What is Gout
Gout is a painful and potentially disabling form of Arthritis that has been recognized since ancient times. Gout is sometimes referred to as the “Disease of Kings” because it long has been associated incorrectly with the kind of overindulgence in food and wine only the rich and powerful could afford. In fact, anyone can be affected, and the risk factors are varied. Fortunately, it is possible to treat Gout and reduce its agonizing attacks by avoiding food triggers and taking advantage of medication options.
Causes of Gout
Gout occurs when excess Uric Acid (a normal waste product) accumulates in the body, and needle‐like crystals deposit in the Joints. This may happen because either uric acid production increases or, more often, the Kidneys are unable to remove uric acid from the body adequately. Certain foods, such as shellfish and alcohol, may increase uric acid levels and lead to gout attacks. Some medications also can increase Uric Acid Levels. Examples of such medications include moderate‐dose aspirin (81 mg used for prevention of heart attack and stroke has minimal effect and generally can be continued), Diuretics such as Hydrochlorothiazide (Esidrix, Hydro‐D), and Immunosuppressants used in organ transplantation such as s cyclosporine (Neoral, Sandimmune) and tacrolimus (Prograf). Over time, increased Uric Acid Levels in the blood may lead to deposits of Monosodium Urate Crystals in and around the joints. These crystals can attract white blood cells, leading to severe, painful gout attacks. Uric Acid also can deposit in the Urinary Tract, causing Kidney Stones.
Gout is very painful. The most common manifestation of gout is acute arthritis, severe pain in a joint. In most cases, it strikes one joint at a time; in half, it’s the first joint in the large toe. Other frequent sites include the forefoot, instep, heel, ankle, and knee. At any site, the attack usually begins abruptly, often at night. Within hours, the joint becomes red, swollen, hot, and painful. And even though only one small joint is affected, the inflammation can be intense enough to cause fever, muscle aches, and other flu-like symptoms.
List of the typical symptoms of Gout are as follows:-
- Sudden Throbbing Pain that often start at night
- The joint Feels Warm and Turns Red.
- Even a sheet over the joint hurts because it is so Tender
- Possibly a Fever.
The first attack only lasts a few days but it will return in half the cases if it is the chronic version. If gout returns, it usually lasts longer than the first attack. Chronic gouty arthritis will leave persistent joint damage and joint pain. Lumps can develop around your joints or even in other parts of your body. These are called tophi and they can leak a fluid that has a chalky appearance.
Risk Factors of Gout
You are more likely to get gout if you
- If you are a man
- You have family member with gout
- You drink alcohol
- You eat too much meat and fish that are high in chemicals called purines.
- you are a women after menopause.
- People with kidney disease.
- Strongly associated with obesity, hypertension, hyperlipidemia and diabetes.
Gout Home Care
- Take medications as prescribed.
- While a joint is hot and swollen, you may want to use a cane or similar support to keep your weight off that joint.
- It may be helpful to keep the swollen joint elevated above your chest as much as possible.
- Ice packs can be helpful in relieving pain and reducing inflammation.
- Maintaining adequate hydration is key for minimizing the frequency and intensity of attacks.
- Cherry juice may decrease the intensity and severity of attacks.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Examples include indomethacin (Indocin), ibuprofen (Advil), and naproxen (Aleve). Newer drugs such as celecoxib (Celebrex) can also be used. Aspirin should not be used for this condition.
- 1 Colchicine (Colcrys)
- This medication is given in two different ways, either to treat the acute attack of arthritis or to prevent recurring attacks.
- To treat the hot, swollen joint, colchicine is given rapidly (generally, two tablets at once followed by another tablet an hour later).
- To help prevent an attack from coming back, colchicine can be given once or twice a day. While the chronic use of colchicine can reduce the attacks of gout, it does not prevent the accumulation of uric acid that can lead to joint damage even without attacks of hot, swollen joints
- 2 Corticosteroids
- Corticosteroids such as prednisone (Meticorten, Sterapred, Sterapred DS) are generally given when your doctor feels this is a safer approach than using NSAIDs.
- When given by mouth, high-dose corticosteroids are used initially and tapered off within a couple of weeks. It is important to take these medications as prescribed to avoid problems.
- Some complications with the short-term use of corticosteroids include altered mood, elevated blood pressure, and problems with control of glucose in patients with diabetes.
- Corticosteroids can also be injected into the swollen joint. Resting the joint temporarily, after it is injected with steroids, can be helpful.
- Occasionally, corticosteroids or a related compound, corticotropin (ACTH), can also be injected into the muscle or given intravenously.
- Probenecid (Benemid) This medication helps the body eliminate excess uric acid through the kidneys and into the urine.
Gout Surgery. Surgery is rarely needed for gout unless significant joint damage has occurred from lack of effective treatment.
If you are at risk for gout, you should do the following:-
- Eat a low cholesterol, low-fat diet.
- Avoid foods that are high in purines (the biochemical in foods that is metabolized into uric acid), including shellfish and red meats.
- Slowly lose weight. This can lower your uric acid levels. Losing weight too rapidly can occasionally precipitate gout attacks.
- Restrict your intake of alcohol, especially beer.
- Stay hydrated.
- Increase your intake of dairy products, such as nonfat milk and yogurt, because they can lower the frequency of gout attacks.
- Avoid fructose, such as in corn syrup.
- Talk to your doctor if you are taking thiazide diuretics (hydrochlorothiazide, HCTZ), low-dose aspirin, levodopa (Larodopa), cyclosporine (Gengraf, Neoral, Sandimmune), or nicotinic acid.
- Cherries a day may keep gout away (abc.net.au)