Overview:
Gout is a common and complex kind of arthritis that can affect anyone.
It’s characterized by sudden, severe attacks of pain, swelling, redness, and tenderness at the joints, often the joint at the base of the big toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the feeling your big toe is about the fire.
The joint is hot, bloated and so tender that even the burden of the sheet onto it may appear excruciating.
Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.
Symptoms of Gout:
Illustration showing gout in the big toe
The signs and symptoms of gout nearly always occur abruptly, and often at night. They comprise:
Intense joint pain- Gout usually affects the large joint of your big toe, but it can occur in any joint.
Other commonly affected joints include the ankles, knees, elbows, wrists, and fingers.
The pain is very likely to be most severe within the first four to 12 hours after it begins.
Lingering distress– After the most severe pain subsides, a few joint distress may last from a few days to a few weeks.
Later strikes are likely to last longer and affect more joints.
Inflammation and inflammation– The affected joint or joints become swollen, tender, red, and warm.
Restricted range of motion – As gout grows, you may not be able to move your joints normally.
Should you experience sudden, intense pain in a joint, call your physician. Gout which goes untreated can lead to worsening pain and joint damage.
Seek medical care immediately if you’ve got a fever along with a combined is hot and inflamed, which can be a sign of disease.
Reasons for Gout:
Gout occurs when urate crystals accumulate in your joint, causing the redness and intense pain of a gout attack.
Urate crystals may form whenever you have high levels of uric acid in your blood.
Your system produces uric acid when it breaks down purines — substances that are found naturally in the human body.
Purines can also be present in certain foods, such as steak, organ meats, and fish. Other foods also promote higher levels of uric acid, such as alcoholic beverages, particularly beer, and drinks sweetened with fruit sugar (fructose).
Normally, uric acid melts in your bloodstream and moves through your kidneys into your urine.
But sometimes either your body produces too much uric acid or your kidneys excrete too small uric acid.
While this occurs, uric acid can develop, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, swelling, and inflammation.
You’re more likely to develop gout when you’ve got high levels of uric acid in the human system.
Factors that increase the uric acid level in your body include:
Alcohol consumption, particularly of beer, also increases the risk of gout.
Obesity– If you’re overweight, your body produces more uric acid and your own kidneys have a harder time eliminating uric acid.
Certain diseases and conditions increase your risk of gout. These include untreated hypertension and chronic conditions like diabetes, metabolic syndrome, and kidney and heart diseases.
Specific medications– Using thiazide diuretics — generally utilized to treat hypertension — and low-dose aspirin can also increase uric acid levels.
So can the use of anti-rejection drugs prescribed for those who have undergone an organ transplant.
Family history of gout– If other members of your household have had gout, you are more likely to develop the illness.
Age and gender– Gout occurs more frequently in men, mainly because women tend to have lower uric acid levels.
Men are more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally create signs and symptoms after menopause.
Experiencing recent surgery or injury has been associated with an elevated risk of developing a gout attack.
Types of Gout Infection:
People with gout can develop more-severe conditions, for example:
Recurrent gout– Some people may never experience gout symptoms and signs. Others may experience gout several times each year.
Medications may help prevent gout attacks in people with recurrent gout. If left untreated, gout can lead to erosion and destruction of a joint.
Advanced gout– Untreated gout might cause deposits of urate crystals to form beneath the skin in nodules called tophi (TOE-fie).
Tophi can grow in many areas like your palms, hands, feet, elbows, or Achilles tendons along the backs of your ankles.
Tophi usually aren’t painful, but they can become bloated and tender during gout attacks. Urate crystals may collect in the urinary tract of individuals with gout, causing kidney stones.
Medications can help reduce the risk of kidney stones.
Prevention:
During symptom-free periods, these dietary guidelines can help protect against potential gout attacks:
Drink plenty of fluids. Remain well-hydrated, including plenty of water.
Limit the number of sweetened drinks you drink, especially those sweetened with high-fructose corn syrup.
