Thursday, May 19, 2022

Is Gout A Type Of Arthritis

How Is Gout Treated

Gout Overview | Causes and Prevention | Johns Hopkins Medicine

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.

What Increases Your Chances For Gout

The following make it more likely that you will develop hyperuricemia, which causes gout:

  • Being male
  • Using certain medications, such as diuretics .
  • Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
  • Eating or drinking food and drinks high in fructose .
  • Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.
  • The Four Stages Of Gout

    Gout is best understood by seeing it as having four phases or stages :

    Stage 1: High uric acid

    Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.

    Stage 2: Acute flares

    This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.

    Stage 3: Intercritical periods

    These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.

    Stage 4: Advanced gout

    This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .

    Figure 1: Stages of Gout

    Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)

    Figure 3: Progression of Gout

    Read Also: What Can You Eat When You Have Gout

    Differences Between Ra And Gout

    Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life.

    However, a close look at initial signs and which joints are involved will clearly differentiate these two diseases. The best way to know whether you have RA or gout is to make an appointment with your doctor for a diagnosis.

    Specific signs that distinguish the diseases:

    Common Symptoms Of Rheumatoid Arthritis

    Gout is a type of arthritis that mostly affects joints on ...

    Symmetrical symptoms: In RA, joint pain usually affects both sides of the body. Symptoms typically begin in the small joints in the hands and feet as the disease progresses, pain can develop in the wrists, knees, ankles, elbows, hips, and shoulders.

    Morning stiffness: The pain of RA is typically at its worst in the morning, which causes a period of stiffness that can last an hour or longer. Motion helps ease RA symptoms, so people generally feel better later in the day as they accumulate more activity.

    Read Also: Foods That Can Help With Gout

    What Is Osteoarthritis Rheumatoid Arthritis And Gout And How Can They Be Treated See Diagram And Video

    What is arthritis? The word arthritis is a general term, not a specific illness. Most everyone knows that if someone has arthritis, then that person is having a problem with their joints. But, most people do not realize that there are over 115 different arthritic diseases. The following explains the most common types of arthritis and a brief explanation about how we can help treat it.

    What Are Some of the Most Common Types of Arthritis?

    Osteoarthritis Osteoarthritis is the most common kind of arthritis. The problem in OA is the breakdown of cartilage in joints. This causes pain in the affected joint with use. For example, OA in the knee causes knee pain with walking or climbing steps.

    Rheumatoid Arthritis In rheumatoid arthritis , inflammation causes the joints to be swollen, stiff, and tender. Unlike OA, however, the inflamed joints in RA will often feel better with use. Because it is an inflammatory illness, RA can affect other parts of the body, including the skin, nerves, heart, and lungs.

    Gout Gout is caused by uric acid, a chemical made by the body, which gets into the joints. It causes sudden episodes of very painful, swollen joints.

    How We Help Treat Arthritis?

    It is important to have an evaluation to determine which arthritic disease is causing the problem. Like other illnesses, early diagnosis and treatment of arthritis can impact the outcome of the illness.

    Contact Us For More Information to Request an Appointment

    About Tristate Arthritis and Rheumatology

    What Are The Symptoms Of Gout

    The most common symptom of gout is pain in the affected joint, such as the big toe. Gout flares often start suddenly at night, and the intense pain may wake you up. In addition, your joint may feel swollen, red, warm, and stiff.

    Gout flares usually occur in one joint. They can be triggered by:

    • Certain foods.
    • Physical trauma.
    • Certain illnesses.

    Flares typically get better over a week or two. In between flares, you usually dont have symptoms. Some people may have frequent flares, while others may not have another flare for years. However, over time, if left untreated, your flares may last longer and happen more often.

    Some people with gout may be more likely to develop other conditions or complications, especially with the heart and kidneys.

    Also Check: How To Alleviate Gout Pain In Big Toe

    Do Ra And Gout Have The Same Cause

    Rheumatoid arthritis and gout both are types of arthritis, but the underlying causes are completely different. RA is an autoimmune condition. It happens when your bodyâs immune system attacks the tissue that lines your joints. This attack causes painful swelling, inflammation, and joint deformity. Since RA is an immune system disease , it can affect other parts of the body, too, including the skin, eyes, and heart.

    Gout affects people with too much uric acid in their blood. Your body creates this type of acid when it breaks down certain foods, including meat. Your kidneys normally get rid of it when you pee. But when thereâs too much of it in your system, the uric acid can form crystals. These needle shaped crystals build up in joints and surrounding tissue where they can cause pain and inflammation.

    Getting Prompt Treatment For Gout Or Ra

    What is Gout?

    If youve been experiencing symptoms of either condition, you should see your doctor as soon as possible because both can cause significant joint damage if a diagnosis is delayed. However, Dr. Portnoff notes that the pain gout causes is so intense that patients with gout rarely put off seeing a doctor when theyre having an attack.

    Theres no cure for gout or RA, but there are several good treatments available for the two conditions. Some pain relief treatments, including NSAIDs and corticosteroids, are recommended to help manage both RA and gout. Because RA is an autoimmune disease, patients may also take disease-modifying immunosuppressant drugs such as methotrexate or other DMARDS or biologics.

    Gout, on the other hand, may be treated with the drug colchicine, which relieves pain and helps prevent future attacks. Rheumatologists may also prescribe drugs called xanthine oxidase inhibitors , and sometimes combine those with medications called uricosuric drugs that improve your kidneys ability to remove uric acid from your body. People with gout are also advised to limit foods that promote high levels of uric acid, including red meat, alcohol, and shellfish. However, diet changes alone cannot usually control gout symptoms, and medications are necessary to help prevent complications.

