Sunday, August 14, 2022

What Causes Gout In Your Foot

First Foods That Can Help

How to Recognize Gout Symptoms | Foot Care
  • There are actually several types of foods that may help protect against gout attacks. These include low-fat dairy foods, complex carbohydrates, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
  • You don’t necessarily have to drink only wateryou can choose non-sweetened juice, tea, and coffee too.
  • Any kind of fluid that keeps that blood flowing and urine flowing is a good choice, says Lona Sandon, PhD, RDN, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.

Next up: The foods to avoid. Read on for a list of potentially problematic eats.

Scallops are okay for an occasional indulgence, but you should cut back on themand all types of meat and seafoodduring a flare-up, says Sandon. These animal foods are rich in purines, which your body breaks down into uric acid.

You have a little more freedom in your food choices when your gout is at bay, but its still a good idea to keep meat and seafood intake to a minimum4 to 6 ounces daily at most.

All meat is not created equal when it comes to purine content: White meat is generally better than red.

But it is okay to eat some types of red meat once in a while. Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin.

And lamb chops are a better choice than leg meat.

Organ meats, such as liver, kidneys, and sweetbreads, are a major no-no.

How Gout Treatment Prevents Disease Progression

Fortunately, in part because of its long history, gout is one of the most well-understood and most medically treatable forms of arthritis. The progression of gout is preventable by starting appropriate treatment as soon as possible, Dr. Meysami says. Uric acid-lowering agents, such as allopurinol , can decrease uric acid levels and prevent gout attacks.

During flares, gout patients can take NSAIDs or corticosteroids to calm the attack. Local steroid injections may also be given. A medication called colchicine is also often used to stop acute attacks, but its given now at a much lower dose in order to avoid side effects, including stomach upset.

After a flare ends, long-term treatment can begin. Almost all people with gout will need medication to control their urate, Dr. Fields says. To get a good outcome, people with gout need to get their blood urate level below 6.0 mg/dl and keep it there. By doing that, the body will gradually pull the urate crystals out of their joints, and the flares can stop. Tophi will also gradually disappear.

Medications called xanthine oxidase inhibitors limit the amount of uric acid your body produces. These include allopurinol and febuxostat . Colchicine, which decreases the inflammatory response to gout, may also be given along with allopurinol at the start of long-term treatment after a flare subsides.

Medications For Gout Attacks

To treat gout attacks and to prevent future ones, you doctor may recommend these medications:

Nonsteroidal anti-inflammatory drugs

Initially, your doctor might suggest over-the-counter NSAIDs, such as naproxen sodium or ibuprofen .

If these OTC medications arent enough, your doctor might prescribe more powerful NSAIDs such as celecoxib or indomethacin .

Colchicine

Colchicine is a medication that your doctor may prescribe based on its proven effectiveness in reducing heel gout pain.

Side effects of taking colchicine, especially in large doses, can include diarrhea, nausea, and vomiting.

Corticosteroids

If NSAIDs or colchicine arent appropriate for you, your doctor might recommend corticosteroid medications, either in pill form or via injection, to control inflammation and pain.

An example of this type of medication is prednisone.

Read Also: Are Almonds Good For Gout

Is There A Test For Gout

There is no one test for gout, and its symptoms are similar to several different conditions. To see if you have gout, your health care provider may:

  • Ask you to provide your medical history, including:
  • Your symptoms.
  • Any other medical problems you have.
  • Any medications you are taking.
  • Examine the affected joints.
  • Order laboratory tests, take a sample of fluid from one of your painful joints, or order imaging tests.
  • What Increases Your Chances Of Gout

    images of gout

    Risk factors that may contribute to developing gout include:

    • Body weight: Being overweight or obese can lead to higher uric acid levels in the blood, which increases your risk of developing gout.
    • Alcohol consumption. Drinking excessive amounts of alcohol increases the production of uric acid by the liver, which can lead to high levels in the blood one of the main risk factors for developing gout attacks
    • High-purine diet High-purine foods include organ meats , seafood , and yeast extract . Purines are broken down into uric acid during digestion, so eating a high-purine diet increases blood levels of uric acid and raises your risk for developing gout.
    • Diabetes mellitus . In fact, people with DM who also have high levels of uric acid in their blood are at an even higher risk for gout than other people with high levels of uric acid in their blood but without diabetes mellitus .
    • Certain medications, such as diuretics

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    Causes Of Gout In The Foot

    Gout is primarily caused by too much uric acid present in the blood, or medically known as hyperuricemia. The exact cause of the accumulation of too much uric acid in the system is still unknown, however, there are theories formulated by researchers as to why a person suffers gout:

    A person gets gout through the genes of ones parents. The parents may have a defective metabolism of the uric acid which causes its buildup in the system.

    An individual may be suffering from damaged or impaired kidneys that would result to abnormal elimination of the uric acid.

    Taking in medications or drugs that cause excessive production of uric acid may also be the culprit. Such medicines would include diuretic medications like thiazides. These kinds of drugs are usually administered to treat high blood pressure.

    Abnormalities of the blood cells in the system. A classic example of this when a person has cancer.

    There are also factors that could worsen the inflammation or the symptoms of gout in foot, such as too much intake of alcohol, obesity, sudden surgery, an injury or trauma to the joints, and chemotherapy.

