Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
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.
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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Avoid Foods That May Trigger Gout
Purines are found in certain high-protein foods, such as certain types of seafood ,and red meat and organ meat . Avoid drinks that may trigger gout:
- Alcoholic beverages
- Sugary drinks
- Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger an attack.
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What Are Symptoms Of Gout
Symptoms of gout can come and go. When gout symptoms worsen it is called gout attack or flare, and remission is a period of no symptoms.
Symptoms of gout attacks include:
- Sudden episodes of severe joint pain
- Usually involves redness, swelling, heat, and tenderness of the joint
- Typically affects a single joint, but some people can develop several inflamed joints at the same time
- Common in the big toe, and also in lesser toe joints, ankle, and knee
- Tends to occur more often during the night and early morning than during the day, though can occur any time
- Pain and inflammation are at their worst within 12 to 24 hours and usually go away completely within a few days to several weeks, even if untreated
Flares are usually followed by periods of remission that can last weeks, months, or years where patients have no symptoms.
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Treating A Gout Attack
As is true for many painful conditions, the first-line treatment for a gout attack is taking one of the nonsteroidal anti-inflammatory drugs , such as diclofenac, ibuprofen, or indomethacin. For people who can’t take NSAIDs, a drug called colchicine is an alternative. It’s been used for centuries maybe even longer specifically for gout. The trouble with colchicine is its side effects, especially the copious diarrhea. If neither an NSAID nor colchicine is an option, then gout attacks can be treated with an oral corticosteroid, such as prednisone, or with corticosteroid injections into the joints.
Who Gets Gout Gout Risk Factors
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 Can A Gout Attack Be Prevented
Diet plays a key role diet in gout prevention: Since foods can directly set off gout attacks, patients with gout should receive counseling as to which foods are more likely to induce attacks. Losing weight is often also helpful. However, as important as diet is in gout, for most people with gout diet, and even weight loss, are not enough, and medications will be needed to get to their uric acid goal.
What To Do During An Attack
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.
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How Is Gout Treated
Treatment may be different for each person. However, the goals for treating gout are the same for each person and include:
- Reduce the pain from gout flares.
- Prevent future flares.
- Taking medications to manage the cause of your gout and treat active gout flares.
- Making changes to your diet and lifestyle.
Health care providers who may provide treatment for gout include:
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
- Dietitians, who can teach you about how to follow a healthy diet to improve your health.
- Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
- Pharmacists, who dispense medications and teach people about the medications, including the importance of taking them as prescribed.
- Primary care providers , such as internists, who specialize in the diagnosis and medical treatment of adults. Most people with gout are managed by their PCPs.
Related Conditions And Causes Of Gout
Other conditions that are sometimes confused with gout include:
- Reactive arthritis
- Infectious arthritis
- Psoriatic arthritis
- Rheumatoid arthritis , which occurs when the body releases too many inflammatory chemicals . Gout is caused by too much uric acid.
- Osteoarthritis , known as wear-and-tear arthritis.
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Am I At Risk Of Having Gout
Youre more likely to have a gout attack if you:
- are male
- have a family history of gout
- have elevated levels of uric acid in the blood
- drink too much alcohol
- eat a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
- are overweight or obese
- use diuretics
- have type 2 diabetes, high blood pressure or high cholesterol these conditions can mean that your kidneys are less able to flush out the urates
- have kidney disease
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.
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Using Tart Cherry Juice For Gout
Tart cherry juice may help decrease uric acid levels and inflammation in gout. Research is limited, with often small numbers of study participants and short-term follow-up.
Nevertheless, a 2019 review of six studies that looked at the effect of cherry juice or cherry extract intake on gout concluded that cherry intake was associated with a reduced risk of gout attacks. Researchers did note that larger, more long-term studies are needed to clarify this association.
When choosing tart cherry juice, be sure to look for unsweetened varieties to help reduce the amount of added sugar in your diet.
Natural Remedies For Gout
A.Vogels Stinging Nettle tincture, made from the anti-inflammatory and slightly diuretic plant, has been successful in resolving excess uric acid, when 25 drops are taken with a little water, three times a day.
For general intestinal and digestive health Molkosan and Bio-Strath can help balance the bodys pH, maintain healthy intestinal flora and help with the digestion of nutrients and elimination of toxins such as uric acid.
Once an attack of gout is under control, a detox treatment can be useful in boosting the ability of the kidneys and intestines to flush out the toxins. A treatment using A.Vogels Boldocynara or Milk Thistle products, which are rich in herbs with choleretic, cholagogue, diuretic and toning effects, is recommended at least twice a year.
Topical use of Absolüt Arnica Gel or a green clay poultice can also be very soothing.
Gout is probably one of the easiest forms of arthritis to manage through a healthy lifestyle. And anything that promotes digestive health and aids the body in efficiently eliminating toxins can do nothing but help prevent or heal gout and optimize ones overall health.
