Thursday, June 16, 2022

Causes Of Gout Flare Up

Tips For Avoiding A Gout Flare

GOUT, Causes, Signs and Symptoms, Diagnosis and Treatment.

    Gout is a form of arthritis that usually affects the joint between your foot and your big toe. Its caused when theres a buildup of uric acid in your bloodstream, and the acid crystallizes. The crystals tend to form around that particular joint because its far from your heart, so your circulation may not be as strong there as in other parts of your body.

    The uric acid crystals cause inflammation that can ultimately lead to joint damage and pain. Gout can be debilitating, but there are some things you can do to avoid the pain of a gout attack.

    Dr. Michael Tran and the staff at AllCare Foot & Ankle Center present these five tips for avoiding gout flare-ups. Youll likely still need medication, but these lifestyle changes can also be an important part of your treatment plan.

    When To See A Doctor

    If you are experiencing your first flare up, it is recommended to visit your doctor.

    There are a few conditions that have the same symptoms as a gout flare, such as joint infections, so getting an accurate diagnosis is critical.

    When you visit your doctor, they will help you manage your current gout flare and explain how to prevent flare ups from occuring in the future.

    If you have had gout before and symptoms persist longer than 14 days or are worsening, you should seek medical care.

    Tips To Minimize Gout Attack

    In addition to taking medication regularly and consuming vegetables for gout sufferers, there are several other ways to prevent or minimize attacks on gout, including:

    • Exercise regularly.
    • Limit your intake of meat and seafood.
    • Inadequate your protein needs by consuming low-fat milk, yogurt, cheese, and milk.
    • Take care of your weight. If you are overweight or obese, you are advised to lose it.
    • Because weight loss can help reduce pressure on your joints which can cause pain.

    If you have gout, it is important for you to take medication and also live a healthy lifestyle, to help reduce or eliminate the symptoms of gout.

    Being a gout sufferer is not an obstacle for you not to eat fruits and vegetables, because there are some vegetables for gout sufferers, fruits, and food and drinks that are safe for consumption for gout sufferers.

    https://youtu.be/Vne6YFqW6UM

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    What Else Should I Ask My Healthcare Provider About Gout

    Consider asking your healthcare provider:

    • What is causing the gout?
    • Do I have any joint damage?
    • What can I do to prevent future attacks?
    • Can any gout medications help me?
    • How long will I need to take gout medications?

    A note from Cleveland Clinic

    Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.

    Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.

    References

    Gout Can Go Awayor Return Again And Again

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    Gout attacks almost always result in stabbing pain, redness, and swelling in a joint. In men, about 50% of first-time gout attacks involve a big toe joint.1 Other commonly affected joints include the instep, heel, ankle, and knee.2

    See Gout Symptoms

    After the first gout attack, the condition can affect people differently:

    • Some people will go months or even years without having another gout attackor very rarely, they may never have another one again.
    • Other people will begin to experience gout attacks regularly. Eventually, these flare-ups may become frequent and longer-lasting. Chronic gout can lead to permanent joint damage and result in disability. Thankfully, early and appropriate treatment of the underlying cause of gouthigh levels of uric acid in the bloodcan prevent joint damage.

    Experts cant predict who will have a one-time attack versus chronic gout. If youve had an attack, its worth your time and effort to make changes that can help you avoid another painful flare-up.

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    Is Sudden Onset Joint Pain Dangerous

    Humans have this bad habit of thinking that pain will go away eventually. Sometimes it does.

    But joints arent supposed to hurt. And when they do, suddenly and out of the blue, then you better start paying attention.

    Obviously if were in a car accident that caused joint pain due to impact injury, thats problematic but not life threatening .If the pain is from a new infection, its a whole different story.

    Is sudden onset joint pain due to infection dangerous?Absolutely, yes it is.

    A new and sudden infection, in your joint, is a BIG and potentially life threatening problem.

    Go see a doctor ASAP. Right now.

    Joint infection can turn septic, which is VERY dangerous. Left unchecked it can kill you, or result in loss of limb.

    If youre saying My joints hurt all over, that can be a non-life threatening issue like rheumatoid arthritis, or it can point to a systemic infection.

    Unless you know enough about your situation to not be worried, sudden onset muscle and joint pain should be a major cause of concern.

    Can Stress Cause A Gout Flare

    Emotional stress can contribute to gout flare-ups, especially when coupled with other illness or fatigue. In particular, medical stress including hospital visits, surgery, and prolonged illness is associated with a higher risk of a gout attack. On a day-to-day basis, managing your stress levels in a healthy way and getting enough sleep every night can lower the risk of an attack.