Talk with your physician about whether any amount or type of alcohol is best for you. Recent evidence indicates that beer may be particularly likely to raise the risk of gout symptoms, especially in men.
Get your nourishment from low-fat dairy products. Low-fat dairy products might actually have a protective effect from gout, therefore these are your best-bet protein sources.
Restrict your consumption of meat, poultry, and fish. A small amount may be tolerable, but pay careful attention to what types — and how much — seem to cause difficulties for you.
Maintain desirable body weight. Choose portions that allow you to keep up a healthy weight.
Losing weight can reduce uric acid levels in the body. But prevent fasting or rapid weight reduction, because doing so may temporarily increase uric acid levels.
Diagnosis:
Joint fluid evaluation. Your physician may use a needle to draw fluid from your affected joint.
Urate crystals could be visible once the fluid is examined under a microscope.
Blood test- Your doctor may suggest a blood test to assess the levels of uric acid and creatinine in your blood. Blood test results can be misleading, however.
Some individuals have elevated uric acid levels, but not experience gout. And a few folks have signs and symptoms of gout but do not have unusual levels of uric acid in their blood.
X-ray imaging– Joint X-rays can be very helpful to rule out other causes of joint inflammation.
Musculoskeletal ultrasound may detect urate crystals in a joint or in a tophus. This technique is much more widely utilized in Europe than in America.
Dual-energy CT scan– This type of imaging may detect the presence of urate crystals in a joint, even when it is not acutely inflamed.
This evaluation is not used routinely in clinical practice due to the expense and is not widely accessible.
Therapy:
Treatment for gout usually involves drugs. What medications you and your doctor choose will be determined by your current health and your own preferences.
Gout medications can be used to treat acute attacks and prevent future attacks.
Medications may also decrease your chance of complications in gout, like the development of tophi from urate crystal deposits.
Medications to treat gout attacks:
Drugs used to treat severe attacks and stop future attacks include:
Non-steroidal anti-inflammatory medications (NSAIDs).
Your physician may prescribe a higher dose to stop an acute attack, followed by a lower daily dose to prevent future attacks.
NSAIDs carry risks of stomach pain, nausea, and bleeding.
Colchicine– The medication’s effectiveness may be offset, but by side effects such as nausea, vomiting, and nausea, particularly if taken in large doses.
Following an acute gout attack resolves, your physician may prescribe a reduced daily dose of colchicine to prevent potential attacks.
Corticosteroids– Like the drug prednisone, may restrain gout inflammation and inflammation. Corticosteroids may be in capsule form, or they may be injected into your joint.
They are usually used only in people with gout who can not take either NSAIDs or colchicine.
Side effects of corticosteroids may include mood changes, increased blood glucose levels, and increased blood pressure.
Medications to prevent gout complications:
If you encounter several gout attacks each calendar year, or if your gout attacks tend to be less frequent but especially painful, your physician may recommend medication to lessen your risk of gout-related complications.
If you already have signs of damage from gout on joint X-rays, or you’ve tophi, chronic kidney disease, or kidney stones, drugs to lower your body’s level of uric acid can be recommended.
Options include:
Medications that block uric acid production. This may lower your blood’s uric acid level and lower your risk of gout.
Side effects of allopurinol contain a rash and low blood counts.
Febuxostat side effects include nausea, rash, decreased liver function, and an increased probability of heart-related death.
Medicine that improves uric acid removal. Uricosuric drugs improve your kidneys’ ability to remove uric acid from your body.
This may decrease your uric acid levels and reduce your risk of gout, but the degree of uric acid in your urine is raised.
Side effects include a rash, stomach pain, and kidney stones. Lesinurad can be obtained only along with an XOI.
Lifestyle and home remedies:
Medicines are often the most effective approach to treat acute gout and can prevent recurrent attacks of gout.
