Tuesday, May 17, 2022

Ok 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.

Gout Statistics And Facts

  • 8.3 million people in the United States have gout .*
  • Among people who have gout attacks, 90% have kidneys that dont remove enough uric acid from their urine while 10% make too much uric acid in their system.
  • 90% of gout attacks start in a single joint. Most often, it is the bunion joint of the big toe.
  • 90% of gout patients have one or more of the following conditions , which make it more difficult to manage gout: kidney dysfunction, coronary heart disease, obesity, high cholesterol and/or triglycerides, diabetes mellitus.**

*Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Zhu Y, Pandya BJ, Choi HK. Arthritis Rheum. 2011.**Comorbidities of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Zhu Y, Pandya BJ, Choi HK. Am J Med. 2012.

Gout Remedies That Work

By Dr. Josh Axe, DC, DNM, CN

Gout is something that plagues more and more people every day, and its caused from uric acid buildup in the body. I want to go over my top six home gout remedies all-natural ways to beat gout symptoms but right before that, go over the diet that is crucial to get rid of gout, along with the worst food offenders.

So if you have gout, the first thing you have to do is eliminate the excess sugar and grains in your diet, as well as processed meat. That means you need to kick that sugar addiction, as sugar feeds yeast in the body and conventional grains turn into sugar. Meanwhile, those meats are full of unhealthy hormones and antibiotics, and theyre so acidic to your system. In terms of beverages, its important to stay away from alcohol. Diet- and drink-wise, those are the best things you can do right now to eliminate gout symptoms.

In terms of a gout diet, its key to begin eating plenty of vegetables, fruits and organic meats. Some of the best foods include bone broth and my Chicken Vegetable Soup recipe.

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Managing Symptoms Of Gout

Medications are available to help you manage symptoms of gout. These include nonsteroidal anti-inflammatory drugs, such as indomethacin , ibuprofen , and naproxen . Side effects of these medications can include bleeding, stomach ulcers, and stomach pain. If your symptoms dont respond to these medications, your doctors may recommend other drugs to stop an attack and prevent future attacks.

Colchicine can reduce gout pain, but side effects may include nausea, diarrhea, and vomiting.

Corticosteroids such as prednisone also reduce inflammation and pain. These prescription medications can be taken orally or injected into your joint. Side effects include mood changes, elevated blood pressure, and water retention.

There are medications that block the production of uric acid and others that help your body remove uric acid, such as allopurinol and probenecid, respectively.

Healthy Chicken Alfredo For Gout

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See the discussions below and ask for recipes if you need them. Because all gout sufferers need to eat healthy meals balancing less meat with lots of vegetables. So this Alfredo Chicken uses whole wheat pasta and includes veg in the recipe. But also serve more veg on the side I suggest broccoli but go with your own faves. Use similar ideas for gout-friendly beef and ham hock meals below.

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Myth: Gout Pain Always Attacks The Big Toe

Truth: Gout occurs when uric acid builds up in the blood, forming crystals that lodge in and inflame joints. It’s true that gout often first attacks the joints of the big toe, but it can also occur in the knees, ankles, feet and hands. In women with osteoarthritis, for example, gout pain commonly starts in the small joints of the hands. Although the first attacks often involve only one or two joints, over time multiple joints become affected. If the disease isn’t treated, it can cause permanent damage.

Avoiding alcohol may reduce your chance of getting gout attacks.

How To Get Rid Of Gout Fast

Gout is a painful type of arthritis that feels similar to the pain experienced with rheumatoid arthritis, as both diseases cause inflammation in the joints.

Gout is caused by a buildup of uric acid in the blood.

When the body cannot get rid of the excess uric acid, that buildup ends up accumulating as crystals in a joint, such as the big toe.

This creates swelling, redness, warmth, and severe joint pain in the affected area.

This condition has historically been seen as a disease that only affects old, wealthy men.

About 4% of Americansmore than 8 million peoplesuffer from gout.

Since gout can be caused by genetic, environmental, and lifestyle factors, anyone can get gouteven if they eat what would typically be deemed a healthy diet.

Attacks and flare-ups of the condition can be painful.

While there is no cure for gout, there are things you can do to get relief from the pain and inflammation.

In this article, Ill talk about ways to get fast relief from a gout attack, treatment options for these flare-ups, and warning signs that an attack may be coming.

Ill also tell you when its best to talk to your doctor or another healthcare provider about gout symptoms.

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Other Symptoms Of Acute Gout Or A Gout Attack

  • Sudden crushing or throbbing pain in one or a few joints that may last for a few days
  • Sometimes an acute gouty arthritis attack has a sudden onset at nighttime. The big toe joint pain may be so severe that even the weight of bedsheets causes discomfort.
  • Joints that appear swollen and inflamed, with reddish-purple skin that may feel warm

Key Points About Gout

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  • Gout causes inflamed, painful joints due to urate crystal deposits at the joints.

