Gout Symptoms, Causes, Treatments, And Relation To Kidney Disease

Content

• What Causes Gout?
• Swelling And Stiffness
• Gout Surgery For Tophi Removal And Joint Damage Repair
• Related Health Topics

Most tophi on the ears, hands, or feet shrink slowly when the uric acid level decreases to less than 6 milligrams per deciliter (0.4 millimoles per litre). A high level of uric acid in the blood causes problems for people with gout and may increase the risk of kidney disease in people without gout. Lowering the level of uric acid in the blood helps dissolve deposits of uric acid in the tissues and prevent flare-ups. With early diagnosis of gout, treatment enables most people to live a normal life.

However, for some patients, gout can be a chronic, relapsing problem with multiple severe attacks that occur at short intervals and without complete resolution of inflammation between attacks. This form of gout, called chronic gout, can cause significant joint destruction and deformity and may be confused with other forms of chronic inflammatory arthritis such as rheumatoid arthritis. Frequently, uric acid tophi are present and contribute to bone and cartilage destruction. Tophi can be found around joints, in the olecranon bursa, or at the pinna of the ear. With treatment, tophi can be dissolved and will completely disappear over time. Uric acid crystals can form stones in the kidneys, in the ureters or in the bladder itself.

What Causes Gout?

These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee. Primary care providers , such as internists, who specialize in the diagnosis and medical treatment of adults. The most common symptom of gout is pain in the affected joint, such as the big toe.

It usually takes a long time to develop—up to 10 years—and is most common in those whose gout is not treated. JEFFREY A. ALLOWAY, M.D., is a rheumatologist at Wilford Hall USAF Medical Center at Lackland Air Force Base and assistant professor of medicine at the USUHS F. Edward Hébert School of Medicine. LORI B. SIEGEL, M.D., is chief of rheumatology at the Finch University of Health Sciences, Chicago Medical School.

Swelling And Stiffness

While the big toe is the most common place for a gout attack to happen, gout can also affect surrounding joints in the foot, ankle, and knee. Purines are a group of chemicals present in all body tissues and in many foods. Our bodies are continually processing purines, breaking them down and recycling or removing the byproducts.

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Diets rich in red meats, internal organs, yeast, shellfish, and oily fish increase the risk for gout. People with insufficient kidney function are at increased risk for gout. Cherries and an herb called devil's claw have been used as anti-inflammatories. Research is needed to evaluate the usefulness of these and other complementary medicines to treat gout. If gout symptoms have occurred off and on without treatment for several years, they may become ongoing and may affect more than one joint. While X-rays of extremities are sometimes useful in the late stages of the disease, X-rays aren't usually helpful in the early diagnosis.

Does soaking in hot water help 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.

Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis. The most reliable method to diagnose gout is by demonstrating uric acid crystals in joint fluid that has been removed from an inflamed joint . Specially trained physicians, such as a rheumatologist or orthopedist, can carefully remove fluid from the joint.

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. Avoid or limit high purine foods and drinks like organ meats, shellfish, beer, and products with high-fructose corn syrup.

For most patients the need and the occasional acute treatment, and do not need long-term treatment. Your podiatrist will work with your primary care doctor and a rheumatologist to create a long-term plan. Excising a deformed small toe joint can also remove an area destroyed by gout crystals. Step by step, Podiatrists are the best doctors to treat gout. The first sign of gout is typically a very suddenly severely painful, red, hot and swollen base of the big toe.

When this happens, needle-shaped crystals form in and around the joint. However, many people with high levels of serum urate will not develop gout. Chronic tophaceous gout is the most debilitating type of gout. Permanent damage may have occurred in the joints and the kidneys. The patient can suffer from chronic arthritis and develop tophi, big lumps of urate crystals, in cooler areas of the body such as the joints of the fingers.