What Is Gout? Symptoms, Causes, Treatment, Medication, Diet, Remedies

Content

• How Gout Is Treated
• What Is Gout? How Is It Caused?
• Myth: There Aren't Effective Medicines For Gout
• Health Solutions From Our Sponsors
• Conditions Related To Diet And Body Weight

Although gout is on the rise, there are now good treatment options for this ancient disease. It is important for patients to understand the four stages of gout since the treatment of each is different. It is also important for patients with gout to be carefully counseled to communicate any changes in the frequency of gout attacks to their practitioner. In view of the effectiveness of our treatments, it is important for a correct diagnosis to be made as early as possible, and therapy begun quickly, when appropriate. Other conditions which can mimic gout, should be definitively ruled out through crystal identification in joint fluid whenever possible.

How Gout Is Treated

Anakinra, given as a daily injection, has been evaluated for treating difficult gout. Anakinra is FDA approved for other indications, but it is not FDA approved for gout. While it is an expensive therapy with significant risk of developing side effects, it can be used for gout in specific circumstances.

Taking medications to manage the cause of your gout and treat active gout flares. Some people may have frequent flares, while others may not have another flare for years. However, over time, if left untreated, your flares may last longer and happen more often. Drink lots of water and avoid alcohol, beer, high-purine foods and sugary drinks to help reduce uric acid buildup. Colchicine- This anti-inflammatory medicine works best if taken within the first 24 hours of a gout attack.

What Is Gout? How Is It Caused?

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.

Gout may occur alone or may be associated with other medical conditions or medications . Some people with gout have continuing problems because they don't take their prescribed medicine. Most people will need treatment every day to keep the uric acid levels in their blood normal. But they may feel perfectly healthy most of the time and wonder why they should keep taking their medicine. If you stop taking your prescribed medicine, nothing may happen at first. But after a while, another gout attack is likely to occur.

As part of the diagnosis, other disorders that cause gout-like symptoms or cause hyperuricemia should be ruled out. In general, it is easy to distinguish acute gout that occurs in one joint from other arthritic conditions. The two disorders that may confuse this diagnosis are pseudogout and septic arthritis.

What are the 10 foods that trigger gout?

If you have gout, dishes like chopped liver and liver and onions are best avoiding, along with other organ meats like kidney, heart, sweetbread, and tripe, since they're high in purines.

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. For example, if a patient is receiving chemotherapy for a tumor, as the treatment kills the tumor cells a gout attack or kidney stone can develop as a result of the breakdown of the purines from those cells.

Some patients have fever and chills as the first warning that an attack of gout is coming on. Uricase is an enzyme that converts poorly soluable urate to the more soluable allantoin . Uricase is present in most mammals, and these mammals with uricase do not develop gout. However, humans and some primates lack uricase and lack the ability to make uric acid more soluable and hence, have gout. Pegloticase is a porcine uricase which was approved by the FDA in September 2010 for the treatment of gout in patients who have failed conventional therapy.

If uric acid in the urine is higher than a certain value, further tests for an enzyme defect or other cause of gout will be ordered. A high level of uric acid in the urine means that the patient is more likely to develop uric acid kidney stones. Some available medications increase uric acid excretion and may alter this test result. Acute gouty arthritis occurs when the first symptoms of gout appear. Sometimes the first signs of gout are brief twinges of pain in an affected joint.

Physical Therapy Management Current Best Evidence:

The process starts with a medical history and a physical exam. A fluid sample may be taken from the joint and checked for urate crystals. This medicine may be used if xanthine oxidase inhibitors alone have not lowered uric acid levels enough. Without treatment, the tophi may form in the cartilage of the external ear or the tissues around the joint . Progressive crippling and destruction of cartilage and bone is possible.

Some people go months or even years between gouty attacks. If you have chronic gout, you can develop joint deformities and loss of motion in the joints and may have joint pain and other symptoms most of the time. Why some people with high uric acid levels will develop gout and others won’t is unknown.

How Hyperuricemia And Gout Develop

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. Doctors can also do a blood test to measure the levels of uric acid in the blood, but, as mentioned, people with high uric acid levels do not always experience gout. Equally, some people can develop the symptoms of gout without having increased levels of uric acid in the blood. People may experience gout with deposits of uric acid crystals in their finger joints.

There are concerns about more deaths with febuxostat compared to allopurinol. Febuxostat may also increase the rate of gout flares during early treatment. However, there is tentative evidence that febuxostat may bring down urate levels more than allopurinol. Risk of gout attacks can be lowered by reducing intake of alcohol, fructose (e.g. high fructose corn syrup), and purine-rich foods of animal origin such as organ meats and seafood.