Monday, September 26, 2022

What Causes Gout And How To Treat It

How To Prevent Gout

How to Treat Gout Flares during the COVID-19 Crisis

Some things that increase the risk of gout are out of your control your age, gender and family history for example.

However, your body weight and diet are also important factors.

The rise in gout in recent years is linked to our widening waistlines.

Being overweight, eating fatty foods and consuming too much alcohol are established triggers of flares of gout.

And although losing weight and avoiding certain foods may not be the magic answer to how to get rid of gout, it may help to reduce the likelihood of a future attack.

Key Points About Gout

  • 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.

Avoid Consuming Large Amounts Of Food High In Purines

Purines are chemical compounds found in some foods and drinks.

Gout sufferers find the chemical harder to metabolise, so avoiding consuming large amounts of high purine foods is advisable.

Beef, lamb, game, offal, and some seafoods such as mackerel, mussels, anchovies, sardines, crab and herring are all examples.

High-fat dairy products, yeast, beer and gravy are also sources.3,4

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Franklin Jefferson And The Comte De Vergennes: Pivotal Figures During The American Revolution Whose Relationships Were Crystallized By Their Gout Affliction

Gout played a role in the outcome, as well as the origins, of the American Revolution, the signing of the Declaration of Independence, and the ratification of the Constitution. Benjamin Franklin the only person to have signed all three founding documents of the USA suffered from severe gout, as did Thomas Jefferson and the Comte de Vergennes, a French nobleman who was instrumental in obtaining the money to finance the Revolution. Reportedly, Franklin was so severely afflicted by gout that he was carried by convicts in a sedan chair to the Constitutional Convention. Some have speculated that these pivotal figures in American history had such strong connections because they were all sufferers of gout.

Cherry Juice To Help Manage Gout

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Many people with gout or experiencing a gout attack drink cherry juice or consume cherries. The use of cherry juice for gout has been around since the 1950s, based on a study of 12 patients with gout. Since that time, several studies in animals have pointed to a role for cherries and cherry products in lowering uric acid levels. More recent studies showed that people with gout who consumed cherry juice concentrate experienced fewer flares, but there was no effect on uric acid levels. Overall, evidence supporting cherries for gout is weak. Larger, more controlled studies are necessary to confirm the absolute effectiveness of cherries and cherry compounds with gout, and the correct therapeutic dose.

The American College of Rheumatology advises against consuming cherry juice or extract for a gout attack. If you are interested in non-medication therapy, talk with your doctor about eating cherries, drinking cherry juice concentrate, or taking cherry-containing supplements. Daily cherry juice concentrate may be appropriate as an add-on therapy for people who are also on urate-lowering therapy to prevent gout attacks.

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What Causes Gout In The Knee

Gout develops when the body has high levels of uric acid, a normal waste product. This is known as hyperuricemia.

Uric acid is normally excreted through the body via the kidneys, but in some people, levels can remain high and uric acid can start to accumulate and crystallize in various joints. When these uric acid crystals affect the joint in the knee, it can cause gout symptoms in the knee, making the knee joint red, swollen, and hot to the touch. The buildup of uric acid can also impair the knee joints full range of motion, which can make it difficult to walk.

A number of factors can influence your risk for gout.

Who Is Most Likely To Get Gout Tophi

Someone who has been diagnosed with gout but rarely has a flare up perhaps you have an attack once or twice a year will be less likely to develop tophi.

Youre most apt to get these nodules if you have frequent, severe attacks. Frequent episodes of gout are an indication that your uric acid levels are consistently too high. That can happen to anyone with gout, but its more likely if you dont follow your doctors instructions and dont take your prescribed medication to keep uric acid levels in check.

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Intense Pain And Swelling

Gout symptoms cause pain that is so severe that some people cant even tolerate a bedsheet touching their affected joint. Research shows some people believe the intense pain is worse than a severe burn, kidney stones, breaking a bone, being hit by a car or childbirth. If untreated, the length of each gout attack gets longer and the severity of each flare gets worse.

Treating A Gout Attack

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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

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What Is Uric Acid

Uric acid is a waste byproduct of purine breakdown in the body. Purines are naturally produced in the body, as well as found in some foods. As purines are broken down, uric acid is created. Normally uric acid is either reabsorbed in the body or excreted via the urine and feces.

When there are more purines in the body than it can process, uric acid builds up in the bloodstream. This is called hyperuricemia. Hyperuricemia can cause gout and/or kidney stones in some people, while others have no signs or symptoms at all.

