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

Content

• What Is The Difference Between Acute And Chronic Gout?
• Facts You Should Know About Gout Gouty Arthritis
• Health Tools
• Diseases And Disorders That Increase The Risk Of Gout
• Gout Treatment And Prevention
• Diagnosis Of Gout
• When Should Someone Seek Medical Care For Gout?

Individual gout flares are often triggered by acute increases or decreases in urate levels that may lead to the production, exposure, or shedding of crystals. Changes in urate levels can result from acute alcohol ingestion, acute overindulgence in foods high in purines, rapid weight loss, dehydration, or trauma. Gout can be considered a disorder of metabolism that allows uric acid or urate to accumulate in blood and tissues. When tissues become supersaturated, the urate salts precipitate, forming monosodium urate crystals. In addition, the crystals also are less soluble under acid conditions and at low temperatures, such as occur in cool, peripheral joints . Elevated serum uric acid levels are the principal risk factor for developing gout.

This patient came back for a follow-up after a few weeks with resolved symptoms of gout. He was educated on diet adherence as well as possible allopurinol treatment in the future if his gout attacks resume. A blood test will be done to check serum uric acid levels.

When the levels of uric acid in your blood are too high, it is called hyperuricemia. Adopting healthy lifestyle habits is a key part of an effective gout treatment plan. Eat a healthy diet, avoid or limit high-purine foods, do regular exercise and lose excess weight to lower your risk of repeated gout attacks. Febuxostat reduces how much uric acid the body produces. Like allopurinol, it’s started at a lower dose, which may be increased if uric acid levels remain high.

What Is The Difference Between Acute And Chronic Gout?

Uric acid is a chemical that is created in the body when it digests and breaks down certain substances in food called purines. Gout is genetically inherited and affects men more than women by a ratio of about 3 to 1. Foods and beverages that are high in purines should be avoided since purines are converted in the body to uric acid. In some cases, the large nodules of uric acid around finger or toe joints, tendons, or bursae need to be removed because they remain painfully inflamed. These nodules may also break open and drain or become infected.

If you forget to take a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the dose you missed. Other factors such as inherited traits and environmental factors also can play an important role in causing gout. 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. It usually affects one joint at a time--often the large joint of the big toe.

Facts You Should Know About Gout Gouty Arthritis

For this reason, it is important to recognize symptoms, understand risk factors, get an accurate diagnosis, and treat and prevent gout. Also called synovial fluid analysis, arthrocentesis, or a joint tap, a joint fluid test is a diagnostic tool that can help identify gout, pseudogout, inflammatory arthritis, and infection. A doctor uses a needle to draw fluid from an affected joint and the fluid goes to a laboratory for analysis. Any treatment that decreases levels of uric acid in the blood can trigger an acute flare-up (mobilization flare-up). Mobilization flare-ups are particularly likely soon after a drug that lowers the blood level of uric acid is started.

Are bananas good for gout?

Bananas are low in purines and high in vitamin C, which make them a good food to eat if you have gout. Changing your diet to include more low-purine foods, like bananas, can lower the amount of uric acid in your blood and reduce your risk of recurrent gout attacks.

If gout is untreated, the frequency of attacks usually increases with time. Some people may not experience gout as many painful attacks. Chronic gout in older adults may be less painful and can be confused with other forms of arthritis.

A white blood cell count as high as 40.0×109/l (40,000/mm3) has been documented. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or kidney damage. If you have many large tophi, your provider may prescribe pegloticase, also known as Krystexxa®, given by intravenous infusion every two weeks to more quickly dissolve gout crystals. This more aggressive treatment is used without other drug therapy and can reduce uric acid levels significantly and quickly and eliminate the tophi, often within eight to nine months.

Is Whiskey good for gout?

Whisky has been found to have a property that decreases the serum uric acid level. Excretion of uric acid from blood is increased by 27% after drinking whisky. Conclusions: Moderate drinking of distilled liquors did not enhance serum uric acid level, blood glucose, or insulin level in healthy male subjects.

Serum uric acid can be normal, especially during the gout attack. The target goal for uric acid treatment is to achieve a level less than 6.0 mg/dL. In cases of repeated episodes, the underlying problem must be addressed, as the build-up of uric acid over time can cause arthritic damage to the joint. Gout is a type of inflammatory arthritis that causes sudden, severe attacks of pain, swelling, and redness in the joints.

Diseases And Disorders That Increase The Risk Of Gout

Although there is no cure for gout, the majority of patients are able to manage their symptoms with medications. The disease typically affects men over the age of 30, post-menopausal women, African Americans, people with kidney disease and those who have had an organ transplant. In addition, some families are genetically predisposed to the condition. Gout is strongly associated with obesity, hypertension, hyperlipidemia and diabetes.

The first attack usually occurs at night and is usually limited to one affected joint. Flares can occur regularly for some people, while for others they may occur every few months or even years apart. Gout pain occurs when excess uric acid, one of the body’s normal waste products, accumulates because the body makes too much of it or fails to excrete it. In healthy individuals, uric acid dissolves in the blood and passes through the kidneys before it is excreted in urine. With gout, uric acid forms into crystals that accumulate in the fluid that lubricates your joints. Febuxostat (trade name Adenuric®) is a new medication for gout that may be used to reduce urate levels in patients with poor kidney function or intolerant of allopurinol.

Gout Treatment And Prevention

Urate-lowering therapy for gout is initiated after multiple attacks or after the development of tophi or urate nephrolithiasis. Allopurinol is the most common therapy for chronic gout. Uricosuric agents are alternative therapies in patients with preserved renal function and no history of nephrolithiasis. During urate-lowering therapy, the dose should be titrated upward until the serum uric acid level is less than 6 mg per dL (355 μmol per L).

Uric acid crystals in polarized light, showing negative birefringence, with yellow color when aligned parallel to the axis of the red compensator, and blue when aligned perpendicularly to it. Light microscopy of a touch preparation of a gout tophus, showing needle-shaped crystals. As gout progresses, you may not be able to move your joints normally. Brain tumor, breast cancer, colon cancer, congenital heart disease, heart arrhythmia.

Diagnosis Of Gout

Gout is usually diagnosed by a doctor based on the location of the inflamed joint and a history of having similar non-traumatic attacks of pain and swelling. The most reliable test for confirming gout is an arthrocentesis. Arthrocentesis is a procedure where fluid is withdrawn from an inflamed joint with a needle and syringe, using a sterile technique and a local anesthetic such as lidocaine. The fluid is sent to a lab where it is analyzed for the presence of uric acid crystals. If caught and treated early, people with gout can live a relatively normal life.

Diet and exercise are risk factors you can control – but you may need a little help to make those changes stick. Certain racial and ethnic groups may have higher prevalence of gout, and this is likely to be driven by genetic factors. There are particular genes associated with greater susceptibility to develop gout. African-Americans have higher gout rates than white Americans.

When Should Someone Seek Medical Care For Gout?

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