Tuesday, September 27, 2022

What To Do For Gout

Got That Summertime Sadness Ahead Of Waitangi Weekend Why Summer Can Lead To An Increased Risk Of Gout

What is Gout? An Introduction to Gouty Arthritis (1 of 6)

Friday, 4 February 2022, 10:22 amPress Release: ProCare Health

It wouldnt be a summer in Aotearoa if we didnt havebarbeques, kai moana and the odd drink or two. However, thistasty combination can lead to an increased risk of goutwarns ProCare, a leading healthcare provider.

Gout isa form of arthritis where uric acid crystallises anddeposits in the joints. As a result, sufferers often havesevere attacks of pain, swelling, redness and/or tenderness.Although gout often affects the joint of the big toe, it canoccur in nearly any joint including the ankles, knees,elbows, wrists or fingers.

Allan Moffitt, ClinicalDirector at ProCare says: We usually see an uplift in thenumber of gout cases in summertime, because of our Kiwidiets in particular, meat and seafood. Red meat andshellfish have a higher amount of what are known as purinesin it. Purines are then broken down into uric acid, whichcan lead to an individuals gout flaring up.

Weall know that meat should be eaten in limited quantities buttend to forget this when were at the beach and barbequingevery day. This is especially true when it comes to seafoodconsumption, particularly cold-water fish and shellfish, asthey tend to be higher in purines, continuesMoffitt.

When you then add alcohol into the mix,which dehydrates and then impacts kidney functioning, itslittle wonder we see more patients reaching out in pain,he points out.

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.

How To Treat A Gout Flare

Different medications can be used to address gout, but when youre in the midst of a gout flare, the number-one goal is pain management. Because the pain is so severe, its really important to try to bring it under control quickly, says Dr. Saag.

Even though gout is caused by uric acid buildup, now is not the time to start a drug thats specifically designed to lower uric acid levels.

Instead, your doctor will likely prescribe a higher dose of a non-steroidal anti-inflammatory drug , such as naproxen, or a steroid medication like prednisone. Your doctor might also inject a steroid directly into the affected joint, or, if the pain is bad enough, start you on an intravenous version of it, says Dr. Saag.

Colchicin is another medication that is sometimes used to manage gout flares. This drug is not a traditional pain reliever, since it doesnt seem to relieve pain caused by other conditions. According to a Cochrane Review, about 40 out of 100 people who use colchine during a gout attack rated their pain 50 percent lower than those who took a placebo, but theres also a high risk of side effects like vomiting, nausea, and diarrhea, especially when taken at high doses.

If youve had gout flares before and are now seeing a new provider or are being treated in the emergency room, be sure to tell the doctor about the treatments youve previously tried during an acute episode and how well they worked for you.

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Managing A Gout Flare

Gout flares are unexpected and painful heres how to get a handle on them.

Few things in life are more painful than a gout flare, so if youre awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, youll want to act fast. Heres what you can do when a gout flare starts to ease the pain and reduce the risk of others.

Take Medicine You Have on Hand. Start treatment immediately with over-the-counter ibuprofen or naproxen , but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of flares, continue to take that drug.

Ice Down. Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.

Let your doctor know what is going on right away. She may prescribe a new medication, or have you come to the office for a joint fluid test or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of a flare can lessen its length and severity.

Get a Cane. Walking with a cane during an acute gou flare can help keep pressure off your painful joint.

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When Is Surgery Considered For Gout

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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.

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Drink Plenty Of Water

This wont likely provide immediate relief, but inadequate hydration is known to contribute towards the creation of urate crystals.

Drinking water may flush uric acid crystals out of your system.

Preliminary research suggests that adequate water consumption during the 24-hour period before a gout flare can decrease recurrent gout attacks.

The Pathology Of Gout

Gout is primarily a metabolic disorder in which uric acid accumulates in blood and tissues. When tissue levels reach saturation, needle-like crystals form, causing inflammation. This occurs most commonly in the cooler joints, notably the metatarsophalangeal joint of the big toe.

Many people with hyperuricemia never develop gout, but those with the highest levels are most likely to suffer episodes. Hyperuricemia may also lead to kidney stones.

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Symptoms And Signs Of Gout In Foot

An attack of gout is often sudden. Symptoms:

  • It may present with excruciatingly painful swelling of joints in the big toe, it is known as Podagra. The joint may be stiff and appear red or purple, very swollen, and tender to even light touch. Other gout sites include the instep, wrist, ankle, fingers, and knee.
  • Skin may peel and itch as healing begins.
  • An attack often begins at night the acute phase lasts up to 12 hours. If untreated, the inflammation may last up to two weeks. In 10 percent of people, acute episodes present in more than one joint.
  • Kidney stones precede the onset of gout in 14 percent of patients.
  • Chronic gout may develop, and it may affect more than one joint, mimicking rheumatoid arthritis.
  • Tophi are soft tissue swellings caused by urate buildup in chronic gout. They may be found in the ear, fingers, toes, kneecap, and elbow.

Some people have a single attack of gout, others are affected intermittently, often when they have overindulged or experienced dehydration.

COMPLICATIONS OF GOUT IN FOOT

Its rare for complications of gout to develop, but they do happen and can include severe degenerative arthritis, secondary infections, kidney stones and kidney damage, nerve or spinal cord impingement, and joint fractures.

How Is Gout Diagnosed

What Is Gout and How Do You Treat It? [Dr. Claudia]

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.