Verywell / Alexandra Gordon

Treatment for gout often includes medications, diet modification, and lifestyle changes, such as managing weight and quitting smoking. The foods you eat can have a direct impact on gout flares.

During a gout attack, modifying your diet may help decrease the length of the flare. Continuing to follow a gout-friendly diet, specifically a low-purine diet, may help prevent the risk of future gout attacks up to five fold.

Dietary Changes To Improve Gout Symptoms

As gout is associated with diet, here are my top foods to avoid or minimize:

Foods to avoid or minimize:

  • Purine-rich foods including: beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, yeast, spinach, asparagus, beans, lentils, mushrooms and dried peas. 00099-2/fulltext” rel=”nofollow”> 18)
  • Oxalate-rich foods including: spinach, rhubarb, beets, nuts, chocolate, black tea, wheat bran, strawberries and beans.
  • Common allergens including dairy, wheat , corn, and food additives.
  • Refined foods including white breads, pastas and sugars.

Foods to eat and enjoy:

  • High fiber foods including: barley, bran, rye, brown rice, avocados, potatoes and bananas.
  • Vitamin C-rich foods including: oranges, red and green bell peppers, broccoli, strawberries, guava, kiwi and Brussels sprouts.
  • Magnesium-rich foodsincluding: pumpkin seeds, yogurt or kefir, almonds, avocados, figs, artichokes, cashews and wild-caught salmon.
  • Cherries and unsweetened cherry juice. Try my recipe for cherry limeade.
  • Omega-3 rich foodslike wild-caught salmon and tuna, walnuts, flaxseed, chia seeds, natto and grass-fed dairy.

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Gout Frequently Flares In Your Knee But You May Not Always Know That Your Knee Pain Is Due To Gout Heres How To Tell Since Prompt Treatment Can Reduce Your Risk Of Complications

Knee pain can be a common symptom of several types of arthritis, as well as many other conditions or injuries. If your knee stiffness is accompanied by a burning pain and is warm to touch, you may have a gout flare in the knee.

Though gout is most often associated with the big toe, gout tends to flare in areas that already have arthritis, says Robert Keenan, MD, a rheumatologist with Articularis Healthcare in Summerville, South Carolina. Although gout can strike in many different joints, as a general rule, gout works its way up the body. If its not treated, it works its way up from the big toe, through the ankle, to the knee, and then to the lower spine and so on.

Gout can affect both knees, but typically is felt more strongly in one knee say, where you may have arthritis wear-and-tear to begin with.

Learn more about what causes gout in the knee, as well as ways to treat the pain and prevent it in the future.

How Does A Doctor Diagnose Gout

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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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William Pitt: Gout Taxes And The American Colonies

The disabling gouty arthritis of the British statesman William Pitt the Elder was a major factor in Britain’s loss of the American colonies. It was during one of Pitt’s gout-related absences from Parliament that the Stamp Act was passed, which forced the unwilling colonists to pay a tax, determined by the British Parliament, to defray the costs of defending the colonies against French attack. Upon recovering from his gout, Pitt succeeded in getting the Act repealed with the famous words, “The Americans are the sons, not the bastards, of England. As subjects, they are entitled to the right of common representation and cannot be bound to pay taxes without their consent.” Unfortunately, during another of Pitt’s absences due to an episode of gout, Lord Townshend persuaded Parliament to levy a heavy duty on colonial imports of tea to raise the necessary revenues. This precipitated the Boston Tea Party in 1773, and the rest is history!

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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

If you want to learn more natural remedies and natural cures, subscribe to my YouTube channel.

How Do Health Care Providers Diagnose Gout

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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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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.

Radiographs

Southern Cross Medical Library

The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.

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Do Gout Medications Have Any Side Effects

  • Gout medications are well tolerated by most people. However, like other medications, they have potential side effects.
  • Allopurinol is well tolerated by most people, but in some people, it can cause an allergicrash. Very severe rashes rarely can occur after taking allopurinol, and any allergic type rashes that develop while a patient is taking allopurinol are taken seriously.
  • Colchicine can cause signs and symptoms such as nausea, diarrhea, and rarely muscle weakness and abnormal blood counts.
  • Probenecid is generally well tolerated but should not be used in patients who have uric acid kidney stones, as it can worsen the kidney stones and potentially harm the kidneys in these patients.

What Are Risk Factors For Gout

How to Treat Gout Naturally and Prevent Gout Attacks

There are many risk factors for gout. Having high blood pressure is a risk factor for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics , which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol , can also initially cause a flare of gout. This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.

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