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What Is The Main Cause Of Gout
Gout is a common type of inflammatory arthritis that can cause intense bouts of joint painoften at nightand days or weeks of lingering discomfort. These periods of severe pain are referred to as flares. Gout typically affects the joint at the base of the big toe, but it may also impact smaller toe joints, the ankle or the knee. Other possible signs of gout include redness, swelling and warmth around the affected joint.
The main cause of gout is too much uric acid in the body, a condition known as hyperuricemia. Uric acid is produced by the body to help break down purines, naturally occurring chemical compounds found in many foods. There are also beverages that can trigger increased uric acid production, including alcohol and drinks sweetened with fructose. Too much uric acid causes the formation of uric acid crystals that can collect in tissues and joints.
What Are Complications Of Gout
Complications of gout include:
- Kidney stones, due to medications used to treat gout
- Tophi, which are clumps of uric acid crystals that can form under the skin on joints and cartilage
- Joint damage and deformity
- Psychological and emotional problems due to constant pain and inability to perform everyday activities
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Gout In Children And Teens
If a child or teenager has gout, it is important that blood and urine tests be done to determine why gout has occurred. It is usually a sign of an underlying problem that is often easily treated.
In children, the first test to do if gout is suspected is to measure the blood uric acid level. If this is elevated , this could be a sign that gout is present. Other important procedures are for a doctor to insert a needle into the affected joint, withdraw fluid, and examine this fluid for uric acid crystals.
Causes of gout in children and teenagers include:
- Inherited conditions that cause over-production of uric acid. These include HPRT deficiency and PRPP synthetase overactivity. These disorders are uncommon but are easily tested for. Patients produce extra uric acid and can have gout and kidney stones containing uric acid. These conditions usually occur in boys but can occasionally happen in girls as well.
- Kidney diseases resulting in decreased ability of the body to get rid of uric acid. These can include:
– The most common type is due to mutations in the gene that produces a protein called uromodulin. In this condition, patients develop gout in their teenage years and have slow worsening of kidney failure over time. There are usually many other family members who have had gout or kidney disease.
– Any type of kidney disease can also cause gout in childhood.
Keep Track Of Your Triggers
Gout triggers differ from person to person. Some people can eat a steak or drink an occasional beer with no problems. Others canât tolerate a bite or a sip without a flare. So you need to learn what yourtriggers are.
Keep a diary of what you eat for a while. That way, you can go back and see whether you can link flares with specific foods. Then youâll know what you really need to avoid.
Along with avoiding triggers, here are other things you can do to stay healthy and prevent flares:
- See your doctor regularly. You may need adjust your dose of gout medication over time.
- Always have medicine on hand for flares. The faster you take it, the sooner you can control the symptoms.
- Eat a heart-healthy diet full of vegetables, fruits, whole grains, low-fat dairy, and plant proteins . Cut down on processed foods .
- Get regular exercise.
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Gout Myths And Misconceptions And The Facts
Gout was once called the disease of kings, because of its propensity to affect overweight, rich men throughout history. Famous gout sufferers have included Alexander the Great, Charlemagne, Henry VIII of England, and Benjamin Franklin.
While gout is no longer thought to be a disease of the wealthy, it is more common in men and people with weight-related health problems including high blood pressure and type 2 diabetes.
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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Decreased Excretion Of Uric Acid
Two thirds of urate excretion occurs in the kidneys while the rest is excreted through the gastrointestinal tract . Reduced secretory function of the transporter ABCG2 leads to decreased excretion of uric acid through the GIT resulting in rise of serum levels of uric acid and enhanced renal excretion .
Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
Read more about the complications of gout.
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A Trigger Event Such As Injury Surgery Or Medical Therapy
Specific events can trigger a change in body chemistry and bring on a gout flare-up. Such events include, but are not limited to2,12:
- Infection
- Illness
- Sudden and dramatic weight loss
Interestingly, many people who experience an episode of gout may not ever have symptoms again, or at least not for several years. People who do experience gout symptoms repeatedly may notice that episodes get longer and more severe. Gout and its precursor, hyperuricemia, should be addressed to prevent future joint damage.
Epidemiology And Risk Factors
Gout is the most common cause of inflammatory arthritis in men over the age of 40, with a peak incidence in the fifth decade. The peak incidence for females occurs over the age of 60. It is difficult to determine incidence and prevalence rates of the disease, as the course of the disease is characterized by exacerbations and remissions, and there is also a tendency for misdiagnosis by both patients and clinicians. Estimated prevalence for self-reported gout in the general population is 0.71.4% in men and 0.50.6% in women. This is higher in adults over 65, with prevalence of 4.45.2% in men and 1.82.0% in women. Studies of gout over the past two decades suggest increasing incidence, especially in the elderly population.
It has been estimated that gout is the second most common form of inflammatory arthritis in the United States. It occurs worldwide, and regional differences may reflect racial predisposition, although this has not been proven. Gout frequently results in occupational limitations, increased use of medical services, and significant short-term disability, making the disease a significant public health problem.
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