    Recommended Reading: How Long Do Gout Attacks Normally Last

    Amazing Facts About Gout

    Fact-No-01

    In humans, inherited metabolic disorders lead to the buildup of excess uric crystals, which gets deposited in joints. These generate an inflammation of joints called gout.

    Fact-No-02

    Gout is one of the specific health disorders caused by high uric acid levels in the blood cells. Intake of alcohol, niacin and other genetic disorders are also considered as the reason behind the cause for gout.

    Fact-No-03

    The best and the natural ways of preventing gout is by avoiding the intake of alcohol, having a balanced diet, drinking plenty of water, complete stop of sweets and other sugary products and by limiting the intake of purine-rich foods.

    Fact-No-04

    Constipation, sudden and severe joint pain, swollen joints, stiffness in the muscles and muscle tenderness are a few of the significant symptoms associated with gout.

    Read more: Osteoarthritis

    Fact-No-05

    Along with genetic disorders, gout can also be caused due to certain lifestyle changes. Therefore, there are various natural therapies, which can control and lower the symptoms of gout.

    Fact-No-06

    The primary cause for gout is the accumulation of excess uric crystals than the required amount near the joints. Once the uric crystals start to accumulate near the joints, it results in severe pain. Generally, the pain begins from the back and spreads to the thighs of an individual.

    Fact-No-07

    Fact-No-08

    Fact-No-09

    Fact-No-10

    Also Refer: Deficiency Diseases

    The Role Of Medication In Prevention Of Gout

    Table 3: Medications to pevent attacks of gout

  • Colchicine: to decrease the ability of uric acid crystals to cause inflammation.
  • Allopurinol and febuxostat: to decrease production of uric acid
  • Probenecid and lesinurad: to increase the excretion of uric acid
  • Pegloticase: to increase the breakdown of uric acid
  • Standard medications in preventing gout attacks

    i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8

    ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.

    Table 4: Reasons to use medication to lower uric acid

    Read Also: How To Know If I Have Gout In My Foot

    Infectious And Reactive Arthritis

    Infectious arthritis is an infection in one of your joints that causes pain or swelling. The infection can be caused by bacteria, viruses, parasites, or fungi. It can start in another part of your body and spread to your joints. This kind of arthritis is often accompanied by a fever and chills.

    Reactive arthritis can occur when an infection in one part of your body triggers immune system dysfunction and inflammation in a joint elsewhere in your body. The infection often occurs in your gastrointestinal tract, bladder, or sexual organs.

    To diagnose these conditions, your doctor can order tests on samples of your blood, urine, and fluid from inside an affected joint.

    The fingers are most commonly affected with psoriatic arthritis , but this painful condition affects other joints as well. Pink-colored fingers that appear sausage-like, and pitting of the fingernails, may also occur.

    The disease may also progress to your spine, causing damage similar to that of ankylosing spondylitis.

    If you have psoriasis, theres a chance you could also develop PsA.

    How Will Gout Affect Me

    Gout is an inflammatory type of arthritis that cause red ...

    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.

    Also Check: Are Almonds Good For Gout

    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

  • 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.
  • How Do Health Care Providers Diagnose Gout

    The most reliable method to diagnose gout is by demonstrating uric acid crystals in joint fluid that has been removed from an inflamed joint . Specially trained physicians, such as a rheumatologist or orthopedist, can carefully remove fluid from the joint. The fluid is then examined under a microscope to determine if uric acid crystals are present. This is important because other medical conditions and diseases, such as pseudogout and infection, can have symptoms similar to gout.

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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.
  • Two Main Categories Of Arthritis

    What is gout arthritis? How does uric acid cause inflammation?

    Arthritis conditions fall into one of two categories: degenerative or inflammatory. Degenerative arthritis diseases cause damage to the area surrounding a jointcommonly referred to as the wear and tear variety. Inflammatory arthritis conditions involve the immune system they are autoimmune disorders. These disorders cause the body to mistakenly attack its own tissues, which cause issues or damage inside joints. A tell-tale sign of inflammatory arthritis is the presence of white blood cells in the joint fluid.

    Despite its prevalence, arthritis isnt completely understood. It can begin unexpectedly, masquerade as other diseases, and defy treatment. Sometimes symptoms are clear and visible , but often the pain and discomfort wont show up on the surface of the body.

    If you suspect arthritis is the source of your pain, stiffness, and inflammation, the first step is a concise and accurate diagnosis.

    Recommended Reading: Do You Use Heat Or Cold For Gout

    Do Doctors Treat Ra And Gout The Same Way

    Neither RA nor gout is curable. But there are treatments to help manage your symptoms. Some are the same for either condition:

    • Pain treatments. Over-the-counter pain relievers like ibuprofen and naproxen can help with either condition. A medication called colchicine can also ease gout pain.
    • Inflammation treatments. Corticosteroids like prednisone can help with inflammation and the pain it causes.

    When it comes to treating the underlying disease, doctors focus their efforts on treating the cause. RA treatment may include drugs that suppress the immune system.

    Gout treatment usually includes medications that prevent the buildup of uric acid crystals.

    What you eat can also affect the levels of uric acid in your blood. If you have gout, take these steps to prevent an attack of gout:

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