Gout is a form of arthritis that is a painful inflammation and swelling of the joints caused by the buildup of uric acid in the body.This is a complex disorder that can affect anyone. Men are more likely to get gout than women are, but women become increasingly susceptible to gout after menopause.

Fortunately, gout is treatable, and there are ways to reduce the risk that gout will recur.

Signs and symptoms:

The signs and symptoms of gout are almost always acute, occurring suddenly – often at night – and without warning. They include:

  • Intense joint pain. Gout usually affects the large joint of your big toe but it can occur in your feet, ankles, knees, hands and wrists. If untreated, the pain typically lasts five to 10 days and then stops. The discomfort subsides gradually over one to two weeks, leaving the joint apparently normal and pain-free.
  • Inflammation and redness. The affected joint or joints become swollen, tender and red.

Causes

Excess uric acid in the body is recognized as the cause of gout. The excess can be caused by:

  • increase in production of uric acid by the body.
  • by under-elimination of uric acid by the kidneys.
  • by increased intake of foods which contain purines which are metabolized to uric acid in the body.

Certain meats, seafood, dried peas, and beans are very high in purines. Alcohol also can increase uric acid levels and precipitate gout attacks.

Elevated levels of uric acid in the blood may result in deposits around the joints (sharp needle-like crystals of monosodium urate). Uric acid also can collect under the skin as tophi, or in the urinary tract as kidney stones.

Gout is predominantly a disease of adult men. It is the most common cause of inflammatory arthritis in men over age 40, and men have at least four times greater likelihood of developing gout than women. Gout is uncommon in men under 30 years of age, and often occurs between the ages of 40 and 50. Women rarely develop gout before reaching menopause, and more often do after the age of 60.

The onset of gout is usually quick and unexpected. Often, people who develop gout will do so during the night while sleeping, after having gone to bed in good health. During the night, they are awakened by acute pain in the big toe or, more rarely, in the heel, ankle or instep. This pain has been described as feeling at first like a bucket of cold water has been poured over the affected area, with the pain increasing to a violent stretching, tearing sensation. There is also a pressure and tightness around the area, and the pain becomes so acute that not even the weight of a bed sheet can be tolerated. The soft tissues, such as the muscles and tendons, around the joint can become hot, red and swollen, and wearing of a regular shoe may become impossible.

Diagnosis

Standard diagnostic tools for gout may include a medical history and physical examination, a blood test for hyperuricemia, and urine sample. For a definitive diagnosis, a sample of synovial fluid from the affected joint is required. X-rays can provide helpful information in some cases.

What can you do about gout?

  • If your doctor thinks you have gout, he or she may perform tests to measure the amount of uric acid in your body. These tests may include a urine test, or your doctor may insert a needle into the painful joint to take a sample of joint fluid.
  • Although there is no cure for gout, there are a number of steps you can take to bring your gout under control.
  • Learn as much as you can about this disease. Speaking with people who are specialists in arthritis care can provide you with the information you need.

The goal in treating gout is to safely provide relief of acute attacks, prevent further attacks and damage to the joints, and prevent the formation of tophi or kidney stones. Establishing the correct diagnosis is important, because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease.

Foods that cause Gout:

Some people may benefit from a reduction of purine rich foods. These include beer and other alcoholic beverages, anchovies, sardines (in oil), fish roes, herring, yeast, organ meats (e.g., liver, kidneys), legumes (e.g., dried beans, peas, and soybeans), meat extracts, consommé, gravies, mushrooms, spinach, asparagus, cauliflower, and poultry. Weight loss can help reduce uric acid levels in those people that are overweight.

Complementary and alternative medicine

If gout treatments aren’t working as well as you’d hoped, you may be interested in trying complementary and alternative treatments for your gout. Discuss these treatments with your doctor first. Your doctor can help you weigh the benefits and risks and tell you if the treatments will interfere with your gout medications.

Though you may be reluctant to discuss complementary and alternative medicine with your doctor, many mainstream doctors are becoming more open to discussing these options. But, since few of these treatments have been extensively studied in clinical trials, it’s difficult to assess whether these treatments are helpful for gout pain. In some cases, the risks of these treatments aren’t known.

Some complementary and alternative treatments that have been studied include:

  • Coffee. Studies have found an association between coffee drinking – both regular and decaffeinated – and lower uric acid levels, though no study has proved how or why coffee may have an influence on uric acid in your body. The available evidence isn’t enough to encourage noncoffee drinkers to start, but it may give researchers clues to new ways of treating gout in the future.
  • Vitamin C. Supplements containing vitamin C may reduce the levels of uric acid in your blood. However, vitamin C hasn’t been studied as a treatment for gout. Don’t assume that if a little vitamin C is good for you, then lots is better. Mega doses of vitamin C may increase your body’s uric acid levels. Talk to your doctor about what a reasonable dose of vitamin C may be. And don’t forget that you can increase your vitamin C intake by eating more fruits and vegetables, especially oranges.
  • Cherries. Cherries have been associated with lower levels of uric acid in studies, but it isn’t clear if they have any effect on gout signs and symptoms. Adding cherries and other dark-colored fruits, such as blackberries, blueberries, purple grapes and raspberries, to your diet may be a safe way to supplement your gout treatment, but discuss it with your doctor first.

Other complementary and alternative medicine treatments may help you cope until your gout pain subsides or your medications take effect. For instance, relaxation techniques, such as deep-breathing exercises and meditation, may help take your mind off your pain.

Sources: Artritis Insight, Artritis

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