Spotlight On Gout

Content

• Daily Health News
• To Treat An Acute Attack
• All About Gout
• Differential Diagnosis
• What Gout Affects
• Diagnosis And Tests

Avoiding alcohol may reduce your chance of getting gout attacks. Tell a doctor about other health problems, particularly if you have a history of peptic ulcer disease or intestinal bleeding, if you are taking warfarin , or if you have problems with kidney function. It is the ultimate method of being certain of a diagnosis of gouty arthritis, as opposed to other causes such as an infection in the joint. Attacks of abdominal pain due to kidney stones may be related to uric acid kidney stones from gout. People with insufficient kidney function are at increased risk for gout. Uric acid is generated as we metabolize the food we eat and as the body's tissues are broken down during normal cell turnover.

What is the difference between gout and arthritis?

Both cause pain, swelling, and stiffness of the joints that can limit your range of motion. However, the cause differs. RA is an autoimmune disease, which means the body's own immune system attacks the joints, whereas the pain of gout is due to elevated levels of uric acid in the blood.

Some patients experience progressive joint damage with functional limitation. CPPD also can cause chronic arthritis that can resemble osteoarthritis or rheumatoid arthritis. Results of a study by Hubert et al suggest that osteoarthritis of the ankle can be a complication of CPPD.

Daily Health News

All these mechanisms may fail in patients with refractory arthritis, preventing the self-limited natural course of acute gout. In the U.S., gout affects nearly 6 million men and 2 million women, or about 4 percent of the population, according to the Arthritis Foundation. The buildup of uric acid can form needle-like crystals in a joint and cause sudden pain, tenderness, redness, warmth and swelling, often in the big toe. But it’s also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea. In addition to NSAIDs or corticosteroids, supplementary analgesics, rest, ice application, and splinting of the inflamed joint may be helpful.

To Treat An Acute Attack

The word arthritis is a general term, not a specific illness. Most everyone knows that if someone has arthritis, then that person is having a problem with their joints. But, most people do not realize that there are over 115 different arthritic diseases. The following explains the most common types of arthritis and a brief explanation about how we can help treat it. Gout most commonly affects middle-aged men, but it can affect anyone at any time. Anyone suspecting gout should talk to their medical professional immediately.

Colchicine may also be used either po or by IV and may produce substantial pain relief if started immediately after onset of symptoms. Supplementary analgesics may also be recommended along with rest, elevation, and joint protection strategies. With early diagnosis of gout, treatment enables most people to live a normal life.

Gout tends to run in families; from 20% to 80% of those affected have a family history of the disease. Diets high in purines, male gender, being overweight, lead exposure, and alcohol consumption are other risk factors. It predominantly attacks males after puberty, with a peak age of 75. A small number of men develop gout right after puberty due to an increase in uric acid production.

Gout Research

Gouty tophi, in particular when not located in a joint, can be mistaken for basal cell carcinoma or other neoplasms. A definitive diagnosis of gout is based upon the identification of monosodium urate crystals in synovial fluid or a tophus. All synovial fluid samples obtained from undiagnosed inflamed joints by arthrocentesis should be examined for these crystals.

Gout is caused by increased levels of uric acid in the tissues and blood from abnormal metabolism. Eating certain foods rich in purines such as liver and dried beans can elevate the body’s level of uric acid. These Increased levels of uric acid can also cause kidney stones. Gout usually affects the big toe and can later attack ankles, heels, knees, wrists, fingers, and elbows.

During the first six months of uric acid-lowering medication, medication to reduce inflammation may be provided. This is because uric acid-lowering medications change serum and tissue uric acid levels, and so may trigger acute attacks of podagra and gout. Podagra may become chronic, in which there are repeated episodes of pain and inflammation, which may also spread to multiple joints and lead to joint damage and disability.

Gout affects about 1 to 2% of the Western population at some point in their lives. This is believed to be due to increasing risk factors in the population, such as metabolic syndrome, longer life expectancy, and changes in diet. Gout was historically known as "the disease of kings" or "rich man's disease". It has been recognized at least since the time of the ancient Egyptians. Similarly, Solomon and colleagues reported a reduced risk of a CV event in patients with gout who take colchicine.

Deposition of monosodium urate crystals in the kidney can result in inflammation and fibrosis, leading to reduced renal function or chronic nephropathy. Rarely, gout can produce spinal cord impingement when deposition in tissues produces a local mass. Gout often is associated with high blood pressure, heart and kidney disease, or the use of medications that increase uric acid levels. Therefore, health care providers should test for these related health problems.

The stones may block the urinary tract, resulting in excruciating pain and, if untreated, infection and kidney damage. If untreated, tophi in and around the joints can burst and discharge chalky masses of uric acid crystals through the skin and may eventually cause deformities and osteoarthritis. The symptoms gradually disappear, joint function returns, and no symptoms appear until the next flare-up. However, if the disorder progresses, untreated flare-ups last longer, occur more frequently, and affect several joints.

Join us today and help lead the way as a Champion of Yes. By sharing your experience, you’re showing decision-makers the realities of living with arthritis, paving the way for change. You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own. To learn more about these drugs and their side effects, visit the drug guide.

Gout affects more than one million Americans from all walks of life. It can occur at any age but the first attack often affects men between the ages of 40 and 50. If a patient is allergic to allopurinol, there are often limited options.

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. Certain carbohydrates, such as oatmeal, wheat germ, and bran have moderate purine content but have not been shown to be significant gout risk factors. For those interested in achieving the maximal lowering of uric acid by dietary means, two “Gout Haters Cookbooks” are listed in the “Books about Gout” section below. Special effort should be made to distinguish gout from the other crystal-induced types of arthritis. For example, pseudogout, caused by a different type of crystal , causes the same type of hot, red joint, and the same rapid acceleration of pain as does gout.

Diagnosis And Tests

These include high blood pressure, diabetes, kidney disease, and some types of anemias. The first attack of gouty arthritis usually happens in just one joint. Half of the time, gout affects the metatarsophalangeal joint at the base of the big toe. Eventually, 90 percent of people with gout will have pain in the MTP joint.