However, making certain lifestyle modifications also are significant, for example:
Limiting alcoholic drinks and beverages sweetened with fruit sugar (fructose). Instead, drink plenty of nonalcoholic beverages, particularly water.
Limiting intake of foods high in purines, such as red meat, organ meats, and seafood.
Exercising regularly and slimming down. Maintaining your body at a wholesome weight reduces your risk of gout.
Alternative medicine:
If gout treatments are not working and you had expected, you could be considering trying an alternate approach.
Before trying such treatment by yourself, talk with your physician — to weigh the benefits and dangers and learn whether the treatment might interfere with your gout medication.
Since there isn’t a lot of research on alternative therapies for gout, nevertheless, in some cases the risks aren’t known.
Certain foods have been analyzed for their potential to lower uric acid levels, for example:
Coffee– Studies have found an association between coffee drinking — both regular and decaffeinated coffee — and lower uric acid levels, although no research has demonstrated how or why java may have such an impact.
The available evidence is not sufficient to encourage non-coffee drinkers to start, but it might give scientists clues to new methods of treating gout in the future.
Vitamin C– supplements containing vitamin C can reduce the amount of uric acid in your blood.
Talk with your physician about what a sensible dose of vitamin C may be.
And don’t forget you could increase your vitamin C intake by eating more vegetables and fruits, especially oranges.
Cherries– Cherries have been reported to reduce levels of uric acid, in addition, to reduce the number of gout attacks. But more research has to be done in order to confirm this.
Eating more cherries and drinking cherry extract may be a safe way to supplement your gout treatment, but discuss it with your doctor first.
Other complementary and alternative medicine treatments might help you cope before your gout pain subsides or your medications take effect.
For example, relaxation techniques, for example, deep-breathing meditation and exercises, may help take your mind off your pain.
Preparing for your appointment:
Make an appointment with your doctor if you have symptoms that are common to gout.
After an initial examination, your doctor may consult with a specialist in the identification and treatment for arthritis and other inflammatory joint conditions (rheumatologist).
Here is some information that will help you get prepared for the appointment, and also what to expect from the doctor.
Everything you can do:
Write down your symptoms, such as when they began and how often they happen.
Note important personal information, like any recent changes or major stressors in your life.
Create a list of your key medical information, such as any other conditions for which you are being treated and the titles of any medicines, supplements, or vitamins you are taking.
Your health care provider will also need to know whether you have some history of gout.
Require a relative or friend as well, if possible. Occasionally it can be tricky to recall all the information offered to you during a scheduled appointment.
Somebody who accompanies you might remember something that you forgot or missed.
Creating your list of questions in advance can help you take advantage of your time with your doctor.
Questions to ask the physician at the first appointment include:
What are the probable causes of the symptoms or illness?
What tests would you recommend?
Are there any treatments or lifestyle changes that may help my symptoms today?
Can I see a specialist?
Questions to ask if you are called to a rheumatologist comprise:
Which are the possible side effects of the drugs you’re prescribing?
Just how soon after beginning treatment should my symptoms begin to improve?
Do I want to take medications long term?
I have these other health states. How do I best manage these collectively?
Can you recommend some adjustments to my diet?
Are there any handouts or sites that you’d recommend for me to learn more about my situation?
If some additional questions happen to you during your medical appointments, then don’t hesitate to ask.
What to expect from your doctor:
Your doctor is very likely to request a number of questions. Being ready to answer them can book a time to discuss any issues that you need to talk about in detail.
Your Physician may ask:
What are the symptoms?
When did you first experience these symptoms? How often?
Does anything, in particular, seem to activate your symptoms, such as certain foods or bodily or emotional stress?
Are you currently being treated for any other medical conditions?
What medicines are you taking, including prescription and over-the-counter drugs in addition to vitamins and supplements?
Do some of your first-degree relatives — like a sibling or parent — have a history of gout?
What do you eat on a normal day?
Do you drink alcohol? If so, just how much and how often?
Ask your friends and loved ones for support. If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain…
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