Whats Causing A Rise In Gout Cases
There a variety of factors scientists and doctors believe have led to the rise in gout cases. In the U.S. and U.K., were eating more red meat. Fructose is added to more processed foods. And theres been a big rise in beer consumption and binge-drinking. Medications like beta-blockers and diuretics are used more often.
Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
How Is Foot Gout Diagnosed
If you are experiencing sudden bouts of intense pain in your joints, or if you feel you are experiencing the symptoms of foot gout, you should see your doctor immediately. Early detection can improve your chances of catching the gout during its early stages and successfully treating the condition.
Your doctor will perform a number of tests on you and ask questions about your family history, medical history, personal habits, and diet. He or she may also perform a joint fluid test. During this test, a needle is used to draw fluid from your affected joint for analysis. Your doctor may also order a blood test to measure your uric acid levels.
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How Is Genital Herpes Spread
You can get genital herpes by having vaginal, anal, or oral sex with someone who has the disease.
If you do not have herpes, you can get infected if you come into contact with the herpes virus in:
- A herpes sore
- Saliva or genital secretions
- Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.
You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.
You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider.
Avoid Foods That May Trigger Gout
Purines are found in certain high-protein foods, such as certain types of seafood ,and red meat and organ meat . Avoid drinks that may trigger gout:
- Alcoholic beverages
- Sugary drinks
- Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger an attack.
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What Is Gout In Knee
Gout in knee or gout knee is an inflammatory condition of the joint leading to swelling, pain, and redness of the knee. Gout is a complex form of arthritis that can affect anyone. Men are documented as having the condition more often, but postmenopausal women become increasingly susceptible in their later years. It is estimated that about one million Americans are affected by gout pain each year.
The most common joint affected by gout is the big toe, but joint pain may also be experienced in the knees, hands, ankles, and wrists.
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.
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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.
What Is The Link Between Genital Herpes And Hiv
Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, having genital herpes increases the number of CD4 cells found in the lining of the genitals. When a person has both HIV and genital herpes, the chances are higher that HIV will be spread to an HIV-uninfected sex partner during sexual contact with their partners mouth, vagina, or rectum.
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Some Signs Of Gout Like Pain In The Big Toe May Be Obvious But Other Gout Symptoms Can Be More Subtle
Once upon a time, gout was known as the disease of kings because it was thought to be more common among wealthy, overweight men who could afford to over-indulge in rich foods and alcohol. While diet and obesity remain important gout risk factors, your social class or bank account is no longer relevant to your risk of developing gout, which is on the rise. Incidence of gout more than doubled between the 1960s and 1990s today nearly 4 percent of U.S. adults have it.
Gout is a form of arthritis that causes severe, sudden attacks of inflammation. Gout happens when there is too much of a chemical called urate in your blood . This causes uric acid crystals to build up in your joints, causing the telltale gout pain. Your body produces uric acid when it breaks down purines, substances that are naturally found in your body as well as in certain foods. While diet itself does not cause gout, certain foods and drinks may trigger gout flares. People who develop gout likely have some genetic predisposition combined with other risk factors or conditions such as kidney disease or diabetes that cause uric acid to build up in the body.
Gout is highly treatable, but in order to address it you have to know that you have it and the symptoms of gout arent always obvious.
Causes And Risk Factors Of Gout In Knee
Gout occurs due to the accumulation of urate crystals in the joint, causing inflammation and intense pain. These crystals can form when you have high uric acid in the blood. Your body innately produces uric acid when it breaks down purinessubstances that are found naturally in the body. Purines are also found in certain foods, such as steak, organ meats, and seafood. Other foods that promote higher levels of uric acid include alcoholic beverages, and drinks sweetened with fructose .
In a normal individual without gout, uric acid dissolves in the blood and passes through the kidneys to be expelled in the urine. But sometimes the body produces too much uric acid, or the kidneys excrete too little of it. When this happens, uric acid can build up, forming sharp, needle-like urate crystals that become deposited in a joint or surrounding tissue, causing pain, inflammation, and swelling.
Uric acid crystals tend to form in cooler temperatures. This is why they accumulate most often in the distal extremitiesareas that are more likely to become colder than the rest of the bodysuch as the hands and feet.
Several influences play a role in the development of gout, making some people more susceptible to it than others.
Here are some gout risk factors:
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Differences Between Men And Women
Sex differences play a role in which joints are affected:
- In men, about 85% of gout flare-ups affect joints in the lower extremities. About 50% of first-time gout attacks involve a big toe joint.8
- In women, a gout attack is most likely to occur in a knee.10 In addition, women may be more likely to get gout in the upper extremities.9
While women are less likely to get gout, they are more likely to have multiple joints affected by gout.13
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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Joints Affected By Gout
Gout can affect any joint, but some joints are more likely to be affected than others. Joints commonly affected include the big toe, the foots instep, heel, ankle, and knee.2 Less often, gout affects the elbow, wrist, fingertips, or spine.2–7
Gout is acute, painful swelling in the joints from uric acid buildup. Common areas include the foot and big toe.