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    Medications For Acute Gout

  • Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen , ibuprofen , celecoxib , indomethacin and many others. These agents reliably decrease the inflammation and pain of gout. However, patients with ulcers, hypertension, coronary disease, and fluid retention must be careful with these agents, even for the short courses needed to resolve a gout attack. The doses of non-steroidal anti-inflammatory agents needed to resolve a gout attack are on the higher side, since full anti-inflammatory effect is needed. See examples of dosage in Table 2. Over-the-counter dosage levels, for example, ibuprofen at 200mg, two tabs three times a day, are often insufficient.
  • Corticosteroids, such as prednisone and methylprednisolone , are anti-inflammatory agents that are quite effective against gout attacks. Anti-inflammatory steroids are very different in action and side-effects as compared to male hormone steroids. Anti-inflammatory steroids have long-term risks, such as bone thinning and infection, but their risk for short-term therapy is relatively low. These agents can raise blood pressure and blood sugar, so can be a problem for those with uncontrolled hypertension or uncontrolled diabetes mellitus.
  • Choose A Diet You Can Live With

    The Type of Arthritis that Keeps You Up All Night | Gout

    If you are overweight, losing weight can protect you from gout flare-ups. However, losing weight fast can do more harm than good for gout, as rapid weight loss can raise uric acid levels in your bloodstream. Avoid fad diets and crash diets. Consider consulting a dietician, who can help you choose a diet plan that works for you.

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    Gout can be very painful indeed

    How come gout hurts, where does all that pain come from? Simple, when the uric acid accumulate in the blood and tissues it can crystallise out into a joint, forming a multitude of tiny, jagged, needle-shaped crystals. This triggers an intense inflammatory response that causes a painful arthritis attack called a gout attack. Have you ever stood on a pin or a needle, perhaps some broken glass and got annoyed and irritated by this? Then you will know how a gout sufferer will feel they can be most irritated and annoyed like a child who has just stood on a pin cushion. Pain has a way of bringing out the worst in many people! As I mentioned, gout commonly strikes the big toe, but other joints can be affected, including the instep, ankle, knee, wrist, elbow and fingers. Acute pain is generally the first symptom and then the affected joint becomes inflamed : red, swollen, hot and extremely sensitive to the touch. I have many times seen a case of gout in the clinic that the patients doctor referred to as osteoarthritis, when in fact it had all the makings of gout. Signs and symptoms such as a needle-like pain affecting the small joint, male patient who enjoys alcohol drinker, crayfish and roe , enjoys barbeques and steaks, etc. Common things happen to people commonly, I have often said.

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    What Can Trigger A Gout Attack

    Several things can cause the crystals to shake loose into your joint cavity, triggering an attack. These include:

    • a knock or injury to the joint
    • an illness that may make you feverish
    • having an operation
    • having an unusually large meal, especially a fatty meal
    • drinking too much alcohol
    • dehydration
    • starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.

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      Ease Gout Flares By Hydrating

      Staying hydrated is the most readily available means of managing gout. Hyperuricemia occurs when the blood has too much uric acid. A number of conditions and circumstances can cause this, including diseases and medications. Drinking water dilutes uric acid levels in the blood and flushes the organs. The more water consumed, the more uric acid excreted, decreasing the risk of urate crystals in the joints.

      What Is Uric Acid

      Gout Treatment and Gout Attack Pain Relief

      Uric acid is a waste byproduct of purine breakdown in the body. Purines are naturally produced in the body, as well as found in some foods. As purines are broken down, uric acid is created. Normally uric acid is either reabsorbed in the body or excreted via the urine and feces.

      When there are more purines in the body than it can process, uric acid builds up in the bloodstream. This is called hyperuricemia. Hyperuricemia can cause gout and/or kidney stones in some people, while others have no signs or symptoms at all.

      Verywell / Alexandra Gordon

      Treatment for gout often includes medications, diet modification, and lifestyle changes, such as managing weight and quitting smoking. The foods you eat can have a direct impact on gout flares.

      During a gout attack, modifying your diet may help decrease the length of the flare. Continuing to follow a gout-friendly diet, specifically a low-purine diet, may help prevent the risk of future gout attacks up to five fold.

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      Sugary Beverages Rich In Fructose

      Research also indicates that intake of sugary beverages that contain high levels of fructose also increase the production of uric acid in your body. Also, fructose when trying to get eliminated out of the body through the kidney stops uric acid from eliminating and causes the build-up of uric acid too. Fructose is also known to stimulate the production of uric acid in the body with the help if glycine, an amino acid precursor.

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      Beef

      If youre suffering from gout, the last thing you should be doing, is to reach out for that juicy steak. Beef is loaded with purines, which are a major trigger for gout. Instead, choose white-meat poultry, as it does not contain a high amount of purines.

      Scallops

      Scallops should also be avoided by those suffering from gout. This is because it contains a high amount of purines, which is broken down by the body to form uric acid crystals. Health experts suggest that you restrict your seafood intake to 4-6 ounces daily.

