Who Is At Risk Of Gout
Gout is sometimes called the disease of kings because of a false link to overindulgence in food and alcohol. Anyone can get the condition, but certain factors can increase your risk:
- Gender: Males are more likely to get gout than females.
- Age: Middle-aged and older men and women after menopause are more at risk for gout.
- Family history
- Diet: A diet high in purines, which are broken down into uric acid, can lead to gout. High purine foods include meats like bacon, turkey, veal, venison, and liver, and seafood like anchovies, sardines, mussels, codfish, scallops, trout, and haddock. High fructose foods and drinks such as soda pop also can increase your risk.
- Alcohol use
Preventing And Treating Gout
When you first come to AllCare Foot & Ankle Center with gout symptoms, we conduct a thorough examination to determine the best course of treatment. We typically prescribe nonsteroidal anti-inflammatory medications to help control symptoms and prevent further joint damage.
If youve already had or continue to have multiple gout attacks, it can lead to a variety of health complications, including the erosion and destruction of your toe joint and the development of kidney stones. This is why preventing future gout attacks is essential for your overall health and wellness, not just for relieving the pain in your toe.
We recommend the following to help prevent future gout flare ups:
- Drink plenty of fluids
- Limit or avoid alcoholic drinks
- Reduce meat, poultry, and seafood in your diet
- Consume more low-fat dairy products for protein
- Lose weight, if necessary
The common symptoms of gout arent something you should ignore, and we can help you get it under control. Give us a call at our Arlington or Dallas offices, or request an appointment online today.
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Common Myths About Gout
Drinking too much alcohol and eating too much rich food were once considered the prime suspects in causing gout. Although eating certain foods and drinking alcohol may cause uric acid levels to spike, these habits alone may not cause gout.
A recent study indicates that our DNA is a key factor in gout flare-ups. Researchers found that diet was less important than genetics in determining whether or not patients would develop high levels of uric acid.
If you suspect you have gout, make an appointment with your doctor to be tested and learn how to prevent or reduce future gout attacks.
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Excess Uric Acid Leads To Gout Attacks
Gout is not only unpredictable and debilitating but also relatively common. According to the UK Gout Society, one in 14 men and one in 35 women will develop this joint disease. The problem occurs mainly in the lower extremities the knees, ankles and feet with big toe joints at the greatest risk. The NHS website includes a the skin looks extremely red and swollen.
People develop gout as a result of hyperuricemia, i.e. high levels of uric acid in the bloodstream. Uric acid crystals build up around the joint at the base of the big toe and other joints, ultimately tricking your body into thinking its under attack. White blood cells try to defend you by surrounding the crystals, leading to the severe joint pain and inflammation familiar to gout sufferers.
Gout pain can last for more than a week and often returns. To reduce the likelihood of permanent joint damage, urgent medical treatment is vital. Your doctor may prescribe medicine to lower uric acid levels, as well as anti-inflammatories.
How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
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What Are Symptoms Of Gout
Chances are you wont even know you have gout until youve experienced your first painful attack, often at night. Symptoms may not develop for years, but these often include:
- Arthritis that develops quickly, resulting in a swollen, red, and warm joint with limited movement
- An arthritis attack in only one joint often the big toe, as well as a foot, ankle, or knee
- Bright red or purplish skin around the affected joint
- More than one attack of acute arthritis
How Do You Get Gout
How do you Get Gout?
Before we can answer the query how do you get gout? we need to explain what gout is. Gout is a specific form of arthritis that is characterized by extreme pain, stiffness, redness and heat in the region and usually accompanied by swelling in the affected area. Without treatment, these episodes are repeated and can cause lasting damage to joints, tendons and surrounding tissues. Gout is more prevalent in men, but a general rule is that it can effect women after menopause.
So how do you get gout?In order to get gout, uric acid levels in the blood must be excessive. Bear in mind, however, that not all people with excessive uric acid levels will develop gout. Gout only occurs when the uric acid deposits crystals in the joints, typically in the big toe, or knees. You will be more susceptible to developing gout if you are overweight, consume excessive amounts of alcohol or have a diet that includes meat and fish that are rich in purines. Purines will be explained later. Some medications, such as those designed to reduce water retention can also result in a gout condition.That’s how you get gout.
Foods to avoid – How do you get Gout?
It is not enough to know How do you get gout? it is also necessary to understand which foods may be causing the problem. It should be noted at this point that there is no cure for gout and the approach is to treat the symptoms only or to recommend a diet that is low in purines.
How do you get Gout!
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Why Do I Get Gout
You might think that gout is caused by drinking too much beer and fizzy drinks and eating too much meat and shellfish. In fact, gout is caused by having too much of a chemical called uric acid in your blood.
Your body makes uric acid when you eat food. It is normal and healthy to have some uric acid in your body. Most people get rid of uric acid through their urine.
Easing Back Into Walking And Exercise After A Gout Flare
After a gout flare subsides, Dr. Iversen suggests aquatic exercises may be a good way to start re-engaging in exercise because the buoyancy of the water will reduce the impact on the joints.
Low-impact aerobic exercises can be helpful, too, such as on an elliptical machine. She says its important to keep your joints flexible by incorporating stretching and range-of-motion exercises once the gout flare subsides to promote good joint movement.
Be careful not to overdo it once you ease into post-flare exercise, she cautions. Patients should not be experiencing pain when walking once the flare has subsided. If you do experience pain with walking after a flare, go back to using a walking support and reduce your planned exercise until the pain subsides.