    These are the common causes of gout, and because of these, symptoms of gout in the foot such as tingling, pain, tenderness, swelling and redness would develop.

    Plantar Fasciitis Vs Gout In Heel

    It is really confusing to diagnose the problem, as both the conditions cause heel pain. Plantar fasciitis is one of the most common disorders of the heel. But, gout may also affect your heel and result in swelling and pain.

    What symptoms indicate that it is plantar fasciitis in your heel?

    • Heel pain becomes highly intense in the morning.
    • When you do low-impact workouts and stretching, it can trigger pain.
    • Dull and sharp pain with swelling and redness.
    • You are gaining weight.

    Suggested article: Plantar Fasciitis Vs Gout How These Two Are Related?

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    Why Do I Get Gout Attacks

    Gout occurs when theres too much uric acid in your blood . The resulting crystals of uric acid build up inside and around joints like your big toe or fingers. These crystals cause an inflammatory reaction that leads to sudden attacks of intense pain and swelling called acute gout flares as well as long-term problems such as joint destruction .

    Treating Gout With Medications

    Pain and Swelling in Your Feet? Could Be a Gout Attack

    Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs , colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints , the kidneys , and in tissue , helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid.

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    Gout Attack Vs Chronic Gout

    It is possible to have a gout flare-up and never experience another. Repeated instances of acute gout are called chronic gout17.

    The treatment goals for a gout attack are different than those for chronic gout. When treating a gout attack, the goal is to relieve pain and inflammation. When treating chronic gout, the goal is to prevent future gout attacks and long-term joint damage.

    While some people with chronic gout may get frequent gout attacks, others may have years in between attacks. If chronic gout is not treated, attacks may become more frequent and/or last longer.

    Left untreated, a gout attack will usually resolve itself within a few days or weeks. Chronic gout can permanently damage a joints tissues and decrease its range of motion. For this reason, it is important to recognize symptoms, understand risk factors, get an accurate diagnosis, and treat and prevent gout.

    Does Eating Seafood Cause Gout

    Eating seafood may not directly cause an attack of gout, but it can increase your risk of developing an attack if you have one or more of the genes that predispose people to develop this condition. Seafood contains purines which are broken down into uric acid in our bodies and this contributes to the formation of uric acid crystals in our joints which causes inflammation and pain during an attack.

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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

    Where Does A Gout Attack Occur

    gout symptoms foot picture

    Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.

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    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.
  • How Is Gout Treated

    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.

    Read Also: Side Effects Of Allopurinol And Alcohol

    How Uric Acid Crystals Form

    Infographic

    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.

    The Wound Closed Anyway

    Gout In The Foot

    After all the pain that you felt, you will be relieved when the wound finally closes. Unluckily, however, this isnt the end of the risks that you are going to take. Its true that the bacteria will no longer have the capacity to attack from the outside. Tactlessly, the bacteria, which are thriving and breeding inside, may cause various conditions like septic arthritis. This may cause gout like condition and pain as the normally sterile joint cavity becomes fouled. Moreover, this may also cause bone spur. The nerves may grow back to the undesired and wrong places thus causing more agony.

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    Which Foods Cause Gout

    Foods high in purines from animal and seafood sources are thought to be a key element of increasing uric acid precursors. Interestingly, purines can also be found in high concentrations in vegetables such as beans and mushrooms, but these have not been found to be related to the risk of hyperuricemia.

    New evidence over the last decade has shown that some of the foods that were previously thought to be associated with gout, like meat, may not have such a strong relationship as originally thought. Overall, your gout risk may be raised by consuming large quantities of:

    • Some seafoods, like shellfish, shrimp, tuna, mussels, lobster, sardines and salmon
    • Red meats like bacon, liver, beef, pork, turkey, veal and lamb
    • High-fructose corn syrup, which is often found in processed foods including biscuits, syrups, chutneys and sauces, though the evidence is mixed on this one with only one American study finding a relationship between high consumption and gout

    Before you decide to cut out food groups from the list above, according to Arthritis Australia, there is little evidence that avoiding these purine-rich foods can significantly reduce gout attacks and by cutting them out, you may miss out on important vitamins and minerals, particularly when it comes to meats and seafood. We recommend making these decisions together with your GP, dietitian or nutritionist.

    How Is Gout Diagnosed

    Your health care provider will get your complete medical history and do a physical exam. She may run these exams and tests to diagnose gout:

    • Ajoint fluid analysis to see if uric acid crystals are present. This is the only certain way to diagnose gout.
    • Tests to measure uric acid levels in blood and urine

    There are many conditions with symptoms similar to gout. Be sure to see your doctor for a diagnosis.

    Also Check: Are Almonds High In Purines

    How To Prevent The Risk Of Gout

    • Cut back on protein.
    • Eat less salt and processed foods.
    • Avoid tobacco products, alcohol, and caffeine.
    • Reduce stress by getting enough sleep, exercising, and relaxing with friends or family members after work .
    • Drink plenty of water every day to keep your kidneys working efficiently and lower uric acid levels .
    • Get regular physical activity in your everyday life .

    Medications For Acute Gout

    Gout: Symptoms, Pictures, Treatment, and More
  • 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.
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