What Is Gout? Symptoms, Causes, Diagnosis, Treatment, And Prevention

Content

• Request Your Goutful Booklet
• Living With Gout
• What Are Future Possible Treatments Of Gout?
• How Gout Treatment Prevents Disease Progression

An attack of acute gout will reach its most aggressive form 12 to 24 hours after the onset of symptoms. Without treatment, full recovery can take one to two weeks. The major reason people develop gout is because their kidneys have difficulty excreting uric acid.

Unlike allopurinol, which interacts with warfarin (Coumadin®), febuxostat did not have this interaction when studied. Febuxostat is approved by the FDA to start at 40mg daily, and if the uric acid has not reached goal (less than 6.0mg/dL) after two weeks of treatment the dose can be increased to 80mg daily. The 80mg dose of febuxostat brought more patients to less than 6mg/dL of uric acid than 300mg of allopurinol, the dose of allopurinol most commonly used. Rheumatologists often adjust allopurinol doses higher than 300mg when needed to reach uric acid goal, although the literature on higher doses of allopurinol is limited. There are a number of measures that can help resolve an attack of gout.

Request Your Goutful Booklet

In other people, attacks may become more frequent over time. Elevated serum urate levels may support diagnosis but are not sensitive or specific. Levels should be measured on several different occasions and it is possible for levels to be normal during and actute attack.

Living With Gout

Consumption of fructose-rich foods and beverages (eg, those sweetened with high-fructose corn syrup) is associated with an increased risk of gout in both men and women. Advances in early diagnosis and the availability of definitive treatment have significantly improved the prognosis of gout, as evidenced by the declining incidence of disabling chronic tophaceous gout. However, tophaceous gout may still develop because of misdiagnosis, poor management, medication intolerances, or poor patient adherence. Gout and pseudogout are the two most common crystal-induced arthropathies.

How Does A Doctor Diagnose Gout?

People with gout will sometimes think that the prolonged absence of symptoms means that the disease has spontaneously disappeared. Unless the underlying cause of high uric acid levels is controlled, the disease can advance silently and reap irreversible harm. In severe cases, a condition known as acute uric acid nephropathy may develop, leading to kidney impairment and a rapid reduction in renal function. People with underlying kidney dysfunction are at greatest risk. Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away. Gout flares often begin in your big toe or a lower limb.

Is drinking water good for gout?

Drinking water can help flush the uric acid crystals that cause gout out of your system. “A well-hydrated patient should drink enough to urinate every two to three hours,” says Dr. Shakouri.

For many people, the first gout attack (or flare-up) occurs in the big toe. The physical therapist should be aware that any patient with a history of gout, hyperuricemia, and/or a septic joint presentation should be refered for medical evaluation prior to treatment. There are other types of joint and inflammatory conditions that may have the same symptoms as gout, and the painful attack usually goes away in about 5 to 10 days. Gout cannot be cured, but it can be very successfully treated.

Care And Treatment

Getting rid of the old crystals can help protect the joint from further damage. As with all medications, you should report any side effects to your doctor right away. Watch for skin rashes, itching, fever, nausea, vomiting, diarrhea, or other new symptoms not present before taking the serum uric acid medications.

Rehabilitation treatment and advice from a Physical Therapist at Sports Rehabilitation Unlimited can be of benefit for gout. Corticosteroids are used in rare cases when NSAIDs or Colchicine can’t be taken since these drugs have serious side effects including high blood pressure and high blood sugar. Uric acid levels rise when your body breaks down “purines.” Purines are found in foods like red meat and alcohol, as well as in certain medications and naturally in the human body . Gout is a crystal arthropathy due to deposition of monosodium urate crystals in and around the joints.

It passes through the kidneys and out of the body in urine. But sometimes uric acid can build up and form needle-like crystals. Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. If caught and treated early, people with gout can live a relatively normal life.

As always you should drink plenty of fluids, especially water. 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.

Although typically a painless structure, the formation of tophi can cause an acute inflammatory response within the tissue. As the tophi become enlarged they may cause deformities, and there is potential for them to protrude through the skin and exude a white chalky substance . Some of the most common sites of enlarged tophi are the forearm, ear, knee and foot. A program to control uric acid levels and manage symptoms often includes daily colchicine and allopurinol or probenecid along with dietary restrictions. Another serum uric acid-lowering medication that has been shown to reduce the risk of occurrence is Uloric .

Can arthritis be mistaken for gout?

Rheumatoid arthritis (RA) and gout can resemble each other because both diseases cause inflammation of the peripheral joints. In addition, the nodules of RA and the tophi of gout can be similar in appearance.

Low-fat dairy products may be a better source of protein for people prone to gout. This test combines X-ray images taken from many different angles to visualize urate crystals in joints. Your doctor may use a needle to draw fluid from your affected joint.