Gout (gouty arthritis) facts
- Gout is a type of arthritis that causes inflammation, usually in one joint, that begins suddenly.
- Gouty arthritis is caused by the deposition of crystals of uric acid in a joint.
- Gout can cause symptoms and signs such as
- The most reliable method to diagnose gout is to have fluid removed from an inflamed joint and examined under a microscope for uric acid crystals.
- Chronic gout is treated using medications that lower the uric acid level in the body.
- Left untreated, gout can cause irreversible joint damage, kidney problems, and tophi.
- Triggers for acute attacks of gout include surgery, dehydration, beverages sweetened with sugar or high fructose corn syrup, beer, liquor, red meat, and seafood.
- Cherries may help prevent gout attacks.
Quick GuideGout Attack Symptoms, Causes, Treatment, and Diet
The primary dietary goal for gout is to limit your intake of foods with high amounts of purinein them. Ideally, you will have little or no foods that are high in purine and only small amounts of those with moderate amounts of purine.
Foods considered high in purine content include the following:
- Some fish, seafood and shellfish, including anchovies, sardines, mackerel, scallops, herring, mussels, codfish, trout, and haddock
- Some meats such as bacon, turkey, veal, venison, liver, beef kidney, brain, and sweetbreads
- Alcoholic beverages
What is gout
Gout is a type of arthritis that causes sudden joint inflammation, usually in a single joint. Severe gout can sometimes affect many joints at once. This is known as polyarticular gout.
What causes gout?
Gout is caused by too much uric acid in the bloodstream and accumulation of uric acid crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling. Uric acid is normally found in the body as a byproduct of the way the body breaks down certain proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function.
What are the risk factors for gout?
There are many risk factors for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics (commonly known as water pills), which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol (Zyloprim, Aloprim), can also initially cause a flare of gout. This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.
What are gout symptoms and signs?
The characteristic symptoms and signs of gout are
These symptoms and signs usually affect a single joint. The pain is typically severe, reflecting the severity of inflammation in the joint. The affected joint is often very sensitive to touch to the point that some people with gout attacks experience pain from something as simple as pulling the bedsheets over the inflamed joint. The affected joint becomes swollen. The medical term for excessive fluid in a joint is a “joint effusion.”
Gout frequently involves joints in the lower extremities. The classic location for gout to occur is the big toe. Podagra is the medical term for inflammation at the base of the big toe. Gout can also affect the foot, knee, ankle, elbow, wrist, hands, or nearly any joint in the body. When gout is more severe or longstanding, multiple joints may be affected at the same time. This causes pain and joint stiffness in multiple joints.
Another sign of gout is the presence of tophi. A tophus is a hard nodule of uric acid that deposits under the skin. Tophi can be found in various locations in the body, commonly on the elbows, upper ear cartilage, and on the surface of other joints. When a tophus is present, it indicates that the body is substantially overloaded with uric acid. When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout and treatment with medications is necessary.
Longstanding untreated gout can lead to joint damage and physical deformity.
Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.
What types of doctors treat gout?
Rheumatologists traditionally have expertise in diagnosing and treating gout, especially complicated situations. Other specialists such as internists, general practitioners, family medicine doctors, and orthopedists can manage straightforward cases of gout. 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 (hyperuricemia).
How do health care providers diagnose gout?
The most reliable method to diagnose gout is by demonstrating uric acid crystals in joint fluid that has been removed from an inflamed joint (arthrocentesis). Specially trained physicians, such as a rheumatologist or orthopedist, can carefully remove fluid from the joint. The fluid is then examined under a microscope to determine if uric acid crystals are present. This is important because other medical conditions and diseases, such as pseudogout (a type of arthritis caused by the deposition of calcium pyrophosphate crystals) and infection, can have symptoms similar to gout.
When should patients seek treatment for gout?
Changes in lifestyle, such as limiting foods associated with gout, should be initiated in anyone who has had gouty attacks. Treatment of gout with medications is necessary when frequent disabling gouty attacks occur, when kidney stones caused by uric acid are present, when there is evidence of joint damage from gout on X-rays, or when tophi are present. Treatment should be individualized to the patient.
What are treatments and home remedies for gout?
When gout is mild, infrequent, and uncomplicated, it can be treated with diet and lifestyle changes. However, studies have shown that even the most rigorous diet does not lower the serum uric acid enough to control severe gout, and therefore medications are generally necessary. When attacks are frequent, uric acid kidney stones have occurred, tophi are present, or there is evidence of joint damage from gout attacks, medications are typically used to lower the uric acid blood level.
Medications for the treatment of gout generally fall into one of three categories: uric-acid-lowering medications, prophylactic medications (medications used in conjunction with uric-acid-lowering medications to prevent a gout flare), and rescue medications to provide immediate relief from gout pain.
Urate-lowering medications are the primary treatment for gout. These medications decrease the total amount of uric acid in the body and lower the serum uric acid level. For most patients, the goal of uric-acid-lowering medication is to achieve a serum uric acid level of less than 6 mg/dl. These medications also are effective treatments to decrease the size of tophi, with the ultimate goal of eradicating them. Uric-acid-lowering medications include allopurinol (Zyloprim, Aloprim), febuxostat (Uloric), probenecid, and pegloticase (Krystexxa).