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How Are Gout Attacks Prevented
Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.
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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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
Diagnostic Evaluation Of Gout In Foot
What goes into a gout diagnosis? These procedures are options:
- Joint aspiration. Fluid is withdrawn from the joint and inspected for crystals and bacteria.
- Blood tests. White blood cell count, ESR , triglycerides, and kidney function may be elevated.
- X-ray. An x-ray of the affected joint is likely to appear normal during an initial acute episode, but in chronic gout, bone erosion and overhanging edges may be seen.
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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.
How To Treat Gout In The Big Toe: What You Must Know
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What Are Future Possible Treatments Of Gout
Fortunately, present medications are successful in the vast majority of gout patients. But some patients cannot tolerate our present arsenal of gout medications. For others, these agents are not sufficiently effective. Therefore, new treatments are continually being sought. Some of the more promising include anakinra, rilonacept, canakinumab, BCX4208 and arhalofenate.
Gout In Foot: Causes And Risk Factors
In about 90 percent of hyperuricaemia cases, there is impaired renal excretion in about 10 percent, there is a problem with overproduction.
- Urate overproduction can be linked to lifestyle factors and certain diseases such as bone marrow cancers, psoriasis, and hemolytic anemia. Lifestyle factors include being overweight and ingesting excess amount of fructose or alcohol.
- Renal impairment has multiple causes, including gene mutations, hypertension, diuretic drugs, lead exposure, and cyclosporine immunosuppressive therapy.
- Gender and age. Men are twice as likely to develop gout as women. In men, the risk rises with age. Gout is uncommon in younger women but the incidence increases dramatically after menopause, due to falling estrogen.
- Western diet. There is solid evidence from the Health Professional Follow-up Study of a link between gout and purine-rich foods. See gout diet.
- Medications. Diuretics, antihypertensives, niacin, aspirin, chemotherapy and immunosuppressive drugs increase the risk of gout.
- Other conditions. Certain conditions carry an increased risk of gout including: Recent joint injury or surgery, cardiovascular disease, chronic pulmonary disease, anemia, psoriasis, renal disease, blood cancers, and metabolic syndrome.
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Potential Treatments For Gout In The Foot
There are two basic methods of combatting gout or gouty arthritis as is its full term you either stop the pain of a gout attack or you take steps to prevent a future attack happening.
These are typically broken down as follows
Stopping Gout Pain
What I want to do now is look very specifically at what you need to do to apply each of the above and achieve better treatment for gout in the foot
Symptoms Of Heel Pain Due To Uric Acid
Anyone can get gout, although its most common in individuals with the risk factors we covered earlier The symptoms of gout in the heel are subtly different from those of plantar fasciitis in the heel:
- Redness, swelling and tenderness that is most pronounced where the heel meets the ankle. You are also likely to notice symptoms at the base of the big toe.
- Often, gout symptoms will flare-up in the middle of the night
- During a flare-up, your heel will feel so hot and painful to the touch that even wearing socks is excruciating
- Pain that is less intense but lingers after a gout attack flare-up of pain
- Increasing difficulty moving the joint
As a general rule of thumb, pain from plantar fasciitis will improve with rest, while pain from gout will flare up during long periods of inactivity and rest.
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Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
Am I At Risk Of Having Gout
Youre more likely to have a gout attack if you:
- are male
- have a family history of gout
- have elevated levels of uric acid in the blood
- drink too much alcohol
- eat a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
- are overweight or obese
- use diuretics
- have type 2 diabetes, high blood pressure or high cholesterol these conditions can mean that your kidneys are less able to flush out the urates
- have kidney disease
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How Long Does Gout In The Ankle Last
Gout flare-ups can last for several hours at a time, but you may feel pain in your ankle for days or weeks. Some people only have one flare-up in their life, while others have them several times a year.
Keep in mind that gout is a chronic condition, meaning it lasts for a long time and requires ongoing management. Dietary changes and medications can make a big difference, but youll also be at risk of having a flare-up.
Keep in mind that it can also take some time to find the right combination of diet changes and medication that works for you. Dont be discouraged if things dont seem to be improving right away.
Causes And Risk Factors
Gout occurs due to an excess buildup of uric acid, or hyperuricemia.
According to the National Institutes of Health , hyperuricemia is the main risk factor for developing gout. However, a quarter of those with hyperuricemia do not develop gout.
When the body breaks down purines, it produces uric acid. Typically, the kidneys remove a certain amount of uric acid in the urine. However, when they are unable to remove enough uric acid, uric acid crystals can form in the joints and soft tissues, causing swelling and pain.
Gout typically affects males more than females. However, females have higher levels of uric acid after menopause. NIAMS state that being older also the chance of developing gout.
Genetics can also increase the chance of developing gout.
According to the CDC , other factors that may increase the likelihood of gout include:
- Diet: Food can play a role in the development of gout symptoms. Eating seafood, red meat, and drinking alcohol raises uric acid levels in the body.
- Weight: Having overweight increases the chance of developing gout.
- Medications: Certain medications, including diuretics and low-dose aspirin, are associated with gout risk because they increase the level of uric acid in the body.
- Other medical conditions:High blood pressure, diabetes, and kidney disease can increase gout risk.
According to the National Health Service in the United Kingdom, some people with gout may develop complications, such as:
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