Tuesday, May 17, 2022

Google Tell Me About Gout

What To Do During An Attack

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You should:

  • take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
  • rest and raise the limb
  • avoid knocking or damaging the affected joint
  • keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
  • ensure you’re well hydrated

Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.

If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.

What Can Increase Your Risk

A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, it’s still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level don’t.

Other factors that may increase your risk of developing gout are outlined below.

Effective Medical Treatment For Gout

The American College of Rheumatology released gout management guidelines in 2012 and updated them in 2020. They recommend drugs classified as urate-lowering therapy for those who have experienced two or more gout attacks in a year as well as for those with joint damage from gout.

Specifically, the organization recommends allopurinol as a first-line treatment for all gout patients, even those with chronic kidney disease. Next in line is febuxostat both are a class of drugs called xanthine oxidase inhibitors.

In addition, the guidelines recommend use of anti-inflammatory medications including NSAIDs, prednisone, or colchicine along with the other medication.

Also Check: How Long Can A Gout Flare Last

Additional Tips For Treating Gout Naturally

Studies show that many of the dietary items we consume lead to gout as well as other health problems. Changing your diet and lifestyle may be the easy solution to beating gout. One of the first things to do is eliminate certain foods and beverages from your diet to beat gout.

1. Eliminate or reduce sugar intake

As many studies are now illustrating, gout is common in people with excessive sugar intake, especially high fructose corn syrup Its wise to read the labels of all your food and drinks. If you find HFCS then eliminate that from your diet. In addition, look for sugar added under the guise of other common names for sugar look for cose at the end of words and these are probably types of sugar you dont want to be consuming.

2. Eliminate grains

Grains in the body are converted to sugars so again you want to limit or avoid grains altogether. They are also very inflammatory to your body.

3. Limit alcohol consumption

Again, alcohol becomes sugar once ingested so eliminate this completely unless you have a healthy body already. Any substance that will be converted to one or another type of sugar by the body should be avoided at all costs. In order to get your uric acid levels down you must consistently avoid sugar in your diet.

4. Eliminate soda and diet soda

5. Consume cherries and strawberries daily

6. Exercise

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Managing A Gout Flare

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Gout flares are unexpected and painful heres how to get a handle on them.

Few things in life are more painful than a gout flare, so if youre awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, youll want to act fast. Heres what you can do when a gout flare starts to ease the pain of and reduce the risk of others.

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What Does The Future Hold For Gout

Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.

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.
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    Can You Drop 8 Pounds Weight Loss Helps Prevent Gout

    If youre overweight, you are likely to have higher-than-normal uric acid levels, a primary risk factor for developing gout. Thats why weight loss is an important part of a gout diet.

    Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. In fact, a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people, according to a review of studies published in 2017 in the Annals of the Rheumatic Diseases.

    While some people with gout benefit from cutting back on foods that are high in purine, a chemical that contributes to uric acid formation, it is not clear how much purine intake makes a difference. You dont have to avoid all high-purine foods. Moderate changes to your eating style may help you feel better and reduce gout risks, and research suggests that purine-rich vegetables dont trigger gout. High-purine foods such as lentils and beans can be a smart source of lean protein.

    Where Does A Gout Attack Occur

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    Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.

    Also Check: What Body Parts Does Gout Affect

    What Are Causes Of Gout

    Uric acid is generated as we metabolize the food we eat and as the body’s tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid and are medically referred to as “over-producers.” Other people with gout do not effectively eliminate their uric acid into the urine and are medically referred to as “under-excreters.”

    How Is Gout Treated

    Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to

    • Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
    • Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
    • Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.

    In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.

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    Treating A Gout Attack

    Treating an attack of gout doesnt lower your urate levels or stop future attacks. The treatment helps you to manage your symptoms when an attack happens.

    The most commonly used drug treatments for attacks of gout are:

    Some people will be better suited to NSAIDS, while others will be suited to colchicine. But your preference is also taken into consideration many people with gout quickly learn what works best for them.

    In cases where one drug doesnt seem to be working on its own, your doctor might suggest a combination of NSAIDs with either colchicine or steroids.

    Non-steroidal anti-inflammatory drugs

    Attacks of gout are often treated with NSAID tablets, which can help with pain and reduce some of your inflammation. Ibuprofen, Naproxen and diclofenac are three NSAIDs you could be given.

    If youve been prescribed NSAIDs to treat an attack, you should start taking them as soon as you notice signs of one coming on. Your doctor may let you keep a supply so you can start taking them at the first signs of an attack.

    The earlier you start treatment, the better.

    NSAIDs arent suitable for everyone, so talk to your doctor about them first if you have any other conditions. They can also interact with other drugs, so make sure you talk to a doctor before starting on any new medication.

    Colchicine

    Colchicine isnt a painkiller, but can be very effective at reducing the inflammation caused by urate crystals.

    Colchicine tablets can cause diarrhoea or stomach aches.

    Steroids

    How Can An Attack Of Gout Be Treated

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    The management of an acute attack of gout is very different from the prevention of subsequent attacks.

    Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.

    There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.

    If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.

