Gout Symptoms And Diagnosis

Content

• Everything You Should Know About Gout
• The Diagnosis And Treatment Of Gout
• What Are Symptoms Of Gout?
• Relieving Acute Flare
• What To Expect From Your Doctor
• Leading A Gout Free Life

Gout, a form of inflammatory arthritis, is a particularly painful condition that affects millions of Americans. The pain is caused by inflammation in the joint induced by the deposition of sharp uric acid crystals. Uric acid is created when purines are metabolized or broken down by the body. Uric acid in and of itself is not harmful; it only becomes worrisome when the body is unable to properly process the acid or if the body is experiencing unusually high levels of the acid. Gout is a type of inflammatory arthritis that causes sudden, severe attacks of pain, swelling, and redness in the joints. Although gout typically affects the big toe, other joints can also be involved.

But the disease actually progresses through four stages, from the silent buildup of uric acid in the blood to chronic arthritis. Here’s what’s happening at each stage, and how to keep your gout from progressing to the next level. Gout is a type of arthritis best known for its painful attacks on the big toe.

Everything You Should Know About Gout

New medications, including a biologic currently FDA-approved for rheumatoid arthritis, are on the horizon for gout treatment as well. Modern research has demonstrated that overconsumption of luxury foods such as red meat, shellfish, hard liquor, and beer may increase the risk of a gout attack. Colchicine is commonly used to prevent recurrent attacks of gout. Taking low doses of this drug once or twice daily has been shown to prevent gout attacks, especially in patients who have normal or slightly increased uric acid levels.

What are the 10 foods that trigger gout?

High-Purine Foods Include:Alcoholic beverages (all types)
Some fish, seafood and shellfish, including anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock.
Some meats, such as bacon, turkey, veal, venison and organ meats like liver.

As it circulates throughout the body and reaches the feet , the liquid uric acid crystalizes, leading to pain in the joints of the big toe or joint of the heel . In contrast, urate-lowering therapy in patients with gout has been linked to reduced risk for both cardiovascular mortality and all-cause mortality. An analysis of nationwide data on more than 200,000 English patients indicates that individuals with gout are at increased risk for both heart attack and stroke. The rate ratio for myocardial infarction in patients with gout was 1.82. Rate ratios for stroke were 1.71 for all stroke, 1.68 for ischemic stroke, 1.69 for hemorrhagic stroke, and 2.00 for stroke of unspecified type.

The Diagnosis And Treatment Of Gout

Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissues. A gout attack usually starts during the night with moderate pain that grows worse. A gout attack typically causes pain, swelling, redness, and warmth in a single joint, most often the big toe. Urate-lowering medications are the primary treatment for gout.

In particular, 3 genes are noted to have a strong association with hyperuricemia. The locus with the strongest evidence of association is the glucose transporter 9 gene, commonly referred to as the solute carrier 2A9 , the product of which alters the renal excretion of uric acid. Some of the variants are associated with a protective effect, whereas others convey a higher risk of gout.

The diagnosis for gout is made based on a physical examination by your doctor, x-rays, and lab tests. You will be asked about your symptoms and how gout has changed your activities. Because medications and other diseases can cause gout, you will be asked to provide a medical history and a medication list. Drinking too much alcohol and eating too much rich food were once considered the prime suspects in causing gout. Although eating certain foods and drinking alcohol may cause uric acid levels to spike, these habits alone may not cause gout. Corticosteroids – These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack.

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. Gout is considered when a patient reports a history of repeated attacks of painful arthritis, especially at the base of the toes or in the ankles and knees. The most reliable test for gout is detecting uric acid crystals in the joint fluid obtained by joint aspiration. This common office procedure is performed with topical local anesthesia.

In rare cases, patients can have mixed crystal disease. Tophus formation and bony erosions – After five or more years of recurrent flares, the patient with gout may develop tophi under the skin and around joints. While generally not painful, tophi can be disfiguring and interfere with normal joint function. The presence of tophi close to bones can lead to bone and cartilage destruction creating further deformities in the affected joints.

What does a gout diet look like?

The DASH diet focuses on fruits, vegetables, whole grains, and low-fat dairy products along with some fish, poultry, legumes, and nuts. It's also low in red and processed meats and sugary drinks, which are high-purine foods that people with gout are recommended to keep to a minimum.

Anti-inflammatories and corticosteroids can treat the symptoms of gout attacks. Your doctor may also prescribe newer medications that reduce the amount of uric acid in your blood. Left untreated, a gout attack will usually resolve itself within a few days or weeks. Chronic gout can permanently damage a joint’s tissues and decrease its range of motion. For this reason, it is important to recognize symptoms, understand risk factors, get an accurate diagnosis, and treat and prevent gout.

How To Know If Your Gout Is Progressing

When taken by mouth, colchicine can cause diarrhea, nausea and abdominal cramps. If side effects occur, stop taking the drug and notify your doctor. To prevent future episodes, you may have to continue taking a small dose of colchicine after the attack has cleared. For this 65-year-old male, colchicine and a prednisone taper are provided for treatment because he has used NSAIDs in the past with no improvement in pain. Since the patient has also had previous gout attacks with no treatment, the prednisone will help decrease the inflammation.

About 2 o’clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle or instep. This pain is like that of a dislocation, and yet the parts feel as if cold water were poured over them. After a time this comes to a full height, accommodating itself to the bones and ligaments of the tarsus and metatarsus. Now it is a violent stretching and tearing of the ligaments– now it is a gnawing pain and now a pressure and tightening. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room.