Prophylactic medications are used during approximately the first six months of therapy with a medication to lower high levels of uric acid to either prevent gout flares or decrease the number and severity of flares. This is because of any medication or intervention that either increases or decreases the uric acid level in the bloodstream can trigger a gout attack. Colcrys (colchicine) and any of the NSAIDs (nonsteroidal anti-inflammatory drugs) such as indomethacin (Indocin, Indocin-SR), diclofenac (Voltaren, Cataflam, Voltaren-XR, Cambia), ibuprofen (Advil), or naproxen sodium (Aleve) are frequently used as prophylactic medications to prevent gout flares during uric-acid lowering. By taking one of these prophylactic or preventative medications during the first six months of treatment with allopurinol, febuxostat, or probenecid, the risk of having a gout attack during this time is decreased. Prophylactic medications are not used in combination with Krystexxa.
The third category of medications are those used during attacks of acute gout to decrease pain and inflammation. Both colchicine (Colcrys) and NSAIDs can be used during an acute gout attack to decrease inflammation and pain. Corticosteroids such as prednisone, methylprednisolone (Medrol), and prednisolone(Orapred), also can be used during an acute gout flare. However, the total dose of steroids is generally limited due to potential side effects such as cataract formation and bone loss. Steroid medications are extremely helpful in treating gout flares in patients who are unable to take colchicine or NSAIDs.
Gout home remedies
Home remedies for an acute gout attack include drinking plenty of water. Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), can be used when there are no contra-indications, such as decreased kidney function or stomach ulcers.
Home remedies may be very beneficial for the management of chronic gout, as well. The dietary modifications detailed above can be very effective in certain patients. Drinking plenty of water to remain well-hydrated can be beneficial in preventing gout attacks.
What complications are associated with gout
Longstanding untreated gout can cause irreversible joint damage.
Uric acid can deposit in the kidneys and cause kidney stones and decreased kidney function.
Uric acid can deposit in the soft tissues, especially around joints, and cause nodules known as tophi, which can be large and unsightly.
What is the prognosis of gout?
Gout is a chronic condition. Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. Joint damage and other complications of gout may occur. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis.
Is it possible to prevent gout?
Some of the risk factors for gout are genetic, and those are not preventable. However, many of the risk factors for gout, such as obesity and diet, are controllable. Maintaining a healthy weight and a diet low in refined carbohydrates and low in saturated fat and red meat may prevent gout.
What is the latest research on gout?
Research is being done on using medications that block a chemical signal known as interleukin-1 to treat gout flares in patients who do not respond to other therapies. Anakinra (Kineret) and canakinumab (Ilaris) are two medications that block interleukin-1. They are currently used for other conditions and are under investigation for use in gout flare-ups.
There is ongoing research in using a specialized CT scan known as a dual energy CT scan to diagnose gout. There is also a great deal of research investigating the various uric acid transporter genes that are responsible for uric acid metabolism
IF GOUT IS IN THE TOES THAN IT TAKEW WIGGLE ROOM IN YOUR FOOTWEAR TO HELP OFFLOAD THE PAIN AND DISCOMFORT. We got it all at www.dtfootwear in every one of our footwear styles
Here’s a video, of ours, that explains Gout in the visual matter
Protection and support are what is needed in determining great footwear! Women we don’t carry High Heels because they create none of these elements of support, balance, and protection and creates corns, blister, and calluses – so we at Dtfootwear.com let others create those foot damage to your feet. Remember when your bottom of your feet hurt – you need the proper support to offload this pain, and the only way is moldable inserts to create that needed support!! Yes, we give (FREE) 3 sets of heat moldable customized inserts on every one of your purchase of footwear. But guess what High Heels and most comfortable footwear do not allow the room for these inserts. The video will go into more detail dealing with gout in the toes. 2017 was an UNBELIEVABLE year, and I know the growth will be as much so in 2018. The reason why we, at www.DTFOOTWEAR.COM, is so unique on the internet: 1) Free direction and advice before you ever purchase a pair of shoes. Email or call me. 2) Will have you text a photo of your foot conditions – if needed 3) Free 3 Sets of Heat Moldable Customized Inserts reason for the need of these inserts: https://www.youtube.com/watch?v=_rqts… No other website offers this program and wow do these supplements make a DIFFERENCES 4) Free shipping in the USA 5) Easiest return policy on this earth 6) If out of stock ( if it is a stock shoe) we can order from our factories overseas and that is unheard of in the internet world 7) Unheard of a 9E, 10E, and 14E width, in men’s and women’s, in the fashion shoe world 8) Go to a 15 length for Women and a 20 length for Men. 9) 80 percent of our shoe line has leather lining and usually only found in very high footwear. The reason why leather lining is so important: https://www.youtube.com/watch?v=IvztZ… 10) WE WANT YOU TO HAVE “HAPPY FEET” ALL THE TIME!