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Gout: Signs, Symptoms & Treatment


What is Gout?

Gout is a condition often mentioned in literature and historical records. Described as a painful inflammation of the limbs, especially the big toe, Gout develops as a result of the buildup of uric acid crystals in the joints.

Some people are more prone to it based on family history. Chances are that many of their ancestors suffered from it, as well. But other people get it due to their own physiology and lifestyle choices. A form of arthritis, a gout attack can be crippling and keep a person out of commission for one or more days while nursing their painful joints.

How Is Gout Diagnosed?

Even doctor can find gout difficult to diagnose. This is usually the case because the symptoms of gout may be indistinct and often mimic other conditions. Although at some time during the course of gout, most people with gout will have hyperuricemia, but it may not be present during an acute gout attack. Besides, having hyperuricemia does not confirm one to have gout. In actual fact, most people with hyperuricemia do not develop the gout.

To confirm a diagnosis of gout, doctors will first have to test the synovial fluid found in the joint by using a needle to draw a sample of the fluid from a person's inflamed joint. Under the microscope, the doctor will look for monosodium urate crystals in the fluid sample by placing it on a slide. If the person is diagnosed with gout, the doctor will almost always see crystals in the fluid sample obtained from the inflamed joint. Howere their absence does not completely rule out the diagnosis of gout. Doctors may also find it useful to examine joint or tophi deposits to diagnose gout.

Signs and Symptoms of Gout:

The observable signs and symptoms of gout are:

Attack of arthritis in only one joint, usually the toe, ankle, or knee

Arthritis that develops in 1 day

Hyperuricemia

More than one attack of acute arthritis

Painful joint that is swollen, red, and warm

Presence of uric acid crystals in joint fluid

How Is Gout Treated?

Most people diagnosed with gout should be able to control their symptoms and live a normal live with the help of proper treatment. Gout can be treated with one or a combination of therapies. These gout treatments aims to relieve the pain associated with acute gout attacks, prevent future gout attacks, and avoid the formation of new tophi in the joints or in serious cases kidney stones in the kidney.

A common treatment for an acute attack of gout usually includes high doses of nonsteroidal anti-inflammatory drugs (NSAID's) and injections of corticosteroid drugs into the affected joint. NSAID's helps to diminish the inflammation caused by deposits of uric acid crystals at the joints. The NSAID's most commonly prescribed by doctor for gout are indomethacin and naproxen. These drugs can be taken orally every day. Patients on the prescription usually will begin to improve within a few hours of the treatment, and subsequently the gout attacks will go away completely within a few days.

In certain cases, the doctor may consider using colchicines when NSAID's fails to control the gout symptoms. Colchicines is most effective when taken within the first 12 hours of an acute attack of gout. Colchicine can be administered orally every hour until the gout symptoms subside, or they can inject by the doctor directly into a vein. The side effect of colchicines is that it might cause diarrhea when taken orally.

For some patients, the doctor may prescribe either NSAID's or oral colchicine in small daily doses to prevent future attacks of gout. In some cases, the doctor may have to prescribe allopurinol (Zyloprim) and probenecid (Benemid), medicine used to treat hyperuricemia, if gout attacks continues and tophi develop even after the prescription of NSAID's or colchicines.

What Can People With Gout Do To Stay Healthy?

Maintaining a healthy and balanced diet is very important. Avoid foods that are high in purines and drink plenty of fluids, especially water. Fluids can help to remove the excessive uric acid from the body.

Exercise regularly and maintain a healthy body weight. Try to lose weight if you happen to be overweight.

To help prevent future gout attacks, take the medicines prescribed by your doctor Follow the instructions carefully with regards to how much medicine to take and when to take it. Acute gout is best treated when symptoms first occur.

Update your doctor with your medical history and provide information on all the medicines and vitamins you are currently taking. The doctor should be able to tell you if any of the medicine will increase your risk of hyperuricemia.

If you or someone you know suffers from this disease, you may be involved in home care to manage discomfort and help the person to get through the difficult attack.

Tips for Gout Pain:

Keep the foot elevated. It's hard to stay immobile for any length of time, let alone keep a foot aloft for several hours. Arrange a comfortable spot in the living room or family room where the person can remain part of family life and enjoy entertainments like the television, newspaper, and even guest visits. You might want to set up a second area in the bedroom where the person can rest in private or take a nap.

Make the support materials comfortable and firm. When propping the foot, use a solid pillow or folded blanket for support, taking care that they will not sag and gradually lower the foot. Place these in such a way that they are not likely to fall or tilt. Use clean and soft, rather than scratchy, fabric to keep the skin comfortable.

Avoid trigger foods. The doctor will provide a list of these, which include popular low-fat foods like turkey, so you will want to find suitable substitutes, especially if the person likes to keep turkey on hand for frequent meals. Go over the list with the gout sufferer and beside each forbidden food, come up with two or three replacements. Then shop for these and keep them on hand, since you never know when the next attack will occur, and they can come on suddenly.

Eat wholesome foods that reduce inflammation. The doctor should also be able to provide this list, which includes surprisingly tasty choices like cherries. Ask about flax seed oil as a supplement in addition to foods like salmon, with omega 3 oil, and tea, both of which have been shown to reduce or limit inflammation in the body.

Lose weight slowly: People suffering from gout are usually overweight with their body weight about 10 to 15 percent overweight. More your girth, higher your uric acid level. The higher incidence of the uric acid leads to frequent and intense gout attacks. But take care that you should lose weight slowly as crash diet leads to increase in uric acid levels.

Control blood pressure: Gout patients who also suffer from hypertension need to be extra careful. This is because the blood pressure medications raise the levels of uric acid. Hence it is advisable to control the blood pressure naturally by lowering the intake of the sodium, exercising regularly, reducing the excess weight and eliminating stress.

Skip liver: Certain foods contain purine that raise uric acid levels. Though it is found in most foods, it is advisable to skip certain foods like red meat especially organ meats, liver, certain types of fish and some green leafy vegetables like spinach.

Stop the drink: If you are suffering from gout, avoid alcohol. This is because alcohol stimulates the production of uric acid. Beer is the main culprit as it has higher purine content than the other wines or spirits.

Go heavy on water: Drinking lots of water will help kidneys flush out the excess uric acid. Dehydration is also known to trigger the gout attack. You can increase the urinary output by drinking at least five glasses of water a day.

Improve your sex life: It has been found that if you are a man, having frequent sexual activity reduces the levels of uric acid.

Prepare diversions. Keep entertaining videos, interesting books, letter-writing materials, or even a laptop computer nearby. Hand-held puzzles, knitting or sewing, and other stationary games or distractions can be of help. As Hamlet said, "The readiness is all."

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