How Will My Doctor Know If I Have Herpes
Your healthcare provider may diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore and test it. In certain situations, a blood test may be used to look for herpes antibodies. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or how long you have been infected.
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Myth: There Aren’t Effective Medicines For Gout
Truth: Many medications put the brakes on gout. Some control pain and inflammation immediately and others get at the root cause by eliminating the deposited uric acid crystals.
Colchicine is prescribed for acute gout flare-ups. A plant extract, it’s been used to treat gout for 2,000 years, says Reveille. Colchicine works within several minutes to several hours to block gout inflammation. The sooner you start it, the more likely the attack will resolve quickly. An injected steroid also tackles inflammation, usually controlling pain and swelling within 24 hours.
Prescription drugs such as allopurinol , febuxostat and probenecid all alleviate gout by controlling blood levels of uric acid. Also, two years ago the FDA approved an intravenous drug for people with advanced gout pegloticase that lowers uric acid levels and reduces deposits of uric acid crystals in the joints and soft tissue.
Most people who have gout will need to be on a uric-acid-lowering drug for life, usually just one or two pills a day, says George Washington University’s Baraf.
Changing your diet can help reduce the frequency of gout attacks.
How Uric Acid Crystals Form
The build-up of uric acid crystals begins with purines, a chemical compound found in many foods.
- When the body metabolizes purines, it produces a substance called uric acid.
- The uric acid enters the bloodstream.
- The kidneys filter the blood and normally filter out excess uric acid. This uric acid is then excreted via urine or stool .10
- If the kidneys cannot adequately filter out excess uric acid, or if the body produces too much uric acid, there will be too much uric acid in the bloodstream.
- Too much uric acid in the bloodstream is called hyperuricemia.
- In some people, hyperuricemia leads to the formation of uric acid crystals that collect in joint tissue, leading to painful symptoms.
An inability to adequately process and excrete uric acid accounts for an estimated 90% of gout cases.9 Other cases occur because a body produces too much uric acid.
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Can I Still Have Sex If I Have Herpes
If you have herpes, you should talk to your sex partner and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.
You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsexternal icon.
Gout In Children And Teens
If a child or teenager has gout, it is important that blood and urine tests be done to determine why gout has occurred. It is usually a sign of an underlying problem that is often easily treated.
In children, the first test to do if gout is suspected is to measure the blood uric acid level. If this is elevated , this could be a sign that gout is present. Other important procedures are for a doctor to insert a needle into the affected joint, withdraw fluid, and examine this fluid for uric acid crystals.
Causes of gout in children and teenagers include:
- Inherited conditions that cause over-production of uric acid. These include HPRT deficiency and PRPP synthetase overactivity. These disorders are uncommon but are easily tested for. Patients produce extra uric acid and can have gout and kidney stones containing uric acid. These conditions usually occur in boys but can occasionally happen in girls as well.
- Kidney diseases resulting in decreased ability of the body to get rid of uric acid. These can include:
– The most common type is due to mutations in the gene that produces a protein called uromodulin. In this condition, patients develop gout in their teenage years and have slow worsening of kidney failure over time. There are usually many other family members who have had gout or kidney disease.
– Any type of kidney disease can also cause gout in childhood.
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Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot
As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.
The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.
Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.
Figure 5: Location of Gout Attacks
How Can An Attack Of Gout Be Treated
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
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What Does A Gout Attack Look And Feel Like What Would A Foot Or Toe With Gout Look Like
When gout occurs, the joint tends to be extremely painful and is warm, red and swollen . The inflammation that is part of a gout attack is systemic, so that fever and chills, fatigue and malaise are not uncommonly part of the picture of a gout attack.
Figure 6: Toe with Acute Attack of Gout
Gout attacks can occur in joints that look normal, or in joints that have easily visible deposits of uric acid. These deposits are called tophi and can be in numerous locations, but especially on the feet and elbows. In Figure 9, the little finger of the right hand is bandaged since fluid was just removed from it, which demonstrated innumerable uric acid crystals.
Figure 7a: Tophi on Foot
Figure 7b: Tophus Over Achilles’ Tendon
Figure 8: Tophus on Elbow
Figure 9: Tophi on Hands
Figure 10: Large Tophus of Finger
While some gout attacks will solve quickly by themselves, the majority will go on for a week, several weeks, or even longer if not treated. Since gout attacks are usually quite painful and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.