Gout is a complex disorder that can affect anyone
You wake up in the middle of the night, and your big toe feels as if it’s on fire. It’s hot, swollen and so tender that even the weight off a sheet on it seems intolerable.
These problems could indicate an acute of gout or gouty arthritis – a form of arthritis that characterized by sudden severe attack of pain, redness and tenderness in joints.
Gout is complex disorder that can affect anyone. Men are more likely to get gout than women but the later become increasingly susceptible to gout after menopause.
Fortunately, gout is treatable, and there are ways to reduce the risk of recurrence.
Symptoms:
Attacks of gout can occur without warning. They may be triggered by an injury, surgery, consumption of large quantities of alcohol or purine-rich food, or illness. Typically, severe pain occurs suddenly in one or more joints, often at night (probably because of the metabolic changes that occur when a person lies down).
The become progressively worse and is often excruciating, particularly when the joint is moved or touched. The joint becomes inflamed – it swells and feels warm, and the skin over the joint may appear red or purplish, tight, and shiny.
Other symptoms of an attack can include fever (which may reach 39 degree F) and a general sick feeling. The first few attacks usually effect only one joint and last for few days. The symptoms gradually disappear, joint function returns, and no symptoms appear until the next attack. However, if the disorder progress, untreated attacks last longer, occur more frequently, and affect several joints.
After repeated attacks, gout can become severe and chronic and may lead to joint deformity.
Causes:
Gout occurs when urate crystals accumulate around your joints, causing the inflammation and intense pain of a gout attack. Urate crystal can form when you have high levels of uric acid in your blood. Your blood produces uric acid when it breaks down purine, substances that are found naturally in your body, as well s in certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.
Normally uric cid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produce to much uric acid or your kidney excrete to little uric acid. When this happens, uric acid can build up, forming sharp needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
Risk Factors:
You’re more likely to develop gout if you high levels of uric acid in your body.
Factors that increase the uric acid level in your body include:
Lifestyle Factors:
Choices you make in your everyday life may increase your risk of gout. Excessive alcohol use – generally more than two drinks day for men and more than one for women – increases the risk of gout.
Medical Conditions:
Certain diseases and conditions make it more likely that you’ll develop gout. These include untreated high blood pressure (hypertension) and chronic conditions, such as diabetes, high level of fat and cholesterol in the blood (hyperlipidemia), and narrowing of the arteries (arteriosclerosis).
Certain Medications:
The use of thiazide diuretics – commonly used to treat hypertension – and low low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
Family History of Gout:
If other members of your family have had gout, you’re more likely to develop the disease.
Age & Sex:
Gout occurs more often in men than it does in women, primarily because tend to have lower uric acid levels than men do. After menopause, however, women’s uric acid levels approach those of men. Men also are more likely to develop gout earlier – usually between the ages of 40 and 50 – whereas women generally develop signs and symptoms after menopause.
When to Seek Medical Advice:
If you’re experience sudden intense pain in your joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage.
Seek medical care immediately if you have fever and a joint is hot and inflamed, which can be a sign of infection.
Diagnosing Gout:
Test to help diagnose gout may include:
Joint Fluid Test:
Your doctor may use a needle to draw fluid from your affected joint. When examined under the microscope, your joint fluid may reveal urate crystals.
Blood Test:
Your doctor may recommend a blood test to measure the level of uric acid level in your blood. Blood test results can be misleading though. Some people have high uric acid levels, but never experience gout. And some people have sign and symptoms of gout, but don’t have unusual levels of uric acid in their blood.
Complications:
People with gout can develop more severe conditions, such as:
Recurrent gout:
Some people may never experience gout sign & symptoms. But other my experience gout several time each year. Medication may help prevent gout attack in people ith recurrent gout.
Advance Gout:
Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fi). Tophi usually aren’t painful, but they can become swollen nd tender during gout attack.
Kidney Stones:
Urate crystal may collect in the urinary tract of people with gout, causing kidney stones; Medication can help reduce the risk of kidney stones.
Treatment & Drugs:
Treatment for gout usually involves medications. What medication you and your doctor choose will be based on your current health and your preferences. Medications for gout include.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
NSAIDs may control inflammation and pain in people with gout. NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others), as well as more powerful prescription NSAIDs. NSAIDs carry risk of stomach pain, bleeding and ulcers.
Colchicine:
Colchicine controls gout effectively, may cause uncomfortable side effects, such as nausea, vomiting and diarrhoea. If you’re unable to take NSAIDs, your doctor may recommend colchicines.
Steroids:
Steroids medication, such as the drug prednisone may control gout inflammation and pain. Steroids may be administrated in pill form, or they can be injected into your joint. Side-effect of steroids may include thinning bones, poor wound healing and a decreased ability to fight infection. Steroids may be reserved for people who can’t take either NSAIDs or colchicines.
Gout Diet:
No specific dietary changes are proved to reduce your risk of gout. However, it may make sense to eat food that contains fewer purines. If you want to try a gout diet, try to:
Cut back the amount of red meat sea food you eat.
Avoid Alcohol.
Eat more low fat dairy products.
Eat more complex carbohydrates, such as whole-grain breads.
Choose portion that allow you to maintain a healthy weight. Loosing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loos, since doing so may temporarily raise uric acid levels.