  • Gout can also cause urate crystal deposits that cause lumps under the skin.

  • Gout can be triggered by eating foods high in purines and drinking alcohol.

  • Treatment of gout is aimed at reducing pain and the risk of future flare-ups.

  • Gout can be managed with medicines and lifestyle changes.

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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 .

Chronic Gout Signs And Symptoms

  • Compared with the dramatic nature of acute gout pain, chronic gout pain is more of a soreness or persistent ache.
  • Pain that tends to be a more continuous feeling of dull aching or soreness in the joints
  • Hard white deposits or lumps under the skin, called tophi, found on the elbows, ears, or fingers.

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How Is Pseudogout Treated

There is no cure for removing the calcium deposits that cause pseudogout. It is a progressive disorder that can eventually destroy joints. Treatments for acute attacks of pseudogout are similar to those for gout and are aimed at relieving the pain and inflammation and reducing the frequency of attacks.

  • Nonsteroidal anti-inflammatory drugs are effective for treating inflammation and pain from pseudogout.
  • For acute attacks in large joints, fluid aspiration alone or with corticosteroids may help.
  • Colchicine may be used for acute attacks.
  • Magnesium carbonate may help dissolve crystals, but existing hard deposits may remain.
  • Surgery may be required for joint replacement.

Who Gets Gout Gout Risk Factors

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Gout happens when too much uric acid builds up in the body. Uric acid is a normal waste product in the blood resulting from the breakdown of certain foods. Uric acid usually passes through the kidneys and is eliminated from the body in urine. But it can build up in the blood and form painful, spiky crystals in your joints. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out.

Having too much uric acid in the blood is a condition called hyperuricemia. Certain foods, medicines, and lifestyle factors can cause high uric acid levels in the blood, triggering a gout attack.

Your risk of gout goes up when your diet is high in naturally occurring compounds called purines. When purines break down in the body, they cause uric acid to form. Purines are found in certain high-protein foods and some drinks. It used to be thought that gout was caused only by lifestyle and diet, but new research has found that’s not true instead, gout is thought to have a genetic link. Diet, however, does play a role in the disease.

Other risk factors for gout include:

  • Being a man
  • Type 2 diabetes
  • Health conditions that cause rapid turnover of cells
  • KelleySeegmiller syndrome or LeschNyhan syndrome

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How Is It Taken

Allopurinol is taken as a tablet once a day. It is usually better to take it just after eating and the tablet should be swallowed with water. It is important to drink plenty of water during the day because this will help you get rid of more urate through your kidneys.

Your dose of allopurinol may change over time, depending on the amount of urate in your body. Your doctor will monitor your urate levels with blood tests every 2-4 weeks, until they are sure that the dose that youre taking is high enough to reduce the amount of urate in your body.

You may need to remain on a lower dose if you have kidney or liver problems.

Your doctor may recommend that you do not start taking allopurinol until after an attack of gout has passed to avoid triggering further attacks. If this is not possible, it may be started when your inflammation is not too bad.

Allopurinol doesnt treat the immediate pain caused by attacks of gout. But its a long-term treatment to get rid of the urate crystals which causes gout attacks.

It is likely that you will need to take allopurinol for the rest of your life to manage your urate levels. You should keep taking allopurinol even if:

  • you are experiencing more gout attacks, or it doesnt seem to help the pain and inflammation at first
  • you stop having gout attacks stopping your treatment can cause urate crystals to form again, which will lead to more gout attacks.
  • etoricoxib

    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.

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    What Is The Prognosis Of Gout

    Gout is a chronic condition. Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. Joint damage and other complications of gout may occur. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis.

    Medications That Can Trigger Gout

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    Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.

    Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.

    Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:

    • chlorothiazide

    may have high levels of the hormone insulin. This can cause too much uric acid in the body, triggering gout symptoms in your joints.

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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.

    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.

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    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.
  • The Role Of Medication In Prevention Of Gout

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    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

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    Foods You Can Eat In Moderation

    Aside from organ meats, game meats and certain fish, most meats can be consumed in moderation. You should limit yourself to 46 ounces of these a few times per week .

    They contain a moderate amount of purines, which is considered to be 100200 mg per 100 grams. Thus, eating too much of them may trigger a gout attack.

    • Meats: These include chicken, beef, pork and lamb.
    • Other fish: Fresh or canned salmon generally contains lower levels of purines than most other fish.

    Summary: Foods you should eat with gout include all fruits and vegetables, whole grains, low-fat dairy products, eggs and most beverages. Limit your consumption of non-organ meats and fish like salmon to servings of 46 ounces a few times weekly.

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