    Table 2: Medications to treat acute attacks of gout

  • Nonsteroidal anti-inflammatory drugs or COX-2 inhibitorsExamples of : Naproxen 500mg twice daily, indomethacin 25mg three times daily. Example of COX-2 inhibitor: celecoxib 200mg twice a day. Possible side-effects: Elevation of blood pressure, ankle swelling, upset stomach, ulcer . Use with caution if kidney or liver problems.
  • Anti-Inflammatory corticosteroidsExamples of : Prednisone 40mg first day, 30mg 2nd day, 20mg third day, 10mg fourth day. Possible side-effects: Elevation of blood pressure, elevation of blood sugar, mood changes. Short-term use, as in gout, generally much better tolerated than long-term use. Use with caution if diabetic.
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    Effects On Other Treatments

    Some drugs interact with allopurinol, so you should discuss any new medication with your doctor before starting it. You should also tell anyone else treating you that youre taking allopurinol.

    Do not use complementary treatments, such as herbal remedies, without discussing this first with your doctor or pharmacist. Some of them could react with allopurinol.

    You should avoid taking aspirin while youre being treated for gout. If youre in pain, you can take paracetamol and NSAIDs. But remember you should only take one NSAID at a time so do not take another if you have already been prescribed one to reduce the effects of gout attacks.

    Allopurinol can also react with drugs that are often prescribed for high blood pressure, such as bendroflumethiazide, indapamide, lisinopril, ramipril.

    Allopurinol reduces the breakdown of azathioprine, which is used to treat conditions such as rheumatoid arthritis and lupus. Your doctor may change your dose of azathioprine to account for this.

    It can also reduce the breakdown of the leukaemia drug mercaptopurine, so the dose of mercaptopurine will need to be reduced if you take this drug.

    Allopurinol may also increase the risk of developing a rash if you take them with the antibiotics ampicillin or amoxicillin.

    Whats The Best Way To Take Lab

    Your body doesnt typically excrete enough uric acid on its own to minimize the risk of a gout attack. Lab-grade Chanca Piedra is that extra added push for your body to be able to not only flush out uric acid in the kidney and liver, but to also inhibit the formation of uric acid crystals. Chanca Piedra has also been shown to help with inflammation.

    To dissolve uric acid crystals or to prevent them from forming altogether:

  • Take 400mg of lab grade chanca piedra when you wake.
  • Wait one hour before eating to ensure maximum uptake of the herb.
  • Take 400mg of lab grade chanca piedra at night.
  • Once your gout attacks are under control, scale back to just 400mg per day.
  • Keep in mind that each individual is unique and will respond differently to each treatment type. Always discuss any new treatments that you are considering with your physician prior to starting them so he/she can review with you any potential medication interactions and potential side effect concerns.

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    The Role Of Physical Activity In Prevention Of Gout

    Along with diet, physical activity can help with weight loss, and gout has been associated with being overweight.7 in patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot, a low-impact exercise program is reasonable. An exercise program combined with diet in gout can reduce risk for attacks.7 If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on.

    Research And Statistics: How Prevalent Is Gout In The United States

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    Research published in the journal Arthritis & Rheumatology found that gout rates in the United States have been climbing steadily over the past 50 years, likely because of increases in obesity and high blood pressure.

    Gout is the most common type of inflammatory arthritis among men. Its more common in men than women. About 6 percent of men in the United States have gout, while only about 2 percent of women have it. Women rarely develop gout before reaching menopause.

    Gout is rare in children and young adults.

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    Pain In Your Knees Ankles Wrists And/or Elbows

    While uric acid crystals tend to deposit themselves near the big toe, they can form in any joint in the body. That means severe, unexplained pain in any joint could be a sign of gout.

    Some people develop pain in just one joint , but about 25 percent of gout patients have polyarticular symptoms meaning they strike more than one joint at a time, says Dr. Huffstutter.

    Points To Remember About Gout

    • Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away.
    • With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis.
    • The most common symptom of gout is pain in the affected joint, such as the big toe.
    • Your doctor may recommend taking medications to manage the cause of your gout and treat active gout flares, and making changes to your diet and lifestyle.

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    How Do Doctors Diagnose Gout

    Joint aspiration

    • This is the most important diagnostic test. It is the ultimate method of being certain of a diagnosis of gouty arthritis, as opposed to other causes such as an infection in the joint.
    • A needle is inserted into the joint to withdraw a sample of fluid for testing.
    • The fluid is examined under a microscope to see if there are gout crystals or signs of a bacterial infection present. Sometimes other crystals can be found in the joint fluid, such as calcium pyrophosphate, which is caused by an entirely different condition called pseudogout .
    • Gouty arthritis is sometimes diagnosed based on the typical clinical presentation without a joint aspiration.

    Blood tests

    • A doctor may obtain a blood sample to look at cell counts, uric acid levels, kidney function, etc.
    • Unfortunately, the level of uric acid in the blood cannot be reliably used to make a diagnosis of gout. It is normal in approximately 10% of people during an acute attack of gouty arthritis. Moreover, uric acid levels are elevated in 5%-8% of the general population, so the presence of an elevated level does not necessarily mean that gout is the cause of an inflamed joint. Interestingly, the uric acid is typically lowered during a flare of inflammatory gouty arthritis. Therefore, the optimal time to measure the uric acid is after a flare has resolved when acute inflammation is not present.

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