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Arthritis, Rheumatology and Osteoporosis Center

Gout

Gout


Gout is characterized by sudden, severe attacks of pain, redness and tenderness in joints. The joint at the base of the big toe is the most common place for gout attack; however, it can occur in other joints such as your ankles, knees, hands and wrists. It usually occurs in the middle of the night with the sensation that your big toe is on fire the affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.

Gout that goes untreated can lead to worsening pain and joint damage. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi. Tophi can develop in several areas such as your fingers, hands, feet, elbows or Achilles tendons along the backs of your ankles. Tophi usually aren't painful, but they can become swollen and tender during gout attacks. 

Causes and Risk factors 

Your body produces uric acid when it breaks down purines, substances that are found naturally in your body, as well as in certain foods, such as steak, organ meats and seafood, alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose). Please ask your doctor or our staff to give you gout diet. You also can download it from the website.

Normally, uric acid dissolves in your blood and passes through your kidneys into your urine, however sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. Therefore, uric acid can accumulate, forming sharp, needle-shape urate crystals in a joint or surrounding tissue causing, swelling and inflammation. Urate crystals can form when you have high levels of uric acid in your blood.

Other risk factors associated with gout attack include obesity, some medical condition such as Diabetes, hypertension, kidney disorders and using certain medication such as diuretics and low dose Aspirin. Family history also plays important role in developing gout. If other members of your family have had gout, you're more likely to develop gout. Men also are more likely to develop gout earlier, whereas women generally develop signs and symptoms after menopause.


Tests and diagnosis

Tests to help diagnose gout may include: Joint fluid test. Your doctor may use a joint aspiration to draw fluid from your affected joint and examine it under polarized microscope. Also you may be sent to have a blood work to measure your uric acid level, however please consider that the result could be misleading because some people have high uric acid levels, but never develop gout and some have signs and symptoms of gout, but have normal uric acid level.

X-ray imaging. Joint X-rays can be helpful to rule out other causes of joint inflammation and evaluate the joint damage related to goat. 


Treatment 

Gout medications can be used to treat acute attacks and prevent future attacks as well as reduce your risk of complications from gout, such as the development of tophi from urate crystal deposits.

Drugs used to treat acute attacks and prevent future attacks include Nonsteroidal anti-inflammatory drugs (NSAIDs), Colchicine and Corticosteroids. In addition, there are certain medications to prevent gout complications including allopurinol and febuxostat (Uloric) which limit the amount of uric acid your body makes. This may lower your blood's uric acid level and reduce your risk of gout.

Although medications are the most effective way to treat gout symptoms, however, making certain lifestyle changes such as limiting intake of foods high in purines, such as red meat, organ meats and seafood, alcoholic beverages and drinks sweetened with fruit sugar (fructose) may help.

If you have gout, please drink plenty of nonalcoholic beverages, especially water, exercising regularly and lose weight.

Certain foods have been studied for their potential to lower uric acid levels, including Coffee (both regular and decaffeinated coffee) can lower uric acid levels; vitamin C may reduce the levels of uric acid in your blood; don't forget that you can increase your vitamin C intake by eating more vegetables and fruits, especially oranges. Cherries cherry extract have been associated with lower levels of uric acid in studies, as well as a reduced number of gout attacks.