Gout: A Complete Guide For 2020
What Is Gout?
Gout is one of the most painful types of arthritis caused by the formation of crystals in and around the joints. It is more widespread among men, and the risk increases as they get older.
Gout is caused by a buildup of uric acid in the blood. This uric acid accumulates and causes joint discomfort, pain, and inflammation.
What Are The Symptoms Of Gout?
Some of the most common gout symptoms are as follows:
- The affected joints become warm, red, tender, and swollen.
- With the progress of the disease, you may not be able to have a smooth joint movement. You’ll have a limited range of motion.
- Gout generally affects the large bone of the big toe, although any of the joints (such as elbows, wrists, ankles, knees, wrist, and fingers) can get affected. The pain is intense during the first 4-12 hours after the commencement.
- You may experience a lingering discomfort for a couple of days to a couple of months.
What Causes Gout?
When your blood has an excessive level of uric acid, gout is caused due to the accumulation of urate crystals. It can bring about intense pain and inflammation of a gout attack.
Uric acid is naturally formed during the break-down of purines found in human cells and certain food items. Uric acid is circulated through the blood and eradicated in the urine.
When a person’s body produces high levels of uric acid or when the body becomes unable to process it efficiently, a person is at higher risk for developing gout.
What Are The Risk Factors For Gout?
You can suffer from gout if your body has excessive levels of uric acid in it. Following factors can ameliorate uric levels in your body:
- Obesity: The body of overweight people usually produces higher levels of uric acid. Also, kidneys face difficulty in eradicating uric acid from the body.
- Family History: If you’ve some members in your family with gout, you can also develop the condition.
- Diet: The best gout diet abstain from taking sugary beverages, added sugar, fish, and other seafood, yeasts, and all organ meats.
- Medical Conditions: Some medical conditions like high blood pressure and other chronic diseases (such as diabetes, heart and kidney-related disorders, metabolic syndrome, etc.) elevates the risk for gout.
- Certain Medications: A low-dose aspirin and the drugs used to treat high blood pressure can increase uric acid in your body. People who have recently had an organ transplant and have taken anti-rejection drugs are also at severe risk for gout.
- Age And Sex: Women generally have lower acidic levels, and so are at low risk for the disease. However, after menopause, uric acid levels in women become comparable to that of men. That’s the reason women usually develop the signs of gout after menopause. Surveys suggest that men typically get affected with the condition between 30 and 50 years of age.
- Recent Surgery Or Trauma: If you have recently had trauma or have undergone a surgery, you can soon have a gout attack.
What Triggers A Gout Attack?
Certain things can make you more prone to have a gout attack. If you are aware of your condition of gout, try to avoid the following factors.
- Excessive intake of alcohol
- Having an unusually large and fatty meal
- An ailment that causes fever
- A joint injury
- Having an operation
- Not taking the prescribed treatment properly
How Is Gout Diagnosed?
The diagnosis becomes simple when you have typical symptoms of gout attacks like swelling, inflamed gout attack.
In some cases, it becomes quite challenging to detect gout. The doctor enquires about the signs and symptoms a person is experiencing and can also order some tests to confirm the diagnosis.
Following tests can be helpful in the diagnosis for gout:
- Blood Test: Blood test determines the urate levels in the blood, which may indicate that you have gout. But, there can also be conditions when some people have high urate levels but don’t have any gout symptoms. So, blood tests alone cannot confirm gout; you need to consider the signs and symptoms as well.
- Joint Fluid Test: The doctor collects a small sample of fluid from the affected joints and analyzes it under the microscope. The presence of urate crystals in the sample indicates gout.
- Joint X-ray: It can help eradicate other possible causes of joint inflammation.
- Ultrasound: Musculoskeletal ultrasound can identify urate crystals in the joints or tophus. This particular treatment alternative is more prevalent in Europe than in the United States of America.
- Dual Energy CT Scan: This is not generally preferred by people due to its expensiveness, but can help detect urate crystals even when there is acute inflammation.
How Is Gout Treated?
Medications To Treat Gout
Some of the popular gout medications are listed below:
Colchicine: It is a pain reliever that you can take to get relief from gout pain. Taking larger doses of the drug can have some side effects, including nausea, vomiting, diarrhea, etc.
So, the doctor may first prescribe a large dosage and eventually reduce it.
NSAIDs(Non-Steroidal Anti Inflammatory Drugs): It includes:
- Some OTC medications - ibuprofen (including Motrin IB, Advil), etc.
