolves the uric-acid-containing tophi.
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When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout and treatment with medications is necessary. Gout happens when high levels of a substance called serum urate build up in your body.
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If you don’t treat it, you could be dealing with it for a week to two weeks. Instead, your doctor will likely prescribe a higher dose of a non-steroidal anti-inflammatory drug , such as naproxen, or a steroid medication like prednisone. Your doctor might also inject a steroid directly into the affected joint, or, if the pain is bad enough, start you on an intravenous version of it, says Dr. Saag. This procedure involves removing the painful joint and replacing it with artificial parts.
Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints. The diagnosis must rule out the presence of infection, which can be a hidden problem. Your doctor may also get a blood test to look at the levels of uric acid. It should be noted, however, that uric acid levels rise and fall depending on many complex factors in your body.
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