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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.

Treating Gout At Home

This section on how to relieve gout pain is a very useful reference for those nights when you wake

up in agony. When you have a gout attack, you need to get the uric acid out of your system and treat

the pain.

  • Relax and keep your body calm.

  • Take proper medication.

  • For some people an over the counter anti inflammatory such as ibuprofen may be helpful but read the package insert carefully or discuss with the pharmacist.

  • Ice the affected area and elevate the joint.

  • If the pain is severe and doesnt diminish, its recommended to seek medical advice.

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    Natural Remedies For Gout

    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.

    Now here are my top six all-natural gout remedies to get rid of gout for good. If you follow these tips, you can get rid of gout in 24 hours or less. Yes, that fast, you can get rid of gout pain for good.

    1. Celery Seed Extract

    Step No. 1 is to consume celery seed extract and celery juice. Celery seed extract actually has been shown to decrease uric acid buildup in the body.

    Researchers have identified over a dozen different types of antioxidants that are responsible for the benefits of celery these include such phenolic acids as caffeic acid and ferulic acid, plus flavaols like quecetin. This makes celery useful for treating a wide range of conditions that are made worse by inflammation: joint pain , gout, kidney and liver infections, skin disorders, irritable bowel syndrome, and urinary tract infections, just to name a few.

    You can buy the supplement or celery seed extract. You can also use a vegetable juicer to produce celery juice or just eat celery throughout the day all of which are great for getting rid of gout.

    2. Black Cherry Juice

    3. Nettles

    4. Fish Oil

    5. Proteolytic Enzymes

    6. Magnesium

    Genes And Family History

    How to relieve gout pain

    Research over the past decade has increasingly identified a link between a genetic predisposition and high uric acid levels. For example, in a 2012 study, researchers looking at a large number of peoples unique genomes found that patients with gout often shared a similar variation on a gene that affects kidney function. A 2018 study further identified several genes that influence how the body gets rid of uric acid.

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    What Is The Difference Between Rheumatoid Arthritis And Gout

    The main difference between these two conditions lies in their cause. In fact, uric acid crystals do not cause any rheumatoid arthritis symptoms.

    Rheumatoid arthritis is a chronic inflammation of several joints , whereas gout generally only affects one joint .

    Gout and rheumatoid arthritis are also treated in two completely different ways, so these conditions should not be compared.

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    What Are The Signs And Symptoms Of Gout

    Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

    Symptoms in the affected joint may include:

    • Pain, usually intense

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    Immediate Gout Pain Relief: What Are Your Options

    Generally, you can take simple steps to get the pain and swelling under control. Examples include ice, compression of the joint, and rest from sport. Also, you need to keep well hydrated and avoid alcohol.

    Medications from your doctor can help. Anti-inflammatory tablets such as ibuprofen can stop an acute attack if taken early. Similarly, a drug called colchicine can stop gout in its tracks if taken in the first 24 hours. Often, the dose of colchicine is one tablet three times a day decreasing to twice a day after a week as the pain settles.

    Practice Mindfulness And Meditation

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    The good news: A gout attack is self-limited and will clear in time. In the meantime, according to the Arthritis Foundation, meditation, yoga breathing, mindfulness, and guided imagery can help you deal with the pain.

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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.

    Is A Cortisone Shot For Gout An Option For Immediate Gout Pain Relief

    Cortisone is a powerful anti-inflammatory steroid drug that works almost immediately to stop acute gout. Cortisone can be taken by mouth, but side effects are common. In some cases, a cortisone injection into an inflamed joint is very effective. For example, injection for big toe or foot gout can be effective if severe. It is important to use ultrasound to guide a needle into the joint to improve accuracy and effect.

    Generally, a cortisone shot for gout such as foot gout often takes a few days to start working. If given early in an acute attack, it can stop it in its tracks.

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    What Foods Cause Gout In Knee

    • Some fish, seafood and shellfish, including anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock.
    • Some meats, such as bacon, turkey, veal, venison and organ meats like liver.

    Just so, what are the symptoms of gout in your knee?

    intense painjointjointsankleselbowsfingersAttacksunexpectedpainful

    How do you treat gout in the knee?

    Here√Ęs what you can do when a gout attack starts to ease the pain of the attack and reduce the risk of others.

  • Take medicine you have on hand.
  • Ice down.
  • Elevate your foot, if affected.
  • Tame your sheets.
  • What causes gout in the knee?

    GoutgoutGout

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    Epsom Salt Baths And Ice

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    Epsom salts are very alkaline, and will penetrate the skin to get inside the body helping to dissolve the uric acid crystals. Soak the affected joint for 20 minutes in an Epsom Salt bath that is warm, not hot.

    After the bath, apply an ice pack for 20 minutes. The ice should be wrapped in a towel so that it is not in direct contact with your skin. The ice will help reduce the inflammation that is causing the swelling.

    The alternation between hot and cold will increase the blood flow to the area, helping to move the blood and lymph in and out of the joint which will help end the attack.

    . . .

    Bert,Casey here to thank you again for making me aware of the traps waiting to snag us in the food marketing world. If you havent seen theses documentaries already you may find that they support your cause !!! Its relieving for me to know there are some good people out there putting up one hell of a battle against industrialized food. There has to be a change. An analogy mentioned in the Food Inc film mentioned how the tobacco industry was brought down, now its time for the industrialized food organizations to be brought to justice.

    Thanks Bert you are the man.

    . . .

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