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

Content

• Tophi
• Complications Of Gout And Its Symptoms
• Ascertainment Of Gout Flares
• What Is The Latest Research On Gout?
• What Foods Should People With Gout Eliminate From Their Diet?
• Trauma To Joints

Dosing recommendations for colchicine in the treatment of acute gout have undergone modifications as awareness of its toxicities has increased. Newer recommendations trend toward lowered daily and cumulative doses. Treatment of the acute phase of pseudogout is identical to that of acute gout.

If you’re experiencing gout pain, see your healthcare provider. “Even if you don’t need medication, you can talk about diet and possible weight loss and discuss when gout needs more aggressive management,” Dr. Fields advises. drinking at least 8 glasses of nonalcoholic beverages per day.

Tophi

Adverse event rates in both subgroups were comparable with those in the overall trial. Prednisone can be given at a dose of approximately 40 mg for 1-3 days, which is then tapered over approximately 2 weeks . If treatment continues for more than 2 weeks, consider measures to prevent osteoporosis. Taking more colchicine than prescribed can lead to overdose and death. NSAIDs can increase the chance of having a heart attack or a stroke. The following possible side effects of medicines for gout are listed by the U.S.

Over-the-counter dosage levels, for example, ibuprofen at 200mg, two tabs three times a day, are often insufficient. Gout is a type of inflammatory arthritis that happens when levels of uric acid — a normal byproduct of metabolic reactions in your body — become too high. When levels of uric acid get so high that your body can’t easily dissolve and excrete it , uric acid starts to crystallize.

Complications Of Gout And Its Symptoms

Your blood uric acid level may be watched by your doctor until it is lowered to normal levels. The goals of treatment for gout are fast pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage. Treatment includes medicines and steps you can take at home to prevent future attacks. The reported prevalence of gout is highly variable across the world, ranging from 0.1% to approximately 10%, with prevalence estimates greater than 1% in most developed countries .

When purines break down in the body, they cause uric acid to form. In most cases, people who have gout will still need medication even when they follow a diet for gout. That said, tweaking your diet can be a powerful way to help manage gout and gout symptoms. Some research suggests that food changes alone can lower your uric acid levels by up to 15 percent, according to theInstitute for Quality and Efficiency in Health Care. Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen (Naprosyn®), ibuprofen (Motrin®), celecoxib (Celebrex®), indomethacin (Indocin®) and many others.

Kidney stones can be painful and increase the risk of urinary tract infections. On average, nearly 1 out of 100 men with gout will develop kidney stones within one year. Following an attack of gout, the affected joint usually recovers on its own within one to two weeks. Most people who have had a gout attack will have another one anywhere between six months to two years later. Repeated attacks may last longer and affect several joints. Certain medical conditions may also contribute to the build-up of too much uric acid, including some blood disorders or specific cancers such as leukemia.

Can gout be cured forever?

Patients can never be cured of gout. It is a long-term disease that can be controlled by a combination of medication to control the uric acid level, and anti-inflammation drugs to treat a flare-up.

Begin prophylaxis against acute attacks during the first three months of allopurinol treatment, such as colchicine 0.5 mg twice daily begun two weeks before the allopurinol. Reduce the dosage of colchicine to 0.5 mg once a day if creatinine clearance is ml/min or to 0.5 mg every second or third day if it is ml/min. Prophylaxis may need to be lengthened if attacks continue or possibly shortened if toxicity from the prophylactic drug occurs. A more widely used though less evidence based alternative to colchicine is an oral NSAID , which can be started at the same time as the allopurinol. Gout attacks can change the way you feel about your own body.

What Is The Latest Research On Gout?

Having a high uric acid level, as gout patients do, can be an early indication for cancers that develop in skin tissues and the linings of internal organs. Studies show that gout is associated with an increased risk of prostate cancer in men. Liver, lung, and colon cancers have also commonly been detected in people with gout. Gout is often diagnosed upon the finding of uric acid based crystals. The physician may use a needle to extract fluid from an affected joint and will study that fluid under a microscope to find whether urate crystals are present.

Chronic lead exposure and lead-contaminated alcohol are risk factors for gout due to the harmful effect of lead on kidney function. Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor. It is possible to have hyperuricemia and not develop gout.

These include untreated high blood pressure and chronic conditions such as diabetes, obesity, metabolic syndrome, and heart and kidney diseases. Low doses of colchicine or anti-inflammatory medications may be used for an acute attack. Follow up with a doctor after the acute attack has resolved to determine if it is necessary to start medications to lower the blood uric acid level. Anyone who has a sudden onset of a hot, red, swollen joint should seek medical care, either with a primary care physician, at an emergency department, or with a rheumatologist . These symptoms can also be due to an infection, loss of cartilage in the joint, or other reasons. It is important to make an accurate diagnosis of gouty arthritis for optimal treatment.

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These tests are particularly helpful because some people with gout produce and eliminate a large amount of uric acid. These people may be more likely to develop kidney stones. People with gout also may have high blood pressure or kidney infections. Since these problems can cause kidney damage, your doctor will check for signs of these problems and treat them if they occur.

What Foods Should People With Gout Eliminate From Their Diet?

Gout develops when too much uric acid accumulates in your bloodstream. This dissolved uric acid then comes out of the bloodstream and forms microscopic spike-like crystals in joints or soft tissues. Obesity, insulin resistance, high cholesterol, heart disease, hypothyroidism, and kidney disease can be associated with gout. Episodes of gout have been noted after injury or surgery, sometimes involving infection or the use of contrast for x-rays. Physical fitness seems to help with prevention of gout.

Stopping therapy presents a risk for an attack of gout, however. 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. The most common symptoms associated with gout include pain, redness, warmth, and swelling in the affected joint. Patients commonly describe a worsening of pain with touch. Although gout attacks may be slightly different from patient to patient, they typically come on suddenly, occur during the night, and affect the big toe.