      Turkey

      Turkey and goose contain the highest amount of purines than any other food, making it important for you to avoid them. Additionally, those who are prone to gout flare-ups should restrict their intake of wild game.

      Dairy Products

      Those suffering from gout should restrict their intake of full-fat dairy products. You should choose dairy products that are low in fat. Fortunately, low fat versions of most dairy products exist in the market.

      High-Purine Vegetables

      Vegetables, such as spinach, mushrooms, cauliflower, and asparagus, contain high amounts of purine. But, if you like these veggies, adding them to your food preparations occasionally will most likely not trigger gout.

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      Symptoms Of Gout Flares

      Gout is a type of arthritis that flares and subsides, especially at first. Common symptoms of a gout flare include:

      • Intense joint pain that comes on suddenly, often in the middle of the night
      • Most commonly affects the big toe can occur in other toe joints, ankle, knee, and more
      • Typically strikes one joint at a time more can be affected as the disease progresses
      • Affected joint is swollen, painful, warm to the touch, and red
      • Pain from a flare can last up a week or two with long periods of remission in between

      Being Overweight Or Obese

      Gout: Causes and Treatment Options

      Being obese quadruples your likelihood of gout. Obesity, diabetes, and elevated cholesterol are conditions commonly seen together and when present in the same patient are referred to as metabolic syndrome. Patients with these conditions frequently also have elevated uric acid in their blood, says Herbert S.B. Baraf, MD, clinical professor of medicine at George Washington University and senior partner at Arthritis and Rheumatism Associates in the Washington, D.C. area.

      Sometimes diuretics prescribed to treat high blood pressure can cause the high levels of uric acid, but sometimes high levels are present just because of issues related to these health concerns. Weight loss can often help reduce uric acid levels and therefore gout risk, but the amount of pounds shed must be significant.

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      Is Orange Juice Good For Gout

      Orange Juice and Gout RiskMany sugar-sweetened juices can increase your risk for gout, but naturally-sweetened juices like orange juice may also be a gout risk trigger.

      Injured joints seem to make better spots for uric acid to collect, and can lead to a gout attack that can last for weeks. A traumatic event can start a small inflammatory response, which may then precipitate a gout attack in that joint, Dr. Vanittalie says. When uric acid levels remain high, uric acid crystals accumulate in your joints and cause damage. If youre prone to high levels of uric acid, strive to remain properly hydrated by drinking the optimal amount of water based on your activity level. When youre dehydrated, uric acid builds up in the blood that cannot be diluted and efficiently released through the kidneys. Dehydration also slows metabolism to the point of weight gain, which can cause or exacerbate gout.

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      Who Is Affected By Gout

      Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.

      People are more likely to get gout if they have:

      You are also more likely to develop gout if you:

      • Consume a diet high in animal proteins
      • Consume a significant amount of alcohol
      • Are on water pills .

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      Some Meat Fish Eggs Beans And Pulses

      Eat these foods in moderation. Having vitamin C with meals can help to improve the absorption of iron, so drink a small glass of orange juice, have a piece of fruit for dessert, or serve up meals with plenty of vegetables. Keep your portions of meat controlled by using your hands as a serving size guide. A serving is about the size and thickness of the palm of your hand.

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      Risk Factors For Recurrence

      Home Remedies for Gout Flare Ups

      Can the recurrence of gout be prevented? Possibly, if the sufferer is aware of the risk factors.

      The major risk factors are age, gender, and genetics. According to some authorities, more than 50 percent of sufferers have a family history of the disease. My father and grandfather both had gout, says Alfred. Moreover, gout mainly affects men, targeting especially those between the ages of 40 and 50. In fact, men are three or four times more likely to get the disease than women, who rarely develop it before menopause.

      Other risk factors include:

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      Is High Fructose Corn Syrup A Problem

      Yes, absolutely. High-fructose corn syrup is a known factor for gout flare-ups because it raises uric acid levels in your body. Its also used in far more pre-packaged and processed foods than you might think. When youre grocery shopping, always check nutrition labels. If corn syrup is an ingredient in a product, dont buy it.

      When Is Surgery Considered For Gout

      The question of surgery for gout most commonly comes up when a patient has a large clump of urate crystals , which is causing problems. This may be if the tophus is on the bottom of the foot, and the person has difficulty walking on it, or on the side of the foot making it hard to wear shoes. An especially difficult problem is when the urate crystals inside the tophus break out to the skin surface. This then can allow bacteria a point of entry, which can lead to infection, which could even track back to the bone. Whenever possible, however, we try to avoid surgery to remove tophi. The problem is that the crystals are often extensive, and track back to the bone, so there is not a good healing surface once the tophus is removed. In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered.

      Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase , since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus.

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