The Impact Of Gout On Heart Disease

Content

• When To See A Doctor
• Gout Topics

Many of my patients have explored a variety of non-traditional approaches to gout, often in combination with traditional measures. Diet has been discussed in more detail above, and gout is clearly one of the rheumatic diseases where diet is unequivocally important. Devil’s claw , curcumin and many other herbal treatments have been proposed as gout therapy, and further study of these is indicated. Cherry juice, which has long been an alternative remedy and which had anecdotal support, now has been studied. At the American College of Rheumatology meeting in November there were two studies looking at cherry juice.

How can gout be prevented?

Strategies for Preventing a Gout Attack 1. Avoid or limit alcohol.
2. Drink plenty of water.
3. Lose excess weight or maintain a healthy weight.
4. Treat sleep apnea.
5. Avoid foods that can trigger a gout flare-up.
6. Avoid medications that trigger gout.
7. Take prescription gout medication.
8. Foods that may trigger a gout attack.

However, diagnosing gout can be hard, and treatment plansoften must be tailored for each person. Gout Diet Foods Menu Whether you get gout can depend on your diet. Some foods like red meat, alcohol, and high-fructose corn syrup in sodas can raise your risks. Limiting foods that cause gout in your diet can protect you from this painful joint condition, a type of arthritis.

When To See A Doctor

Over-the-counter dosage levels, for example, ibuprofen at 200mg, two tabs three times a day, are often insufficient. About 10% of cases of gout are due to overproduction of uric acid. When uric acid is overproduced, it is high not only in the blood but in the urine, raising the risk of both gout and kidney stone. Some people overproduce uric acid due to a genetic defect in an enzyme in the purine breakdown pathway which leads to overactivity of this pathway. Since cells contain DNA, and DNA contains purines, anything that increases the breakdown of cells in the body can lead to more uric acid and gout.

Patients reported the inconvenience of taking pills daily, the need for multiple medications, the side effects from medications and the concern of potential long-term side effects. In one group, three of the top seven concerns were related to the negative impact of medications on QOL. One patient group described that gout was shaping their social and work interactions and that it was becoming an integral part of their social interactions. Patients were seeking others with similar conditions and bonding with them. Malaika Hill is a freelance health writer specializing in ophthalmology and population health. Malaika can be found on her website mdwesolutions.com, LinkedIn @malaikadavid, or Twitter @malaika_hill.

Gout Topics

The most important differential diagnosis in gout is septic arthritis. This should be considered in those with signs of infection or those who do not improve with treatment. To help with diagnosis, a synovial fluid Gram stain and culture may be performed. Other conditions that can look similar include CPPD , rheumatoid arthritis, psoriatic arthritis, palindromic rheumatism, and reactive arthritis.

When you have gout, you’re more prone to osteopenia and osteoporosis factures. A study in the journal Medicine found that the overall rate of bone fracture in people with gout was nearly 23 percent, which was higher than that of those without gout. Probenecid, sulfinpyrazone and allopurinol also may cause you to have more frequent gout episodes at first. During this time, you may have to take colchicine or an NSAID for the first three to six months to prevent an episode. While the skin rash sometimes can be serious, other side effects usually are not serious and may go away as your body gets used to the medicine. If any side effects continue to bother you, contact your doctor.

Gout happens when too much uric acid builds up in the body. Uric acid is a normal waste product in the blood resulting from the breakdown of certain foods. Uric acid usually passes through the kidneys and is eliminated from the body in urine. But it can build up in the blood and form painful, spiky crystals in your joints. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out. Gout medication is often very effective, but only if you take it.

The prevalence of gout has increased in both older and younger people. The increase in younger people is not explained, but the increase in older people, at least in part, relates to increased life span, increased weight and increased use of diuretics. Diuretics are used commonly for hypertension, for example, and they elevate the blood levels of uric acid and can increase the risk of gout. The doctor will need to rule out other reasons for the joint pain and inflammation such as an infection, injury or other type of arthritis. The doctor may also take an X-ray, do an ultrasound or order a magnetic resonance imaging scan to examine soft tissue and bone. The doctor might also remove fluid from the painful joint and examine it under a microscope for uric acid crystals or bacteria indicating an infection.

If untreated, these disorders can lead to joint destruction and, in the case of uric acid crystals, renal damage. Gout is a monosodium urate, monohydrate crystal deposit disease. It was among the earliest diseases to be recognized as a clinical entity.

These deposits can cause pain-often severe-and swelling in the affected area or areas. Prescription drugs such as allopurinol , febuxostat and probenecid all alleviate gout by controlling blood levels of uric acid. Also, two years ago the FDA approved an intravenous drug for people with advanced gout — pegloticase — that lowers uric acid levels and reduces deposits of uric acid crystals in the joints and soft tissue. It is unclear what causes a flare to stop; the body likely turns off the inflammation response after a certain period of time. During a flare, individuals can experience throbbing or burning pain, swelling, warmth, redness, and difficulty moving the affected joint. Fevers may occur, after which the skin over the affected joint can begin to peel.

It is caused when there is too much uric acid in the blood. Uric acid is a breakdown product of normal metabolism in the body and is normally excreted through urine. Buildup of uric acid results in needlelike crystals forming in the joints, soft tissues, and organs.

Relieve the pain and swelling of an acute attack--these medications include nonsteroidal anti-inflammatory drugs , colchicine, corticosteroid drugs and/or adrenocorticotropic hormone . If you have kidney stones due to uric acid, you may need to avoid or limit foods that raise your uric acid level such as those listed below. Talk to your doctor about what foods you may have to avoid.

Is gout curable or not?

Gout can be extremely painful and incapacitating but is extremely treatable in almost all patients. It's important to identify and treat it early to avoid pain and complications. Gout is a major problem in the foot, but it can also involve many other joints.

Gout frequently affects the large joint of the big toe, but can also affect the forefoot, ankles, knees, elbows, wrists, and fingers. As gout progresses, you may not be able to move your joints normally. The affected joint or joints become swollen, tender, warm and red.

This study, the CARES trial, looked at 5000 patients, all of whom had some cardiovascular disease history, either heart attack, stroke, min-stroke or need for urgent heart surgery for coronary disease. For the combination of these outcomes, the two medications were the same. However, cardiac death was higher in the febuxostat group. There were some problems with interpreting the study, since almost all the patients who died had already stopped their gout medication, whether allopurinol or febuxostat. Many rheumatologists do not think this is a definitive study, and there is other data that does not show increased heart risk with febuxostat.

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"That combination of having high uric acid, being predisposed to gout, and wearing shoes that are hurting your feet, that could do it," Dr. Vanitallie says. Although there haven’t been studies looking at the effect of shoes on gout risk, wearing uncomfortable shoes is rarely a smart health move. Osteoarthritis, which is the wearing down of joint-cushioning cartilage as we age, is also associated with gout. Take this as another reason to try to avoid jamming a toe or finger, twisting an ankle, or putting repetitive stress on a joint. Dehydration can have many ill health effects, and gout is one of them. Additionally, certain treatments like chemotherapy can increase purines as the treatment kills the tumor cells and causes the breakdown of the purines in those cells.