What Is The Difference Between Gout And Cellulitis
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How To Manage Gout Reduce Diabetes Risk And Improve Your Health
Fortunately, there are many things you can do yourself to get your gout under control. And many of the same things that help you to treat and manage gout will also help you to become healthier and prevent future health problems like diabetes as well.
For example, being overweight is one of the major risk factors for gout, and it is also one of the major risk factors for diabetes. If you can get your weight under control, you just might be able to manage your gout and reduce your diabetes risk at the same time.
Here are some of the most important steps to take to manage gout and keep yourself healthy:
1.Eat a healthy diet. As part of your healthy diet, avoid foods high in purines like red meat, organ meats, and some types of seafood . And stay away from sugary foods and beverages, as these can also trigger gout.
2.Lose weight. Being overweight or obese increases your chances of having gout and other health concerns like diabetes, so focus on lifestyle and diet to work towards a healthy weight.
3.Limit alcohol. The more alcohol you drink, the more likely you are to have gout. Beer and hard liquor are especially important to avoid if you have gout.
4.Get active. Choose low-impact activities that are easy on your joints. The more active you can be, the better. This can help keep your risk for other chronic diseases like diabetes and heart disease low.
Effects On Other Treatments
Some drugs interact with allopurinol, so you should discuss any new medication with your doctor before starting it. You should also tell anyone else treating you that youre taking allopurinol.
Do not use complementary treatments, such as herbal remedies, without discussing this first with your doctor or pharmacist. Some of them could react with allopurinol.
You should avoid taking aspirin while youre being treated for gout. If youre in pain, you can take paracetamol and NSAIDs. But remember you should only take one NSAID at a time so do not take another if you have already been prescribed one to reduce the effects of gout attacks.
Allopurinol can also react with drugs that are often prescribed for high blood pressure, such as bendroflumethiazide, indapamide, lisinopril, ramipril.
It can also reduce the breakdown of the leukaemia drug mercaptopurine, so the dose of mercaptopurine will need to be reduced if you take this drug.
Allopurinol may also increase the risk of developing a rash if you take them with the antibiotics ampicillin or amoxicillin.
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Some Signs Of Gout Like Pain In The Big Toe May Be Obvious But Other Gout Symptoms Can Be More Subtle
Once upon a time, gout was known as the disease of kings because it was thought to be more common among wealthy, overweight men who could afford to over-indulge in rich foods and alcohol. While diet and obesity remain important gout risk factors, your social class or bank account is no longer relevant to your risk of developing gout, which is on the rise. Incidence of gout more than doubled between the 1960s and 1990s today nearly 4 percent of U.S. adults have it.
Gout is a form of arthritis that causes severe, sudden attacks of inflammation. Gout happens when there is too much of a chemical called urate in your blood . This causes uric acid crystals to build up in your joints, causing the telltale gout pain. Your body produces uric acid when it breaks down purines, substances that are naturally found in your body as well as in certain foods. While diet itself does not cause gout, certain foods and drinks may trigger gout flares. People who develop gout likely have some genetic predisposition combined with other risk factors or conditions such as kidney disease or diabetes that cause uric acid to build up in the body.
Gout is highly treatable, but in order to address it you have to know that you have it and the symptoms of gout arent always obvious.
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Who Should Diagnose And Treat Gout
The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.
What Happens At Your Appointment
The GP may ask about your diet and if you drink alcohol.
They may refer you to see a specialist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.
The blood test will find out how much of a chemical called uric acid there is in your blood.
Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.
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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 .
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
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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:
What Is The Fastest Way To Get Rid Of Gout
- Nonsteroidal anti-inflammatory drugs : These can quickly relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack. Corticosteroids usually start working within 24 hours after they are taken.
- Colchicine: An anti-inflammatory medicine that works best if taken within the first 24 hours of a gout attack.
Medications for reducing uric acid levels: These are usually prescribed after an acute attack ends to reduce uric acid levels in the body to prevent future attacks.
- Colchicine: Regular and low doses of colchicine may be given along with other medications below to prevent flare-ups.
- Allopurinol: It reduces uric acid production in the body.
- : It reduces uric acid production in the body.
- Probenecid: It acts on the kidneys to help eliminate uric acid.
- Pegloticase: This is a medication that is injected every 2 weeks. It reduces uric acid quickly and used when other medications fail.
Lifestyle and home remedies to treat acute gout and can prevent recurrent attacks:
- Limiting or avoiding alcohol consumption and drinks sweetened with fructose
- Limiting intake of foods high in purines, such as red meat, organ meats, and seafood
- Drinking plenty of fluids
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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.
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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When Is Surgery Considered For Gout
The question of surgery for gout most commonly comes up when a patient has a large clump of urate crystals , which is causing problems. This may be if the tophus is on the bottom of the foot, and the person has difficulty walking on it, or on the side of the foot making it hard to wear shoes. An especially difficult problem is when the urate crystals inside the tophus break out to the skin surface. This then can allow bacteria a point of entry, which can lead to infection, which could even track back to the bone. Whenever possible, however, we try to avoid surgery to remove tophi. The problem is that the crystals are often extensive, and track back to the bone, so there is not a good healing surface once the tophus is removed. In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered.
Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase , since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus.
What Does The Future Hold For Gout
Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.
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What To Do During An Attack
- 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.
Arthritis / Acute Gout Attack
Gout is a form of arthritis, hence it causes pain and discomfort in the joints. A typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint. The clinical presentation of acute gouty arthritis is not subtle with very few mimics other than a bacterial infection.
The joint most commonly involved in gout is the first metatarsophalangeal joint , and is called podagra. Any joint may be involved in a gout attack with the most frequent sites being in the feet, ankles, knees, and elbows.
An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack takes approximately 7-14 days.
An accurate and colorful discription of a gout attack was elegantly written in 1683 by Dr. Thomas Sydenham who was himself a sufferer of gout:
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