- Some powerful drugs - celecoxib (Celebrex) and indomethacin (Indocin)
To treat an acute attack, the doctor generally prescribes a high dosage of the drug, with a subsequent lower dose to prevent recurrence of the condition.
The prolonged utilization of NSAIDs increases the risk of stomach ulcers and bleeding.
Corticosteroids: Some corticosteroids like prednisone can treat joint inflammation and pain. You can take the drug in the form of a pill, or it can also be injected in the affected joints.
When the patient is unable to take Colchicine or NSAIDs, the doctor recommends corticosteroids. Side effects of the drug include mood changes and increased levels of blood pressure and cholesterol.
To prevent gout complications, you can take the medications listed below:
Drugs that block the production of uric acid: xanthine oxidase inhibitors (XOIs) can curb the amount of uric acid the body produces, and thus lowers the risk of gout. Some of the popular XOIs are:
- Allopurinol (Aloprim, Lopurin, Zyloprim)
- Febuxostat (Uloric)
Side Effects Of Allopurinol
Low blood count
Side Effects Of Febuxostat
- Inappropriate functioning of the liver
- Elevated risk of heart-related deaths
Drugs that facilitate uric acid removal: Such drugs are generally referred to as uricosurics and incorporate the following:
- Lesinurad (Zurampic)
- Probenecid (Probalan)
These drugs enhance the kidney’s ability to eradicate uric acid from the body. It reduces the level of uric acid in the body but may increase its levels in the urine.
Side Effects Of Uricosuric
- Kidney stones
- Stomach pain
Home Remedies For Gout
Some of the home remedies that can help relieve the symptoms of gout are as follows:
Drink Plenty Of Water
People with gout usually experience inflammation and swelling of the affected joints. Drink plenty of water as it can significantly reduce the swelling. Excessive intake of fluids encourages kidneys to remove excess fluid, which can reduce the gout swelling.
Some of the most recommended fluids to take include water, broths, and herbal teas. Do not consume sodas or alcohol as they are rich sources of purines.
Do consult with your doctor before increasing your fluid intake if you have a kidney disorder or congestive heart failure.
Stress can lead to a gout attack and aggravate the symptoms of the disease. It's not possible to completely avoid stress, but you can consider some steps and help reduce it.
Reducing stress will also improve your focus on other productive activities rather than pain.
Some other tips to avoid stress are as follows:
- Regular exercising
- Listening to music
- Reading your favorite novel
- Setting aside some time from work schedule
- Sleep properly
Apply Ice To The Affected Joints
Applying ice over the affected joints can reduce inflammation. Take some ice cubes and wrap them inside a thin towel. Apply the ice pack for about 10-15 minutes at a time for optimum results. In case you've got on the feet, you can use a pack of frozen vegetables as it can easily cover the feet.
Eat Fish Moderately
Fish contains excessive amounts of protein, which can exceed uric acid levels in the body. But, protein is required by the body, so eat with proper planning. For example: If you are going to eat fish for lunch, avoid intake of protein-rich foods for dinner to balance the levels.
Coffee can be extremely beneficial for lowering the risk of gout. The production of uric acid in the body reduces, and the process of removal of the substance from the body gets accelerated.
If you already have gout, then also you can increase the intake of coffee and reduce the risk of flare-ups.
Add some low-fat milk to acquire further benefits of drinking coffee, but skip adding sugar. The high consumption of sugar is one of the common risk factors for developing gout.
Drink Lemon Water
Surveys suggest that lemon extract or lemon juice help to reduce uric acid levels in the blood. Consume lemon juice daily even if you don’t have gout as it can be a preventive measure for gout. You can add freshly squeezed juice of half a lemon in your bottle or prepare lemon tea to achieve this.
Avoid Excessive Intake Of Alcohol
Beer is high in purines, and so drink no more than two standard drinks per day. If you don’t drink, don’t start it at any time, as it can lead to various health conditions.
People having gout can prevent gout attacks by taking an adequate amount of cherries and cherry juice extract.
Don’t Consume High-Purine Meats
Following meats are high in purines and need to be avoided:
- Organ meats such as liver
Uplifting The Affected Joints
Cout brings about pain and swelling in the joints of hands, feet, knees, ankles, etc. Uplifting the affected joints promotes the flow of blood and fluid far from those joints and back to the heart. For better results, use this technique along with ice packs to reduce the symptoms of gout.
Best Foods For A Gout Diet
- Fresh fruits and vegetables
- Low-fat and non-dairy fat products like skimmed milk and yogurt
- Peanut butter
- Potatoes, bread, rice, and pasta
- Meats like chicken, fish and red meats are okay when taken in moderation
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