A Patient’s Guide to Gout
Eat a lot of foods rich in purines. Have been exposed to lead.
Several other health problems that can cause a buildup of uric acid in the blood: Renal insufficiency, a condition in which your kidneys don’t get rid of enough waste. High blood pressure. Hypothyroidism, or an underactive thyroid gland. Conditions such as psoriasis , hemolytic anemia and some cancers. Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, which are rare conditions that cause a deficiency of an enzyme that helps control uric acid levels.
In addition, there are some medications that can lead to developing gout: Diuretics, which are prescribed to help the body flush out excess fluid for patients with medical conditions like hypertension, edema and heart disease . Diuretics may reduce the amount of uric acid passed in the urine. Drugs with salicylate, such as aspirin. Niacin, a vitamin also known as nicotinic acid. Cyclosporine, a medication used to block the immune system in order to treat some autoimmune diseases and prevent the body from rejecting transplanted organs. Levodopa, which is used to treat Parkinson’s disease . Gout Symptoms
Gout often starts in one of the big toes. In fact, according to the American College of Rheumatology, 50 percent of first gout episodes occur in the big toe. Gout can also cause lumps under the skin and kidney stones . Although many people first experience gout in one of their big toes, it can also affect other joints in the feet, arms and legs. In addition to pain, swelling and stiffness, the joint may appear red and feel warm. Gout attacks often begin at night, start suddenly and cause such severe pain and swelling that it wakes you up.
The NIH says that a gout attack usually gets better in three to 10 days, even without treatment. After that, it may be months or even years until another attack. But over time, gout attacks tend to happen more frequently and last longer. Diagnosing Gout
The ACR says that there are some other kinds of arthritis that can appear to be gout, so accurate diagnosis is crucial for proper treatment. Gout is suspected when a patient has joint swelling and intense pain in one or two joints at first, followed by pain‐free periods between attacks.
There are several methods to diagnose gout. The first is by finding uric acid crystals. To do this the physician may use a needle to extract fluid from an affected joint and examine it under a microscope. The doctor may also find crystals in deposits, called tophi, underneath the skin. Trophi indicate an advanced case of gout.
A gout specialist can also make a diagnosis by taking a history of which joints are affected, what the symptoms are and how long they last. Blood tests also reveal uric acid levels, but the ACR says blood tests may also be misleading, especially if measured during an attack. This is because levels may be normal, or even low, during an attack. Likewise, you can have increased uric acid levels and not have gout.
Advanced imaging tests also are used to detect gout. X-rays may show joint damage if the patient has had gout for a long time. Ultrasound and dual-energy computed tomography may also be used to detect gout. Treating Gout
Without treatment, gout can progress over a decade or so to the point where it causes permanent damage to joints and kidneys. However, when treated properly, gout rarely causes permanent damage. There are a number of treatments available to your doctor to treat gout. The NIH says the following are common choices: Nonsteroidal anti-inflammatory drugs, (or NSAIDs, to reduce pain and swelling. Corticosteroids , such as prednisone, which are strong anti-inflammatory medications. Colchicine, an oral medication in pill form that should be taken within the first 12 hours of a gout attack to work most effectively.
Diet and lifestyle changes, including losing weight and avoiding alcohol and foods that are high in purines, such as asparagus and sardines, also are recommended. Best Rheumatology Hospitals