What is Gout?Gout was recognized more than 2,000 years ago, making it one of humankind's oldest known diseases. In the past, gout was often known as "the disease of kings" because it was associated with wealthy men who overindulged in rich food and drink. Today, its known that gout is a complex disorder that can affect anyone. In fact, it is a painful problem for more than 2 million Americans.
Gout is an arthritic condition involving needle-like crystals which deposit in the joints, causing swelling and extreme pain. The crystals are uric acid, which is a normal waste product of the body. Uric acid is normally filtered out of the body by the kidneys, and is eliminated as urine. In patients with gout, the level of uric acid rises above normal, and crystals stay in the ligaments and cartilage.
The joint most affected in gout is the big toe, though other joints may also be affected, such as the knee, ankle, foot, hand, wrist and elbow. It appears as an acute attack often coming on overnight. Within 12 to 24 hours there is severe pain and swelling in the affected joint.
Causes of GoutGout is caused by an excess of uric acid in the body, a waste product formed from the breakdown of purines. This excess can be caused by an increase in production by the body, by under-elimination of uric acid by the kidneys or by increased intake of foods containing purines which are metabolized to uric acid in the body. Normally, uric acid dissolves in the blood and passes through the kidneys into the urine. But sometimes, the body produces too much or excretes too little of this acid. In that case, uric acid can build up, forming sharp, needlelike crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
The following are some of the more common causes :
- Higher than normal levels of uric acid (hyperuricaemia). This can be hereditary.
- High alcohol intake
- High intake of food containing purines such as organ meats (liver, brain, kidney, tripe, tongue, sweetbreads, hotdogs, bologna), red meat, shellfish, fish roe, scallops, peas, lentils, beans, fried foods, roasted nuts, cakes and pies, caffeine, cauliflower, fish, eggs, oatmeal, poultry, spinach, and yeast products.
- Crash diets resulting in sudden weight loss
- Severe illness, such as cancer or certain types of red blood cell disorders
- Excess cell destruction associated with diuretic drugs or chemotherapy
- Gout sometimes appears spontaneously as a result of surgery, probably related to changes in body fluid balance
- Many patients with gout have abnormally low thyroid hormone levels (hypothyroidism)
- Some of the drugs used to treat high blood pressure
- A few people have gouty arthritis even though they have normal uric acid levels
Symptoms of Gout
- Inflammation, redness, tenderness and swelling of the joint
- Intense joint pain
- High levels of uric acid in the blood
- Hard lumps of uric acid (tophi) deposited in and around the joints
Side Effects of Allopurinol
The Traditional Gout Medical Answers
- ALLOPURINOL (a prescription drug) is a gout medicine that inhibits uric acid synthesis and blocks the production of uric acid by the body and has been linked to skin eruptions, inflammation of the blood vessels, and liver toxicity.
- COLCHICINE (a prescription drug) is used to alleviate attacks. It may cause nausea, vomiting, and/or diarrhea. This drug can cause serious side effects and toxicity, high doses can cause death.
- INDOMETHACIN is a non-steroidal anti-inflammatory drug (NSAIDs). These NSAIDs have become the treatment of choice for most gout attacks. Indomethacin a NSAID is the most widely used prescription drug to treat gout. NSAIDs may also have significant toxicity, but if used for the SHORT-TERM, they are generally well tolerated.
- Steroids such as prednisone are sometimes used for the most severe attacks. Because of their side effects, however, steroids are not considered a good long term treatment strategy.
Maintenance Measures to Reduce the Effects of Gout
- Rest, relaxation, proper diet and exercise, and weight management can all be of benefit in reducing the effects of gout
- Exercise is always important in maintaining or achieving health and wellness. Exercise helps maintain a normal range of motion, keeps joint cartilage well- lubricated, and strengthens the muscles around the joints. Protection of the joints with braces or splints, and the use of canes, crutches, or a walker can help during an attack
- Applying hot or cold packs, or taking warm baths may help as the acute attack is receding
- Lessen intake of foods high in purines
- Limit or avoid alcohol, especially beer and wine
- Drink plenty of fluids, preferably distilled water
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