Gout Diagnosis And Management

Content

• Prognosis Of Gout
• Who Should Diagnose And Treat Gout?
• What Is The Prognosis For Gout?
• Gout Topics
• Gout Attack Vs Chronic Gout

If side effects occur, stop taking the drug and notify your doctor. To prevent future episodes, you may have to continue taking a small dose of colchicine after the attack has cleared. These are uric acid crystals that form lumps under your skin. Tophi can form on your toes, fingers, hands, and elbows.

Some medications such as diuretics , and having low thyroid hormones may also be risk factors for getting gouty attacks. Pain is the most dramatic, the most common, and the most noticeable symptom of gout. For many people, the first gout attack (or flare-up) occurs in the big toe.

Prognosis Of Gout

When a gout episode begins, call your doctor and begin taking your medication. Your doctor may suggest that you keep a supply of medication on hand to take at the first sign of trouble. You may go to bed feeling fine but then wake up in the middle of the night with extreme joint pain.

What foods cause gout?

Foods and drinks that often trigger gout attacks include organ meats, game meats, some types of fish, fruit juice, sugary sodas and alcohol. On the other hand, fruits, vegetables, whole grains, soy products and low-fat dairy products may help prevent gout attacks by lowering uric acid levels.

Though this rheumatoid arthritis drug is not approved by the Food and Drug Administration , for gout treatment, it can quickly relieve gout symptoms for some patients. For acute gout, symptoms come on quickly from the buildup of uric acid crystals in your joint and last for 3 to 10 days. A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint. A definitive diagnosis of gout is based upon the identification of monosodium urate crystals in synovial fluid or a tophus.

Who Should Diagnose And Treat Gout?

When you have a gout flare, and the body sees the urate crystals as “foreign,” you are seeing the results of your body’s attempts to destroy the crystals. White blood cells attack and ingest the crystals, and inflammatory chemicals are released that bring in even more white blood cells. Your big toe (gout’s favorite spot) may swell up suddenly, turning red and hot, so you think it may be infected or even fractured. It’s not an infection or a fracture, however – it’s inflammation.

Approximately 90% of patients with gout will experience an attack in this joint at some point. Although gout primarily involves joints located in the lower extremities, any joint may be affected. 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.

Arthritis caused by gout (i.e., gouty arthritis) accounts for millions of outpatient visits annually, and the prevalence is increasing. Gout is caused by monosodium urate crystal deposition in tissues leading to arthritis, soft tissue masses (i.e., tophi), nephrolithiasis, and urate nephropathy. The biologic precursor to gout is elevated serum uric acid levels (i.e., hyperuricemia).

You can also get gout attacks in your foot, ankle, or knees, or other joints. The attacks can last a few days or many weeks before the pain goes away. A doctor may recommend changes to your diet to reduce the risk of gout attacks returning. However, while diet is a risk factor for gout, it is not the sole cause.

After several years, the uric acid crystals can build up in the joint and surrounding tissues. They form large deposits called tophi that look like lumps just under the skin. Tophi often are found in or near severely affected joints on or near the elbow, over the fingers and toes and in the outer edge of the ear. If the tophi are not prevented or treated, they can damage joints .

Gout Topics

Nephrologists may treat patients with uric-acid-lowering medications such as allopurinol in order to prevent damage to the kidneys, which can occur with elevated uric acid levels . This medicine can be effective if given early in the attack. However, colchicine can cause nausea, vomiting, diarrhea and other side effects. Patients with kidney or liver disease, or who take drugs that interact with colchicine, must take lower doses or use other medicines. Colchicine also has an important role in preventing gout attacks .

The first symptom of gouty arthritis is typically the sudden onset of a hot, red, swollen, stiff, painful joint. The most common joint involved is in the foot at the base of the big toe where swelling can be associated with severe tenderness, but almost any joint can be involved . In some people, the acute pain is so intense that even a bed sheet on the toe causes severe pain. Acute gouty arthritis at the base of the big toe is referred to as podagra. Research is ongoing to find new strategies to prevent gout. New drugs are being developed to keep the body from having high uric acid levels and decrease the likelihood of a painful gout attack.